Most owners searching for a home care agency insurance cost guide want one thing: a real number they can put in a budget. The honest answer is that home care agency insurance cost is driven almost entirely by three inputs — annual revenue, caregiver payroll, and whether your agency is non-medical or skilled. Everything else is a modifier.
This guide breaks down what each coverage line costs in 2026, what makes your quote higher or lower than the averages, and how to benchmark a renewal so you are not overpaying. The ranges below reflect what we see quoting home care and home health agencies across 20+ A-rated carriers.
Home care agency insurance cost at a glance (2026)
General liability: $600–$2,400 per year for a small non-medical agency at a $1M/$2M limit. Skilled agencies and agencies over $2M in revenue commonly land between $2,500 and $6,000.
Professional liability (E&O / medical malpractice): $700–$3,000 per year for non-medical care; $2,500–$9,000 for skilled nursing, therapy, or hospice services where the claim severity is far higher.
Workers' compensation: usually the single largest line. Budget roughly $1.50–$6.00 per $100 of caregiver payroll depending on your state and class code (commonly NCCI 8835 for home health, 8854 for companion/homemaker where allowed). A $500,000 payroll agency in a mid-cost state typically lands between $12,000 and $20,000 a year.
Hired & non-owned auto: $500–$1,500 per year — required by nearly every agency whose caregivers drive their own cars between clients.
Employee dishonesty / janitorial bond: $150–$600 per year for a $10,000–$25,000 bond, which is what most client contracts and state licensing boards ask for.
Cyber liability: $600–$2,000 per year if you touch protected health information through an EMR, telehealth, or e-billing.
Umbrella / excess liability: $900–$3,000 per year for the first $1M, and it is often cheaper than raising underlying limits when a hospital contract demands $3M or $5M.
Typical total program cost by agency size
Startup, under $250K revenue, non-medical: roughly $3,500–$7,000 per year all-in, with workers' comp making up more than half of it.
Established non-medical agency, $500K–$1.5M revenue: roughly $12,000–$28,000 per year for the full program including workers' comp.
Skilled home health or Medicare-certified agency, $2M+ revenue: $35,000–$90,000+ per year, driven by professional liability limits, payroll, and abuse & molestation requirements.
Those are program totals, not just liability. If a quote you received is far outside these bands, it is usually a class-code, revenue-basis, or limit mismatch rather than a bad carrier.
What actually drives your premium
Services delivered. Non-medical companion and homemaker care is the cheapest exposure to insure. Adding personal care and ADL assistance moves you up a tier. Skilled nursing, wound care, IV therapy, and hospice push you into a specialty market where professional liability pricing changes entirely.
Caregiver payroll and 1099 usage. Workers' comp is rated per $100 of payroll, so payroll is the dominant cost lever. Agencies that pay caregivers on 1099s are usually audited and charged for them anyway — carriers treat uninsured subcontractors as employees.
Experience modifier. An ex-mod of 0.85 versus 1.15 is a 30% swing on identical payroll. Two or three lift-assist or auto claims in a three-year window will show up in your rate for years.
State. Workers' comp rates are filed state by state. The same agency can pay double in a high-cost state versus a neighboring one — see our workers' compensation cost by state breakdown.
Contract requirements. Hospital, hospice partner, and Medicaid contracts frequently require $1M abuse & molestation, $3M–$5M aggregate limits, and additional insured wording. Each of those adds premium, and each is negotiable if you know which carriers include it by default.
Where agencies overpay
Buying a bundled package without splitting workers' comp. The carrier that wins your general liability and professional liability is very often not the cheapest workers' comp market. Quoting comp separately at least every other renewal is the highest-ROI thing most agencies can do.
Leaving payroll unsegregated. Clerical, administrative, and office staff belong in a much lower class code than field caregivers. Failing to segregate that payroll silently inflates premium every single year.
Insuring on estimated revenue that never materialized. If you projected $1.2M and did $700K, you may be owed a return premium at audit — but only if you file it.
Renewing on autopilot. Home care markets move. A carrier that was competitive two years ago may have taken a rate increase or pulled back appetite in your state.
How to benchmark your home care agency insurance cost
Start with a written schedule: annual revenue, caregiver payroll by role, states of operation, services delivered, fleet or non-owned auto exposure, and the limits your contracts require. That single document is what lets a broker put the same risk in front of multiple carriers and get comparable numbers back.
Then benchmark — do not just re-price. KTL shops home care and home health agencies across 20+ A-rated carriers plus applicable state funds, splits class codes properly, and pursues scheduled credits and ex-mod corrections before the quote is issued. Most agencies that have never been formally benchmarked find room on at least one line.
Request a free quote and we will return a coverage-by-coverage comparison — usually within one business day.