Pennsylvania Requirements

Pennsylvania Home Care Agency Insurance Requirements

Pennsylvania home care agencies operate under the Department of Health's Chapter 611 Home Care Agency (HCA) licensure and — for skilled programs — Chapter 601 home health licensure. Between DOH Chapter 611, statewide workers' compensation for caregivers, and the Medicaid Community HealthChoices (CHC) MCO contracts (AmeriHealth Caritas, PA Health & Wellness, UPMC Community HealthChoices), here's exactly what PA home care and home health agencies are required to carry in 2026.

  • DOH Chapter 611 HCA licensure — GL & professional liability required
  • Workers' compensation mandatory for essentially every employee
  • $1M/$2M GL is the practical floor for CHC MCO contracts
  • Non-owned & hired auto essential for caregivers driving between clients

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DOH Chapter 611 Home Care Agency licensure

Pennsylvania's Department of Health licenses non-medical home care agencies under 28 Pa. Code Chapter 611. Applicants must show proof of general liability and professional liability coverage at licensure and renewal. DOH does not publish a hard dollar minimum, but $1M/$2M GL and $1M professional liability is the practical standard reviewers expect — and what every Community HealthChoices MCO contract requires.

Pennsylvania workers' compensation

Pennsylvania requires workers' compensation for essentially every employee, including part-time caregivers. Home care class code 8829 and skilled 8854 rates in PA sit in the middle of the national range, but miscoded payroll — running caregiver hours under a clerical code — is the single most common way PA agencies overpay. The State Workers' Insurance Fund (SWIF) is the market of last resort; most agencies place with A-rated carriers through KTL.

Community HealthChoices (CHC) MCO contracts

Medicaid CHC is administered through AmeriHealth Caritas, PA Health & Wellness (Centene), and UPMC Community HealthChoices. All three require $1M/$2M general liability, $1M professional liability, primary & non-contributory additional insured status, waiver of subrogation, and a 30-day notice of cancellation endorsement. Larger health-system contracts (UPMC, Penn Medicine, Jefferson Health) can push $2M/$4M plus umbrella limits.

Chapter 601 Medicare-certified home health & hospice

Medicare-certified home health agencies licensed under 28 Pa. Code Chapter 601 and hospice programs face higher expectations — usually $2M/$4M GL, $1M/$3M professional liability, cyber liability, and abuse & molestation coverage. Hospital discharge partners in Pittsburgh and Philadelphia often add a $1M–$5M commercial umbrella requirement.

Non-owned & hired auto

Pennsylvania caregivers routinely drive personal vehicles between clients across dense metro areas (Philadelphia, Pittsburgh, Allentown, Harrisburg). Personal auto policies exclude business use, leaving the agency directly exposed after an accident on the way to a shift. Non-owned & hired auto is a low-cost coverage that closes this gap.

Caregiver classification in Pennsylvania

Pennsylvania does not have an AB 5-style ABC test, but PA Department of Labor & Industry and IRS enforcement still make 1099 caregivers risky. Most home care aides fail the common-law and IRS 20-factor tests and should be W-2. Misclassification triggers back workers' comp premium, unemployment claims, and DOH license risk.

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Frequently asked questions

At licensure under DOH Chapter 611: general liability and professional liability. In practice, plus workers' compensation and non-owned auto. CHC MCO contracts (AmeriHealth Caritas, PA Health & Wellness, UPMC CHC) push GL to $1M/$2M and add cyber and abuse & molestation coverage.