DHSS wants $1M / $3M on the certificate.
$1M/$3M is Missouri’s own figure for Medicaid in-home service providers (19 CSR 15-7.021). We set the coverage up and produce the certificate — usually the same day.
Tell us the situation.
One licensed human replies the same business day — not five agents, not an auto-responder. If the policy you have is already the right one, we will tell you.
We use this to quote and service your insurance, and we do not sell it or pass it to lead networks. Privacy policy.
What Missouri requires
Does Missouri require workers compensation for home health agencies?
Missouri requires workers compensation for employers with five or more employees, and for construction employers with one or more (RSMo 287.030). Agencies that contract with DHSS must also carry workers compensation in the amount Missouri law prescribes.
Revised Statutes of Missouri 287.030·checked 2026-10-04
What insurance do MO HealthNet contractors need?
Missouri puts this in rule for agencies that contract to deliver Medicaid in-home services. 19 CSR 15-7.021 requires commercial general liability and professional liability of at least $1 million per event and $3 million aggregate, plus an employee dishonesty bond covering staff in the participant's home.
19 CSR 15-7.021, In-Home Service Standards·checked 2026-10-04
What Missouri DHSS programs do home health agencies contract with?
Missouri DHSS, through its Division of Senior and Disability Services, administers Medicaid home and community based services. Services run through the Medicaid state plan (agency model or consumer directed) or through 1915(c) waivers such as the Aged and Disabled Waiver.
Missouri DHSS, HCBS Services·checked 2026-10-04
Missouri DHSS lists 112 licensed, Medicare-certified home health agencies located in Missouri. (Missouri DHSS Home Health Agency Directory (data.mo.gov))
Send us what you have. We’ll tell you if it’s right.
Your current policy paperwork, a renewal notice, or nothing at all. A licensed agent reads it and replies the same business day.
Limits
What to carry, and why that number.
- General liability$1M / $3M
- Abuse & molestationMatch the contract
- One of the two limits that actually fails a Missouri non-medical contract. Most general liability forms exclude it, and the version that is included is usually too small for the networks here.
- Hired & non-owned autoMatch the contract
- Your caregivers drive themselves between visits, and their personal auto policy stops covering them the moment the trip is work. Missouri contracts require this, and the limit is normally the sticking point.
Coverage
Six lines. Each one closes a specific hole.
Professional liability
Covers claims that care delivered in the home fell below the standard a reasonable provider would meet.
Without it — A single allegation of negligent care is defended out of pocket, and most state and MCO contracts will not accept the agency without it.
General liability
Bodily injury and property damage arising from operations: a fall in a client home, damage to a client residence.
Without it — The most common home-visit claim there is has no defense behind it.
Abuse and molestation
Defense and indemnity for allegations against a caregiver, including claims that the agency hired or supervised negligently.
Without it — Nearly every general liability form excludes it by endorsement, so the exposure most likely to end an agency is the one most often uninsured.
Workers compensation
Statutory benefits for caregiver injury, the highest-frequency loss in the industry, driven by lifting and transfers.
Without it — Medical and indemnity costs land on the agency directly, and in most states operating without it is illegal.
Non-owned and hired auto
Liability when a caregiver drives their own car between clients or transports a client.
Without it — The caregiver’s personal auto policy defends the caregiver. The agency is named anyway, and has nothing responding.
Cyber and privacy
Breach response, notification and regulatory defense for PHI held in scheduling, EVV and billing systems.
Without it — HIPAA notification costs begin immediately and are not covered by any other line on the policy.
What home health and home care agencies we placed in 2025 and 2026 actually paid.
These are annual premiums from policies we bound, effective January 2025 to September 2026. We show the median and the middle half of what clients paid, never the cheapest or the most expensive, and only for lines where at least five agencies stand behind the figure.
- Professional liability (including combined general and professional packages)
- $800median a year
- Middle half: $510 to $1,580
- 33 policies from 24 agencies
- Workers compensation
- $2,060median a year
- Middle half: $1,610 to $3,150
- 21 policies from 17 agencies
- General liability, written on its own
- $350median a year
- Middle half: $350 to $510
- 7 policies from 7 agencies
Payroll moves workers compensation more than anything else, and the services you provide, your limits and your claims history move the rest, so treat these as a sense of scale rather than a quote. Source: Boring Insurance bound policies, cancelled policies and test records excluded, refreshed 2026-10-04.
In Missouri
The organizations that will ask for your certificate.
- Mid-America Regional Council AAA (Kansas City) · Area Agencies on Aging
- St. Louis Area Agency on Aging · Area Agencies on Aging
- Aging Best (Springfield) · Area Agencies on Aging
- Central Missouri AAA (Columbia) · Area Agencies on Aging
- Centene / Home State Health Plan · MO HealthNet Managed Care Organizations
- Molina Healthcare of Missouri · MO HealthNet Managed Care Organizations
- UnitedHealthcare Community Plan of Missouri · MO HealthNet Managed Care Organizations
- Missouri Division of Senior and Disability Services · Other
- Missouri Division of Developmental Disabilities · Other
Questions
Does my Missouri agency need hired and non-owned auto coverage?
Yes. A personal auto policy excludes business use and general liability carries no auto coverage, so the visits your Missouri caregivers drive between are uninsured without this endorsement.
Our caregivers drive their own cars. What does the carrier require?
That they keep their own auto insurance, and that you check their driving records every year. Hired and non-owned auto is written excess of the driver’s personal policy rather than instead of it, so a caregiver whose own coverage lapsed is functionally uninsured on a client visit and the agency absorbs what follows. Annual motor vehicle record checks are the second condition, and annual means annual: a check at hire and nothing after is the version carriers find at claim time. Both are cheaper to build into hiring and review than to explain afterwards.
What limits do most contracts require?
$1,000,000 per occurrence and $3,000,000 aggregate is the common requirement across state Medicaid contracts and managed care organizations. Some MCOs require the agency be named on a certificate before the first authorization is issued.
Is abuse and molestation coverage really necessary?
For an agency sending caregivers into private homes, it is the coverage most likely to be needed and least likely to be present. Standard general liability forms exclude it, so it has to be added deliberately, and most contracts now require evidence of it.
Do caregivers driving their own cars need to be covered?
Yes. A caregiver’s personal auto policy responds for the caregiver, not the agency. Hired and non-owned auto liability is what responds when the agency is named in the suit, which it will be.
How fast can coverage be bound?
Same day is normal for a licensed agency with clean loss history. What slows it down is missing payroll detail or an incomplete list of services provided. Have both ready.
Read next
The coverage itself, explained.
Missouri decides what you must carry. These explain what you are buying, what it excludes, and what moves the price.
Coverage
Tell us what you do. We’ll tell you what it costs.
Licensed in Missouri. Have your payroll figures and a list of services on hand — those are the two things that slow a quote down.
Start a quoteLast reviewed 2026-08-16