Ohio Requirements

Ohio Home Care Agency Insurance Requirements: Bonds, BWC Comp & Limits (2026)

Ohio changed the rules in 2021. Chapter 3740 of the Revised Code created two separate Department of Health licenses — Skilled Home Health Services and Nonmedical Home Health Services — each with its own surety bond. Add the fact that Ohio is a monopolistic workers' compensation state, where coverage can only come from the state Bureau of Workers' Compensation, and an Ohio insurance program looks different from any neighboring state's.

  • Two ODH licenses: skilled and nonmedical, under ORC Chapter 3740
  • $50,000 bond for skilled applicants, $20,000 for nonmedical
  • Workers' comp comes only from Ohio BWC — no private policy exists
  • Owner fingerprinting is part of the license application

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Ohio's two home health licenses

The Ohio Department of Health licenses skilled agencies under a Skilled Home Health Services license and non-medical personal care and homemaker agencies under a Nonmedical Home Health Services license, both created by ORC Chapter 3740 effective in 2021. Each carries a $250 application fee and requires owner fingerprint impression cards submitted to ODH. Which license you hold determines your bond amount and, in practice, which payer contracts you can pursue.

Surety bonds by license type

The bond requirement applies to applicants who were not already providing direct care on or before September 30, 2021. Established agencies from before that date are generally exempt, which is a common point of confusion for buyers acquiring an existing Ohio agency.

License typeSurety bondSource
Skilled Home Health Services$50,000ORC 3740.03(A)(1)(b)
Nonmedical Home Health Services$20,000ODH Nonmedical HHS Surety Bond form
Agency operating on or before 9/30/2021Generally exemptORC Chapter 3740

Ohio BWC: a monopolistic workers' comp state

Ohio employers cannot buy a standard workers' compensation policy from a private carrier. Coverage comes from the state-run Bureau of Workers' Compensation, or through self-insurance for employers that qualify. Two consequences matter for home care agencies. First, your comp premium is set by BWC's manual classifications and your own experience, not by shopping carriers. Second, your private package should carry stop-gap employer's liability, because the employer's liability protection bundled into a standard comp policy in other states simply does not exist in Ohio. Agencies that move here from Kentucky or Indiana miss that endorsement constantly.

Liability limits Ohio payers expect

ORC Chapter 3740 and rule 3701-60 do not publish a general or professional liability dollar limit. The numbers come from the payer. PASSPORT, the statewide aging waiver, MyCare Ohio for dual-eligible members, and the Ohio Home Care Waiver each run through Department of Aging certification and Department of Medicaid provider agreements, and those agreements carry the insurance exhibit. Treat any specific figure you see repeated on start-up blogs as unverified until you read your own agreement — then send it to us and we will match it exactly.

Send us your provider agreement's insurance exhibit

The coverage an Ohio agency actually needs

Beyond BWC coverage and the license bond, a complete Ohio program includes general liability at $1M per occurrence and $2M aggregate, professional liability on the same tower, a dedicated abuse and molestation limit, stop-gap employer's liability, an employee dishonesty bond with third-party coverage so client theft is actually insured, hired and non-owned auto for caregivers driving between clients, and cyber liability once you hold clinical records or bill Medicaid electronically.

Don't confuse the license bond with being bonded

The ODH surety bond protects the state and the public, and the surety will seek repayment from you after paying a claim. It is not what a client means when they ask whether your caregivers are bonded. That question is answered by a fidelity bond with third-party coverage, which is a separate and inexpensive product.

Fidelity bonds for home care explained

Have Insurance Requirements From a Client?

Send us the insurance requirements from your contract, lease, vendor agreement, or licensing agency. A KTL commercial insurance specialist will review the requirements and help determine the coverage, limits, and endorsements you need.

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Frequently asked questions

$50,000 for Skilled Home Health Services applicants under ORC 3740.03 and $20,000 for Nonmedical Home Health Services applicants per the ODH bond form. Agencies already providing direct care on or before September 30, 2021 are generally exempt.