South Dakota Department of Health wants $1M / $3M on the certificate.
Where no state rule on this page sets a figure, your referral contracts set it, and the one asking the most decides what you carry. Ask each referral source for its insurance exhibit before you buy. 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 South Dakota requires
Does South Dakota require workers compensation for home health agencies?
Yes. South Dakota's workers compensation law reaches any employer using the service of another for pay (SDCL 62-1-2), and every covered employer must secure payment of compensation through insurance or approved self-insurance (SDCL 62-5-1).
SDCL 62-1-2 and 62-5-1·checked 2026-10-04
Does South Dakota license home health agencies?
No. South Dakota does not require state licensure for Medicare-certified home health agencies; the Department of Health surveys them for Medicare certification. Non-medical in-home care, such as bathing, light housekeeping or meal preparation, is not regulated by the Department of Health.
South Dakota Department of Health·checked 2026-10-04
What is South Dakota’s HOPE waiver?
South Dakota's Medicaid waiver for older adults and adults with disabilities is the HOPE waiver (Home and Community-Based Options and Person-Centered Excellence), run by the Department of Human Services' Long Term Services and Supports division. It provides home and community-based services to people who need nursing facility level of care.
SD Department of Human Services, LTSS·checked 2026-10-04
CMS Care Compare lists 23 Medicare-certified home health agencies in South Dakota (July 2026 data). (CMS Care Compare, Home Health Care Agencies dataset)
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 South Dakota 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. South Dakota 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 South Dakota
The organizations that will ask for your certificate.
- East River AAA (Sioux Falls) · Area Agencies on Aging
- West River / Lyman-Jones AAA (Rapid City) · Area Agencies on Aging
- Aberdeen Area AAA · Area Agencies on Aging
- South Dakota Medicaid (fee-for-service) · South Dakota Medicaid
- Wellmark Blue Cross Blue Shield · South Dakota Medicaid
- SD Division of Long Term Services and Supports · Other
- Aged and Disabled Medicaid waiver · Other
Questions
Does my South Dakota 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 South Dakota 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.
South Dakota 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 South Dakota. 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