Does Delaware Medicaid Cover Home Birth? 2026 Guide: CNM Coverage, Licensed CPM Home Birth, and the Payment Gap
Limited. Delaware Medicaid covers Certified Nurse-Midwife services as a federal mandatory benefit [1] at 100 percent of the physician rate, [4] but the state reported to a national survey that it does not cover home births as a delivery setting. [3] Certified Professional Midwives are licensed for home birth in Delaware under detailed safety rules [2] yet are not an enrollable Medicaid provider type. [4] Most Delaware Medicaid families either pay privately for a licensed midwife or use covered hospital CNM care. Confirm current policy with Delaware Medicaid or your Diamond State Health Plan MCO.
Delaware splits home birth into two questions with two different answers. Legality: yes. Certified Professional Midwives have been licensed here since a 2015 law, with regulations that spell out client screening, required equipment, and a second birth attendant for every home birth. [2] Payment: mostly no. Delaware Medicaid covers CNM services as a federal mandatory benefit, [1] but the state reported that it does not cover home births as a setting, [3] and CPMs are not among the provider types Delaware Medicaid pays. Roughly 18 states plus DC now reimburse midwives without nursing degrees; Delaware is not one of them. [4] This guide explains what that means in practice.
On this page
Sources cited (4)
- Social Security Act § 1905(a)(17)
- 24 DE Admin. Code 1795, § 4.0 Home Birth
- KFF, 2021 Pregnancy Services Survey
- NASHP Midwife Medicaid Tracker (2023)
Does Delaware Medicaid cover home birth?
The provider and the setting get different answers. Delaware Medicaid covers CNM services as a federal Medicaid mandatory benefit [1] and pays CNMs at 100 percent of the physician rate. [4] But in a 50-state survey of Medicaid programs, Delaware answered no on home birth coverage: it was one of 17 responding states that reported not covering home births as of July 2021. [3] Coverage policy can change, so ask Delaware Medicaid or your MCO directly, but do not assume the home setting is payable just because CNM care is.
The licensing side is friendlier than the payment side. Certified Professional Midwives are licensed in Delaware through the Midwifery Advisory Council under the Board of Medical Licensure and Discipline, a framework created by a 2015 law. [2] Delaware's midwifery regulation includes an entire home birth section: licensed midwives may accept only clients screened as low risk, must bring specified maternal and newborn equipment, and must have a second attendant certified in neonatal resuscitation at every home birth. [2] Home birth with a licensed CPM is legal and regulated in Delaware.
Put together: a Delaware family on Medicaid can lawfully hire a licensed CPM for home birth, but Medicaid will not pay her, [4] and the state has reported it does not pay for home birth as a setting at all. [3] Most Medicaid families here either budget for private-pay midwifery or use hospital-based CNM care that Medicaid covers in full.
Which midwife credentials does Delaware Medicaid cover?
Delaware licenses two midwifery credentials, but only one can bill Medicaid.
Certified Nurse-Midwives (CNMs) are licensed by the Delaware Board of Nursing as Advanced Practice Registered Nurses. CNM services are a federal Medicaid mandatory benefit, [1] and Delaware pays CNMs at 100 percent of the physician rate. [4] Delaware's small CNM workforce practices mostly in hospitals and offices, so CNM-attended home birth is rare here even before the payment question.
Certified Professional Midwives (CPMs) are licensed by the Division of Professional Regulation through the Midwifery Advisory Council; the license requires current NARM certification, neonatal resuscitation and basic life support training, plus pharmacology and IV therapy coursework. [2] Licensed CPMs may attend home births for low-risk clients under the state's home birth regulation. [2] What they cannot do is enroll with Delaware Medicaid: the state is not among the roughly 18 states plus DC that reimburse midwives without nursing degrees. [4] CPM care in Delaware is private pay.
| CREDENTIAL | DE MEDICAID COVERAGE | HOME BIRTH ALLOWED |
|---|---|---|
| Certified Nurse-Midwife (CNM) | Yes (federal mandate) [1] | Legal, but DE reported the home setting is not covered [3] |
| Certified Professional Midwife (CPM) | No: not an enrollable provider type [4] | Yes: licensed for home birth since 2015 [2] |
How do you find a Medicaid-accepting home birth midwife in Delaware?
