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Help That Costs Less, or Nothing

The master list

I had resources many women don’t. This is the list I’d hand a friend who couldn’t pay: covered and free help in New York, New Jersey, California and Texas, national resources and the search terms that find the local version anywhere.

Key points

  • Pregnancy Medicaid has higher income limits than regular adult Medicaid, and your baby counts in your household. In New York, a household of three can earn up to about $60,924 a year and qualify. Check your state’s limit before you rule it out.
  • Most states now extend Medicaid coverage to 12 months after birth. Check the tracker from KFF, a nonprofit health policy research group, for your state, so you know how long your postpartum care is covered.
  • The Family and Medical Leave Act (FMLA) gives eligible employees up to 12 weeks of unpaid, job-protected leave. Ask HR in writing whether you’re eligible, and separately whether your state pays wages during leave.

Each fact links to the page it came from, as of October 2026. Programs, limits and benefits change, so confirm with the program before you rely on it.

Where to start, by situation

  • You might qualify for Medicaid, or aren’t sure: start with the income limits just below. Pregnancy Medicaid can unlock covered doulas, home visits and WIC (the federal nutrition program for women, infants and children).
  • You have private insurance: call your insurer, ask for a nurse case manager, and ask the coverage questions near the end of this post.
  • You want someone to check on you at home after birth: see the home visits list under “A nurse or trained visitor at home, free.”
  • You want feeding help: your plan’s lactation benefit and, if you qualify, WIC.
  • You want a doula: see the doula list under “Doulas.”

Start here: do you qualify for pregnancy Medicaid?

Pregnancy Medicaid has higher income limits than regular adult Medicaid. And under federal rules, a pregnant woman’s household counts her plus the number of babies she’s expecting. So a couple expecting their first baby, living together, would generally count as a household of three. States apply their own rules about who else counts, so let the application decide.

Approximate yearly household income limits for pregnancy Medicaid, 2026

  • New York (223%): household of 2, $48,257; household of 3, $60,924; household of 4, $73,590
  • New Jersey (205%): household of 2, $44,362; household of 3, $56,006; household of 4, $67,650
  • California, Medi-Cal (213%): household of 2, $46,093; household of 3, $58,192; household of 4, $70,290
  • Texas (203%): household of 2, $43,929; household of 3, $55,460; household of 4, $66,990

The percentages are the limits KFF reports as of January 2026, applied to the 2026 federal poverty guidelines and rounded. New Jersey’s own page gives 205%, or $5,638 a month for a family of four. States may calculate slightly differently, so treat this as a guide and let the application decide. Two more routes have higher limits, per KFF: California’s Medi-Cal Access Program covers pregnancy up to 322% (about $87,970 for a household of three), and Texas’s CHIP (Children’s Health Insurance Program) Perinatal program goes up to 207%.

Where to apply: NY State of Health · NJ FamilyCare · BenefitsCal in California · YourTexasBenefits in Texas. In any other state, search [STATE] Medicaid for pregnant women income limit apply.

Why it matters beyond the bill: pregnancy Medicaid can unlock covered doulas, free home-visiting programs and WIC. It also lasts through the year after birth in New York and Texas; check KFF’s postpartum coverage tracker for New Jersey, California and any other state.

Doulas

Covered and free doula support

  • New York
    • What’s available: Medicaid doula benefit: up to 8 visits across pregnancy and the year after, plus support during labor
    • Who qualifies: Anyone enrolled in NY Medicaid who is pregnant or within 12 months after pregnancy
    • How to find it: If you have Medicaid managed care, ask your plan for a participating doula. If you have fee-for-service Medicaid, use the state’s doula directory.
  • New York City
    • What’s available: Citywide Doula Initiative: free doula support for birth planning, labor and newborn care, with connections to home visitors
    • Who qualifies: Income-eligible for Medicaid, and living in one of the city’s designated neighborhoods, a shelter or a foster home; teen parents anywhere in the city
    • How to find it: Call 844-OK-DOULA (844-653-6852), weekdays 9 a.m. to 5 p.m., or email cdi@health.nyc.gov
  • New York, EmblemHealth Medicaid
    • What’s available: Mae: doula matching and care coordination
    • Who qualifies: Eligible EmblemHealth Medicaid members
    • How to find it: Request an eligibility check on Mae’s site
  • New Jersey
    • What’s available: NJ FamilyCare doula benefit: community doula care in pregnancy, labor and postpartum
    • Who qualifies: NJ FamilyCare members
    • How to find it: Managed care members (enrolled through a health plan): call your plan and ask for the maternity case management team. Fee-for-service (no health plan): search “Doula Provider” in the NJMMIS Provider Directory, the state Medicaid provider directory. Connecting NJ county hubs can also refer you.
  • California
    • What’s available: Medi-Cal doula benefit: an initial visit, up to 8 more prenatal or postpartum visits, labor support and up to two extended three-hour postpartum visits; up to 9 more postpartum visits with a clinician’s recommendation
    • Who qualifies: Medi-Cal members who are pregnant or were pregnant within the past year
    • How to find it: The Medi-Cal Doula Directory, by county; managed care members can also call Member Services
  • Texas
    • What’s available: When I checked, I couldn’t confirm a statewide Medicaid doula benefit. The legislature has considered a Medicaid doula pilot.
    • How to find it: Ask your Medicaid plan directly
  • Central Texas
    • What’s available: Black Mamas ATX: free community doula support through pregnancy, birth and check-ins for a year
    • Who qualifies: Black pregnant residents of Travis, Williamson, Bastrop, Hays and Caldwell counties, enrolling by 28 weeks
    • How to find it: Request through the site; contact early, because capacity is limited
  • San Antonio
    • What’s available: San Antonio Healthy Start: case management, home visits, lactation support and doula services for high-risk mothers
    • Who qualifies: Pregnant or with a baby under one, living in listed ZIP codes
    • How to find it: 210-207-4725

