Home health care and home care sound interchangeable, but they are two different service models with two different risk profiles. The insurance market treats them differently too, and buying the wrong program can leave a serious coverage gap when a claim hits.
This guide compares skilled home health care (medical) with non-medical home care (companion and personal care) and explains what each type of agency needs from an insurance standpoint.
What is skilled home health care?
Skilled home health care is medical care delivered in a patient's home by licensed professionals. This includes registered nurses, licensed practical nurses, physical therapists, occupational therapists, speech therapists, and certified home health aides working under clinical supervision. Services may include wound care, IV therapy, medication administration, post-surgical recovery, and disease management.
Because these agencies deliver medical treatment, they carry professional liability severity that companion care agencies do not. A missed medication error, a fall from improper transfer technique, or a failure to monitor vital signs can result in a high-dollar malpractice claim.
What is non-medical home care?
Non-medical home care, also called home care or companion care, focuses on activities of daily living and household support. Caregivers help with bathing, dressing, meal preparation, light housekeeping, medication reminders, transportation, and companionship. They do not perform clinical tasks or make medical judgments.
The liability profile is lower in severity but still meaningful. Common claims include slip-and-fall injuries inside a client's home, caregiver auto accidents while running errands, and allegations of theft or abuse. General liability, non-owned auto, and employee dishonesty coverage are usually the primary drivers.
Side-by-side insurance comparison
General liability: both agency types need it. Home health agencies typically need higher limits because they enter homes with clinical equipment and may be named in patient injury lawsuits. Non-medical agencies need coverage for bodily injury and property damage in client homes, but limits are often lower.
Professional liability: critical for home health. Medicare-certified agencies and hospital contractors usually require $1M to $5M per occurrence. Non-medical agencies still need professional liability for care-related negligence, but the severity and required limits are usually lower.
Workers' compensation: required in nearly every state once you have employees. Home health nurses and therapists may carry higher risk classifications than companion caregivers, and workers' comp rates vary significantly by state and payroll class code.
Non-owned and hired auto: important for any agency whose caregivers drive personal vehicles to clients. Home health nurses may drive more frequently and carry medical supplies, increasing auto exposure. Non-medical caregivers driving clients to appointments also need this coverage.
Cyber liability: more heavily emphasized for home health agencies that handle protected health information, electronic medical records, and HIPAA-covered data. Non-medical agencies with client schedules and billing records still benefit from cyber coverage.
Abuse and molestation coverage: both agency types should carry it, but the requirement is more commonly enforced by state Medicaid programs, hospital systems, and referral networks.
Why liability limits differ
The difference in limits comes down to claim severity. A professional liability claim against a skilled nursing visit can reach six or seven figures. A general liability claim for a caregiver who accidentally damaged a client's floor is typically much smaller. Underwriters price home health programs more aggressively because of that medical malpractice exposure, and not every carrier is willing to quote skilled services.
Non-medical home care agencies are easier to place in the standard market, but they still need the right endorsements. A generic small business policy often excludes professional liability, non-owned auto, and abuse coverage — all essential for even a basic home care agency.
How KTL helps both types of agencies
KTL works with skilled home health agencies, hospice providers, and non-medical home care agencies across the United States. We benchmark each risk against A-rated carriers that actually understand home-based care, not just general commercial lines.
For home health agencies, we focus on professional liability form, Medicare Conditions of Participation, hospital contract requirements, and cyber liability. For non-medical agencies, we focus on general liability, workers' comp class codes, non-owned auto, and fidelity bond requirements. The result is a program sized correctly for the services you actually provide.
If you are unsure whether your current policy matches your service model, send us your declarations page and we will tell you exactly where the gaps are — no obligation.