What Insurance Does a Home Health or Hospice Agency Need?

The short answer: A home health agency typically needs several coverages working together, not just one policy. At minimum, most agencies need general liability, professional liability (also called malpractice or errors and omissions), workers' compensation, and crime coverage for theft of patient property. Many also carry cyber liability for the patient health information they handle, employment practices liability (EPLI) for employee claims, and hired & non-owned auto if staff drive between client homes. The exact mix depends on your services, your state's requirements and your payer contracts, since many Medicare-certified agencies and managed care contracts write specific insurance minimums into them.

Home health and hospice agencies deliver skilled care in the least controlled setting there is: a patient's home. There's no charge nurse down the hall, the environment changes with every visit, and your team spends a lot of time on the road. That combination creates a specific set of risks, and an insurance program should be designed around them.

This guide walks through the coverages most agencies need, what each one actually does, and the questions to ask before you renew.

The core four

1. Professional liability

Professional liability (malpractice) responds when a patient or family alleges that your care caused harm: a medication error, a missed change in condition, a pressure injury, or a fall during a transfer.

What to check:

• Are your employed nurses, aides and therapists covered as insureds, or only the agency?
• Is the policy occurrence or claims-made? If claims-made, what's the retroactive date, and will you need tail coverage if you switch carriers?
• Is there a separate limit for licensing board defense?

2. General liability

General liability covers non-clinical accidents, like a visiting family member who trips in your office or a clinician who damages a patient's property. Referral sources, landlords and payers will almost always ask for a certificate showing it.

3. Workers' compensation

Home-based clinicians lift and transfer patients in cramped spaces, encounter pets and icy steps, and drive constantly. Workers' comp is required in nearly every state we serve and is often the largest single premium. Correct class codes and a carefully reviewed experience mod can save real money.

4. Hired & non-owned auto

Your staff drive their own cars between visits. Their personal auto insurance pays first, but in a serious accident the injured party will look to the agency as well. Hired & non-owned auto (HNOA) liability protects the agency for a modest premium.

Coverages that are easy to overlook

• Abuse & molestation. Many professional and general liability policies exclude abuse allegations entirely. Agencies serving elderly, pediatric or disabled patients should have specific A&M coverage.
• Third-party crime (client property). Standard employee dishonesty coverage protects your money, not your patients'. Third-party coverage responds when a staff member is accused of stealing from a patient's home.
• Cyber liability. Laptops and phones with EMR access leave the office every day. A lost device or phishing attack can trigger HIPAA notification obligations for thousands of patients.
• EPLI. High-turnover, shift-based workforces generate employment claims. EPLI defends wrongful termination, discrimination and harassment allegations.

Hospice-specific considerations

Hospice adds a few wrinkles:

• Controlled substances in the home. Make sure your professional liability doesn't exclude claims related to medication management, and document your disposal procedures.
• Volunteers. Confirm volunteers are covered as insureds under your liability policies.
• Nursing facility contracts. When you serve residents in skilled nursing or assisted living facilities, those contracts typically require additional insured status, waivers of subrogation and specific limits.

What referral partners and payers usually require

Expect to see some version of:

• Professional liability: $1,000,000 per claim / $3,000,000 aggregate
• General liability: $1,000,000 per occurrence / $2,000,000 aggregate
• Workers' compensation: statutory, with employer's liability of $1,000,000
• Additional insured status and waiver of subrogation for the contracting party
• 30 days' notice of cancellation

Before you sign, send us the insurance section of the contract. We'll tell you whether your current program meets it and what it would cost to close any gaps.

Questions to ask at every renewal

1. Did the carrier add any new exclusions this year?
2. Are all of our states, locations and service lines listed correctly?
3. Has our payroll or visit volume changed enough to affect the premium or the workers' comp audit?
4. Have we been shown real alternatives from other carriers?

That last question is the one we take most seriously. We shop the market at every renewal and show you real options, not just the incumbent's renewal offer.