If you have private insurance: ask your plan; some cover doulas. Check whether your employer offers a family-health benefit, such as the one I used; mine connected me with a virtual doula. And ask your health savings account (HSA) or flexible spending account (FSA) administrator whether doula fees qualify, and whether they need a letter from your clinician.

Policy updates, as of October 2026. These will change faster than the rest of this post.

Everywhere: search the National Black Doulas Association, the Sista Midwife Directory and The Bridge Directory. Ask local doula collectives whether they offer sliding-scale fees.

Search terms: [STATE] Medicaid doula benefit enrolled provider directory · [CITY] free community doula program · [CITY] Black doula collective

A nurse or trained visitor at home, free

These aren’t all the same service. Some send a nurse, some send a trained home visitor, and some are group programs.

Free home visits and support

  • Family Connects NJ
    • Type: Nurse visit
    • Where: Participating New Jersey counties, including Hudson since January 2025
    • Who qualifies: Any family, any income, with or without insurance, first baby or not
    • How to reach it: Sign up on the site. A nurse visits, usually within two weeks of birth, for a 90-to-150-minute check on you and the baby.
  • New Family Home Visits
    • Type: Home visiting
    • Where: New York City
    • Who qualifies: Families in designated neighborhoods, public housing, or receiving support from the city’s child services agency
    • How to reach it: 347-396-7979. Visitors help with feeding, safe sleep, home safety, mental health screening and referrals.
  • Black Infant Health
    • Type: Group sessions and one-on-one support
    • Where: 13 California counties plus Long Beach and Pasadena, including Los Angeles, Orange, San Diego, Alameda and Sacramento
    • Who qualifies: Black women and birthing people, 16 or older, pregnant or up to six months postpartum; any income
    • How to reach it: Free. Ten prenatal and ten postpartum group sessions, plus one-on-one support. Contact your county’s program.
  • Harris County Maternal and Child Health
    • Type: Maternal and child health services
    • Where: Harris County, Texas
    • Who qualifies: Pregnant, delivered in the past year, or a pregnancy loss in the past year
    • How to reach it: 713-368-6667. No cost.
  • Texas Home Visiting
    • Type: Home visiting
    • Where: Participating Texas counties
    • Who qualifies: Pregnant women and families with young children
    • How to reach it: Use Find Local Support on the state site
  • Nurse-Family Partnership
    • Type: Nurse visits
    • Where: National, in its service areas
    • Who qualifies: Traditionally, first-time mothers who enroll early in pregnancy and meet local income rules. Some programs now accept later enrollment or parents with older children. The Bronx and Nassau County program expanded eligibility in 2026. Ask the program serving your area rather than ruling yourself out.
    • How to reach it: Call or text 844-637-6667. A nurse visits from pregnancy until the baby is two. Free.
  • Healthy Start
    • Type: Varies by project
    • Where: National, local projects
    • Who qualifies: Varies by project
    • How to reach it: Use the locator from HRSA, the federal Health Resources and Services Administration

Search terms: [COUNTY] postpartum nurse home visiting program · [COUNTY] Healthy Start pregnancy postpartum self referral. Or dial 211, a free local help line, and ask for pregnancy and postpartum services near you.

Feeding

  • Your insurance. Under the Affordable Care Act, most plans must cover breastfeeding support, counseling and a breast pump for as long as you breastfeed. Grandfathered plans (older plans that existed before the law) are the exception. Ask about pre-authorization, which supplier to use, and whether a hospital-grade rental is covered.
  • WIC. Food benefits and breastfeeding support. If you or a child in your care receive Medicaid, SNAP or TANF, you may already meet WIC’s income requirement. The program also checks pregnancy/postpartum or child-age eligibility, residency and nutritional risk. Apply through your state WIC agency; don’t assume income eligibility is the whole decision.
  • La Leche League. Volunteer-led breastfeeding groups and leaders; find one near you on its map.
  • Your hospital. Before discharge, ask whether it runs a lactation warmline (a phone line for feeding questions) or a postpartum feeding group.

Night and home help

This is the biggest gap. Ask your insurance plan and your employer’s benefits team whether any overnight support is covered. The programs listed here shouldn’t be assumed to provide overnight care.

