HHSC wants $1M / $3M on the certificate.
The floor written into HHSC contracts and most Texas MCO agreements. We set the coverage up and produce the certificate — usually the same day.
What Texas requires
Texas is the only state that does not require private employers to carry workers compensation.
Texas Department of Insurance, Division of Workers’ Compensation·checked 2026-08-15
HHSC contracts and most Texas managed care organizations require $1M per occurrence and $3M aggregate before an agency can accept authorizations.
HHSC provider contract terms·checked 2026-08-15
Texas Medicaid delivers long-term services through waiver programs — HCS, CLASS and DBMD — each with its own provider requirements.
Texas HHSC waiver program documentation·checked 2026-08-15
Texas has more than 3,000 HHSC-licensed home health agencies. (HHSC licensed provider registry)
Limits
What to carry, and why that number.
- General liability$1M / $3M
- Professional liability$1M / $3M
- Usually required on the same certificate, often on a shared aggregate.
- Abuse and molestation$1M
- Excluded from the base GL form. MCOs increasingly ask for it explicitly before contracting.
- Workers compensationStatutory
- Optional under Texas law, but non-subscribers lose their common-law defenses — and MCO contracts generally require it regardless.
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.
In Texas
The organizations that will ask for your certificate.
- Superior HealthPlan (Centene)
- Amerigroup Texas
- Aetna Better Health of Texas
- Molina Healthcare of Texas
- UnitedHealthcare Community Plan
- HCS — Home and Community-based Services
- CLASS — Community Living Assistance and Support Services
- DBMD — Deaf Blind with Multiple Disabilities
- Dallas Area Agency on Aging
- Houston-Galveston Area Agency on Aging
- Alamo Area Agency on Aging
- Metrocare Services · Dallas
- Spindletop Center · Beaumont
- Heart of Texas Region MHMR · Waco
Questions
Does a Texas home health agency have to carry workers compensation?
Not by statute — Texas is the only state where private employers may opt out. But a non-subscriber gives up its common-law defenses in an employee injury suit, and HHSC contracts and MCO agreements generally require coverage anyway. In practice almost every agency accepting Medicaid authorizations carries it.
What does HHSC require on the certificate of insurance?
General and professional liability at $1M per occurrence and $3M aggregate, with the contracting entity named as certificate holder. Several MCOs additionally require abuse and molestation coverage be shown.
Are HCS and CLASS providers underwritten differently?
Yes. Waiver programs involve longer engagements and higher-acuity clients in residential settings, which changes both the professional liability and the abuse exposure. Carriers price them separately from standard skilled home health.
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.
Tell us what you do. We’ll tell you what it costs.
Licensed in Texas. 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 2026-08-15