The waiver pays for the service. The state decides what insurance comes with it.
We insure home and community-based services providers enrolled in Medicaid waivers, to the limits each state’s provider rules and agreements set, and we read your provider agreement before we quote.
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.
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.
What a waiver provider actually needs.
General liability
Injury and property damage arising from your services, in the participant’s home, the community or a program site, at the limit your state or provider agreement names.
Without it — Certification stalls at the first document the state asks for. In Washington and Ohio the rule itself names the number.
Professional liability
Claims that the support itself caused harm: a missed medication, a behavior plan followed wrongly, a participant left unsupervised.
Without it — General liability excludes professional services, and paid support is a professional service.
Client property and theft
Third-party crime coverage or an endorsement that answers when a participant’s money or belongings go missing while your staff are there.
Without it — Most general liability forms will not pay for theft by an employee, which is why Ohio writes the requirement into the rule.
Abuse and molestation
Defense and indemnity for allegations involving the people you support, including claims of negligent hiring or supervision.
Without it — Excluded from standard general liability, and the allegation most likely to end a waiver provider’s enrollment.
Hired and non-owned auto
Liability when staff drive their own cars to a participant’s home or drive a participant to an appointment.
Without it — The driver’s personal policy answers for the driver. Your agency is named in the suit and has nothing responding.
Commercial auto
Vehicles the agency owns or leases to transport participants, including wheelchair-accessible vans.
Without it — Virginia and New Jersey both require vehicle liability in their rules, and a personal auto policy on an agency van is not it.
Workers compensation
Injury to direct support staff, above all from transfers, lifting and participant behavior.
Without it — Required with employees in nearly every state, and verified at enrollment by most.
Cyber and privacy
Breach response for the participant records, care plans and visit verification data your systems hold.
Without it — Notification duties start the day a laptop is stolen, and no other policy on this page pays for them.
What the regulators actually wrote down.
Washington requires certified residential services and supports providers to carry commercial general liability of $1,000,000 each occurrence and $2,000,000 general aggregate, rising to a $3,000,000 aggregate for community protection providers, covering the acts of employees and volunteers.
WAC 388-101D-0040, Washington DSHS · checked 2026-10-03
A Washington provider that employs professional staff must also carry professional liability or errors and omissions insurance of $1,000,000 each occurrence and $2,000,000 aggregate.
WAC 388-101D-0045, Washington DSHS · checked 2026-10-03
Ohio requires an agency provider certified by the Department of Developmental Disabilities to hold general liability insurance of at least $1,000,000 that includes coverage for individuals’ losses due to theft or property damage.
Ohio Adm. Code 5123-2-08(C)(5), effective September 29, 2024 · checked 2026-10-03
Ohio’s companion rule for independent providers, who work alone rather than as an agency, contains no insurance requirement at all.
Ohio Adm. Code 5123-2-09 · checked 2026-10-03
Virginia requires providers licensed by DBHDS to carry general liability, professional liability, commercial vehicle liability and property damage coverage, and the rule names no dollar amounts.
12VAC35-105-220, Virginia DBHDS · checked 2026-10-03
Indiana requires supported living providers to insure against personal injury, loss of life or property damage to an individual arising from the services they provide, without stating a limit.
460 IAC 6-12-2, Indiana Bureau of Developmental Disabilities Services · checked 2026-10-03
Arizona requires every contractor providing developmental disability services to carry liability insurance in amounts approved by the risk management division of the Department of Administration and to file proof with it.
A.R.S. 36-557(E)(3) · checked 2026-10-03
New Jersey requires a licensed community residence for people with developmental disabilities to keep valid liability insurance on every vehicle used to transport them.
N.J.A.C. 10:44A-5.7 · checked 2026-10-03
Pennsylvania lists general liability, fidelity bond and errors and omissions premiums among the allowable costs in its cost-based rates for ODP providers.
55 Pa. Code 6100.668 · checked 2026-10-03
Federal law requires electronic visit verification for Medicaid personal care services that involve an in-home visit, in force since January 1, 2020, and for home health services since January 1, 2023.
21st Century Cures Act, section 12006 (Medicaid.gov) · checked 2026-10-03
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.
The claims we actually see.
Ordered by how often we see them, not by how dramatic they are. Each one names the coverage that answers it — and the policy people wrongly assume already does.
Most common
A participant falls or is injured during support
Covered by General and professional liability
Whether it is a premises claim or a care claim decides which policy answers, and a provider with only one of the two finds out at the worst time.
Most common
A staff member is hurt lifting or by a participant
Covered by Workers compensation
Injury from participant behavior is an expected, rated exposure in this class. Classifying staff as contractors to avoid it is found at audit.
Common
Money or belongings go missing from a participant’s home
Covered by Third-party crime or a theft endorsement
General liability usually excludes theft by your own employee. The accusation arrives whether or not anyone took anything.
Less common, severe
An abuse or neglect allegation
Covered by Abuse and molestation
Excluded from general liability and often written claims-made, so a gap between policies can leave years of work uninsured.
Kevin Kelsey
Founder | Principal Agent
Owned and ran a home health agency before insurance, so the licensing paperwork, the state and Medicaid requirements, caregivers driving their own cars to clients and an allegation from one-to-one care with nobody else in the room were learned running an agency rather than from a rate manual.