Delaware's home birth community is small, and the Medicaid path is narrow. The realistic playbook: confirm what your plan will actually pay, then decide between private-pay licensed midwifery and covered hospital CNM care.
For a full guide to home birth midwives in Delaware, including licensing, costs by region, and what to ask before hiring, see our Delaware home birth midwife guide.
Confirm your Delaware Medicaid plan
Diamond State Health Plan members are enrolled with one of three MCOs: AmeriHealth Caritas Delaware, Delaware First Health, or Highmark Health Options. Benefit rules on birth settings come from the state program, but billing runs through your MCO.
Ask the setting question directly
Call your MCO and ask: "Does my plan pay for a planned home birth attended by a certified nurse-midwife?" Ask for the answer in writing. This is the load-bearing question in Delaware, and phone representatives sometimes conflate midwife coverage with home birth coverage.
Consider cross-border options
Some Delaware families work with home birth midwives based in Maryland, Pennsylvania, or New Jersey who travel into Delaware. A midwife enrolled with another state's Medicaid usually cannot bill Delaware Medicaid, so treat cross-border care as private pay unless proven otherwise.
Default to hospital-based CNM care
Delaware Medicaid fully covers hospital-based CNM-attended birth. If home birth funding does not come together, a hospital midwifery practice keeps you with the midwife model at no cost.
What if you cannot fund a home birth in Delaware?
Delaware is a small state with a thin home birth provider pool and a Medicaid program that has reported not paying for the home setting. [3] You still have a few realistic moves.
First, ask licensed midwives about self-pay pricing. Some Delaware-area midwives offer sliding-scale fees or payment plans for Medicaid-eligible families when direct billing is not available. See our sliding-scale guide for how to have that conversation.
Second, price out midwives in adjacent counties of Pennsylvania, Maryland, or New Jersey who travel to the Wilmington area or lower Delaware. Cross-state Medicaid billing rarely works, so compare their private-pay packages against Delaware-based midwives and factor travel fees.
Third, ask Delaware Medicaid which midwife-led facility options are currently enrolled. Delaware regulates freestanding birthing centers as licensed facilities, and where one is operating and Medicaid-enrolled, it offers an out-of-hospital, midwife-led birth that bills as a facility service rather than a home birth. Availability shifts, so confirm what exists at the time you are due.
Fourth, split the model: covered prenatal care with a Medicaid CNM or OB practice, plus private doula support for labor. Doula support is not a substitute for a licensed birth attendant, but it materially improves the hospital birth experience while Medicaid pays the clinical bills.
For a complete guide to home birth options in Delaware including licensing, costs, and transfer hospitals, see our Delaware home birth midwife guide.
Bottom line: Delaware licenses CPMs for home birth under real safety regulations, [2] but the money does not follow: CPMs cannot enroll with Delaware Medicaid, [4] and the state reported that its Medicaid program does not cover home births as a setting. [3] CNM services are covered everywhere as a federal mandatory benefit [1] at 100 percent of the physician rate, [4] which in practice means covered hospital midwifery care. Delaware Medicaid families wanting home birth usually pay privately, sometimes on a sliding scale, or keep the midwife model in a hospital. Ask your Diamond State Health Plan MCO the setting question in writing before you plan around coverage.
- Social Security Act § 1905(a)(17), 42 U.S.C. § 1396d(a)(17). Mandatory Medicaid coverage of nurse-midwife services. View source
- Delaware Administrative Code, Title 24, Regulation 1795. Midwifery Advisory Council: Home Birth (Section 4.0). Division of Professional Regulation. View source
- Kaiser Family Foundation and Health Management Associates. Medicaid Coverage of Pregnancy-Related Services: Findings from a 2021 State Survey. May 2022. View source
- National Academy for State Health Policy. Midwife Medicaid Reimbursement Policies by State. Updated 2023. View source
▶ How we research and review this content Editorial standards
Every guide on Home Birth Partners is researched against primary sources (federal regulations, peer-reviewed clinical literature, and state-level licensing boards) and reviewed by a credentialed midwife before publication.
We update articles when source data changes, when state laws are revised, or at minimum every 12 months. The "Last reviewed" date in the byline reflects the most recent review.
If you spot an error or have a primary source we should add, email [email protected].