  • Postpartum doula visits through Medicaid, in New York and California. Ask how long and when visits happen; they may not cover overnight care.
  • Fewer paid nights. Two or three a week, with family covering the rest on a written schedule.
  • Shifts. Split the night so each adult gets one protected stretch of sleep. If you’re breastfeeding, ask a lactation consultant how to protect your supply.
  • Meals. A Meal Train, which has a free version, lets people sign up for dinners without anyone coordinating by text.
  • Referrals. The best caregiver I found came through a personal referral. Ask people you trust before you pay an agency.

Mental health

Gear and safety

  • Car seat checks. Certified technicians will usually check your installation for free; find one through the National Highway Traffic Safety Administration (NHTSA) or Safe Kids Worldwide.
  • Hand-me-downs. Search Buy Nothing [your town] for free baby gear, but check the model against CPSC recalls and the manufacturer’s instructions before using it. A used crib must meet current federal safety standards and have all its original, undamaged parts; the date alone is not proof it is safe. Don’t use a recalled product or a sleep product whose safety you cannot confirm.
  • Diapers. Search diaper bank [your county].
  • A blood pressure cuff. If you’re high risk, ask your clinician to prescribe one and ask your plan whether it’s covered. Some plans, including some Medicaid programs, cover them.

Your insurer, for free

  • Ask for a nurse case manager. Mine called practices for me, walked me through filing a grievance and explained my out-of-network options.
  • Ask what happens when no in-network provider can see you in time. Some plans make exceptions.
  • Call before you book, and write down the representative’s name and a reference number.
  • On Medicaid managed care, ask for the maternity case management team.

Paid leave, 2026

Wage replacement and job protection are separate questions. A state benefit can pay you without guaranteeing your job, so ask about both.

State paid leave for a new baby

  • New York
    • Bonding leave: Up to 12 weeks of Paid Family Leave
    • Pay: 67% of your average weekly wage, up to $1,228.53 a week
    • Job protection: Included with Paid Family Leave
  • New Jersey
    • Bonding leave: Up to 12 weeks of Family Leave Insurance; Temporary Disability Insurance covers pregnancy and recovery
    • Pay: 85% of your average weekly wage, up to $1,119 a week
    • Job protection: Not from the insurance itself; comes from the state Family Leave Act or federal FMLA if you’re eligible
  • California
    • Bonding leave: Up to 8 weeks of Paid Family Leave; State Disability Insurance covers pregnancy and recovery, starting up to 4 weeks before birth
    • Pay: Since 2025, 70% to 90% of wages, depending on income
    • Job protection: Not from the benefit itself; comes from the California Family Rights Act or federal FMLA if you’re eligible
  • Texas
    • Bonding leave: No state paid family leave
    • Pay: Depends on your employer
    • Job protection: Federal FMLA, up to 12 weeks unpaid, if you’re eligible

Everywhere, two federal laws apply to most employers. The Pregnant Workers Fairness Act requires covered employers to provide reasonable accommodations for known limitations related to pregnancy, childbirth or related conditions. The PUMP Act gives most employees reasonable break time and a private space, other than a bathroom, to pump for a year after birth. In other states, search [STATE] paid family leave bonding benefits.

Researching care, for free

Every directory, hospital report card and outcomes report I use is free, and they’re all in “How to Choose a Hospital, Then a Doctor,” with search terms for any state.

How to search, anywhere

Search terms for any state

  • Pregnancy Medicaid: [STATE] Medicaid for pregnant women income limit apply
  • Covered doulas: [STATE] Medicaid doula benefit enrolled provider directory
  • Free doulas: [CITY] free community doula program
  • Home visits: [COUNTY] postpartum nurse home visiting program
  • Care navigation: [COUNTY] Healthy Start pregnancy postpartum self referral
  • Lactation help: [CITY] free breastfeeding support group or [HOSPITAL] lactation warmline
  • Pelvic floor therapy: [CITY] pelvic floor physical therapist postpartum cesarean insurance
  • Perinatal therapy: [STATE] perinatal therapist pregnancy loss insurance
  • Paid leave: [STATE] paid family leave bonding benefits
  • Your plan’s benefits: [EXACT PLAN NAME] maternity case management doula pelvic floor benefits

Facebook groups. Local parent groups are some of the best sources for referrals to nannies, doulas, pediatricians and lactation consultants, and for honest accounts of local hospitals. Try [town] moms, [town] parents, [city] nanny, postpartum doula [city] and Buy Nothing [town]. Then vet what you find:

  1. Ask for people others have actually used, not ads.
  2. Check credentials and licenses yourself.
  3. Call references, and do a paid trial before you rely on anyone.
  4. Keep the referral request general. You don’t need to share medical or financial details to ask for names.

Take this back

To discuss with your insurer: Do I have a nurse case manager? Which of these are covered under my exact plan: a doula, lactation visits, a breast pump, pelvic floor therapy, a blood pressure monitor, mental health care? What needs a referral?

To discuss with your care team: Can you refer me to a home-visiting program? Will you write a recommendation for doula visits or a blood pressure cuff if my plan needs one?

To discuss with the people in your life: Which item on the help list can you own, for how many weeks?

Sources

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