What the insurance company will ask about your Medicaid waiver provider business
We read the applications the markets use for businesses in this field and pulled out what they actually ask. Have these answers ready and a quote takes a day instead of a week, because nobody has to come back to you for the missing piece.
About the business
- What type of organization are you (for-profit or not-for-profit)?
- What year did you establish your organization?
- Do you have all the licenses and permits your state requires to operate?
- Has any of your licenses ever been lost, revoked, or suspended?
- What is your annual operating budget?
How you operate
- How many people do you serve (clients, students, or members)?
- What age groups do the people you serve fall into?
- Do you provide overnight housing or overnight supervision?
- Do you provide health screenings or other medical services to the people you serve?
- Do you operate or control any day care facilities?
Safety and controls
- Do people who receive health screenings or medical services sign liability waivers?
- Do you require all participants in sports activities to have accident and health insurance?
- Do you have written policies against abuse that define appropriate behavior, make clear you have zero tolerance, and say you will investigate and work with law enforcement?
- Do you run criminal background checks and check driving records on all employees and volunteers at hire and annually?
- Do you require employees and volunteers who drive to show proof of their personal auto insurance each year?
Your history
- Do you currently have insurance with another company?
- Has any of your insurance coverage ever been declined or cancelled because of losses or claims?
- Have there been any claims against you that say you were negligent or didn't follow licensing or safety rules?
- Are there any facts, circumstances, or situations right now that might lead to a claim?
Money and people
- How many employees and volunteers work for you (full-time and part-time)?
- Do any of your employees or volunteers use their personal cars for your business (like running errands or transporting people)?
- Do you spend more than $2,500 per year on renting or leasing vehicles?
- What is your annual revenue?
Have these ready
- Your basic business information including your name, address, and licenses
- Your current insurance information, including policy dates and what you paid last year (called a loss run)
- A list of all employees and volunteers by position, including whether you have degreed professionals
- Your written abuse prevention policies and employee screening procedures
- Information about any claims or incidents from the past several years
You answer what you can; a licensed agent fills the rest with you.
What our Medicaid waiver provider clients ask us.
Does the state set my insurance limits, or does the provider agreement?
It depends on the state, and the rules we read split three ways. Washington and Ohio put dollar figures in the rule itself. Virginia, Indiana and Arizona require named coverages and leave the amounts to the provider agreement or a state risk office. Others say nothing in rule and put everything in the contract. Send us the agreement and the certification checklist, and we will match the policy to the wording rather than to a default.
Ohio wants coverage for an individual’s losses from theft. What does that mean for us?
A standard general liability policy rarely pays when an employee is accused of taking a client’s money or belongings. Ohio’s rule asks for exactly that, so the policy needs an endorsement or a third-party crime policy alongside it, and the certificate has to show it. We confirm the wording with the carrier before the certificate goes to the county board, because a certificate that only says “general liability, $1,000,000” does not prove it.
We are an independent provider, not an agency. Do we need any of this?
Some states do not require it. Ohio’s rule for independent providers has no insurance requirement. You are still personally liable for a fall or an accusation of theft, with nobody funding your defense. A small general and professional liability policy is inexpensive against that, and it is what a family or a case manager asks to see once you start hiring.
Is this the same as being a California regional center vendor?
The same buyer and the same exposures, under a different system. California funds these services through regional centers under Title 17, and each center sets its own vendor requirements. Other states run them through waiver enrollment with a state agency or a county board. If you are in California, the regional center page is the right one.
We are newly enrolled. What will an underwriter want to see?
The owners, mostly, because a new entity has no loss history. Expect to provide resumes showing years with this population, the credentials held and any program you ran before. Also list every service you are enrolled to provide, since residential support, respite, day services and transportation are rated differently. Carriers writing hired and non-owned auto will also require annual driving record checks on staff who drive.
What does a Medicaid waiver provider insurance application ask for?
The applications for Medicaid waiver provider businesses ask about 4 things above all: what type of organization are you (for-profit or not-for-profit); how many people do you serve (clients, students, or members); do people who receive health screenings or medical services sign liability waivers; do you currently have insurance with another company. Have your basic business information including your name, address, and licenses and your current insurance information, including policy dates and what you paid last year (called a loss run) ready and a quote takes a day instead of a week.
What do home health and home care agencies pay for insurance?
From policies we bound effective January 2025 to September 2026. Professional liability (including combined general and professional packages): home health and home care agencies we placed paid a median of $800 a year, with the middle half between $510 and $1,580 (33 policies from 24 agencies). Workers compensation: home health and home care agencies we placed paid a median of $2,060 a year, with the middle half between $1,610 and $3,150 (21 policies from 17 agencies). General liability, written on its own: home health and home care agencies we placed paid a median of $350 a year, with the middle half between $350 and $510 (7 policies from 7 agencies). Payroll, services, limits and claims history move the figure, so treat it as scale rather than a quote.
Commercial insurance is 96% of what we do — it is not a department here, it is the whole business. Not ready to talk? The guides answer the questions this page raises in more depth. Already insured with us and need a certificate or a policy change? Ask the service team rather than starting a quote — it is faster and it goes to the people whose job it is. We also write home and auto, which is usually cheaper alongside the business policy than apart from it.
Handed a lease, a vendor packet or a client contract with insurance requirements? Paste it into the COI Requirements Decoder to see what each one means for your business, or read what the requirements mean.