Insurance for Home Care and Home Health Agencies
Your caregivers work alone in clients’ homes, help with bathing and transfers, and often drive clients to appointments. We work with agencies to match coverage to the state license, the aides you employ and the families who rely on them.
Two licenses, two kinds of agency
California treats non-medical home care and home health care as separate businesses. The Home Care Services Consumer Protection Act requires Home Care Organizations to hold a state license, a rule in force as of January 2016, and the Home Care Services Branch of the California Department of Social Services (CDSS) issues those licenses, investigates complaints and makes unannounced visits. The same law created a public online registry of home care aides who have been background checked. Health and Safety Code 1796.12 describes home care services as nonmedical services and assistance that a registered aide gives a client, which in practice means help with meals, dressing, hygiene, housekeeping and companionship.
A home health agency answers to a different department. The California Department of Public Health (CDPH) requires a state license for any organization that provides or arranges skilled nursing services to people where they live, under Title 22 section 74600. SB 164 then put a moratorium on new home health agency licenses: as of June 29, 2026, CDPH stopped issuing them or approving new branch offices unless its Centralized Applications Branch accepts an exception request showing need based on geographic concentration. CDPH’s home health application page carried that notice when we last checked it in October 2026. When you apply for insurance, say which of the two you operate, or whether you run both, because skilled nursing changes the professional liability and workers’ comp side of the quote.
The coverage the HCO license asks for
Health and Safety Code 1796.37 lists what CDSS needs before it issues a home care organization license, and three of the items are insurance. The applicant submits proof of general and professional liability insurance of at least $1,000,000 per occurrence and $3,000,000 in the aggregate, proof of a valid workers’ compensation policy covering its affiliated home care aides, and proof of an employee dishonesty bond, including third-party coverage, with a minimum limit of $10,000.
Treat those figures as a floor. A client who falls while an aide helps her from the bed to a wheelchair can bring a claim that reads both as ordinary negligence and as a failure of care, so many agencies place general and professional liability together on one form with shared definitions. Contracts with referral partners and payers can set limits of their own, so put those agreements beside the policy at renewal.
Keep the paperwork lined up with the license file. Each of the three proofs carries its own renewal date, and a lapsed bond or a cancelled comp policy becomes a problem with the department as well as an insurance gap. Put all three dates on one calendar so the proofs on file stay current.
Care claims and professional liability
General liability answers for bodily injury and property damage in the ordinary sense, such as an aide who knocks over a lamp or backs into a client’s mailbox. Professional liability answers for the care itself: a missed medication reminder, a scald from bath water that was too hot, a fall during a transfer, or a change in a client’s condition nobody reported to the family. For a home health agency the list grows to wound care, medication administration and nursing assessments, which is why underwriters read skilled and non-medical revenue separately.
Underwriters also look at preparation. Health and Safety Code 1796.44 requires each affiliated aide to complete at least five hours of entry-level training before being present with a client, and at least five hours of training each year after that. Have those records ready, along with how you match aides to clients with dementia or limited mobility, how often a supervisor visits, and how care plans and shift notes are kept. A family’s lawyer asks for the same file after an incident. Those files hold clients’ health details, so a stolen tablet or a breached scheduling app is a cyber insurance question too. Our professional liability page explains how these policies are written.
Abuse allegations against caregivers
Home care clients are often elderly, frail or living with dementia, and they spend hours at a time alone with one caregiver. That makes an abuse allegation the claim an agency most needs to plan for. IRMI describes the sexual abuse exclusion as precluding coverage for claims alleging sexual abuse, and notes that favorable versions still provide a defense against those allegations. Ask whether your liability policy carries that exclusion, and whether abuse and molestation coverage comes back by endorsement or a separate policy, with its own limit.
The underwriting questions center on hiring and supervision: how you confirm an aide is on the CDSS registry before the first shift, what your reference checks look like, how clients and families report concerns, and what happens the day a complaint comes in. Childcare programs face the same question about children, and our page on insurance for childcare centers covers it from that side.
Caregivers behind the wheel
Driving is part of the job in home care: grocery runs, pharmacy pickups, doctor’s appointments and outings. Most aides use their own cars. The Insurance Information Institute warns that a business can end up liable for injuries and property damage when an employee causes a crash while driving a personal car for work, and describes non-owned auto coverage as the protection for that situation, sitting excess over the employee’s personal auto limits.
Non-owned coverage protects the agency rather than the aide’s car, so physical damage to that car stays with the aide’s own policy. Keep a driver list, check motor vehicle records, and collect each driving aide’s personal auto declarations page so you know what sits underneath. If the agency owns a van or car for client transport, it belongs on a commercial auto policy instead. Our guide to hired and non-owned auto shows how the two fit together.
Workers’ comp for caregivers
Caregivers placed by a home care organization are its employees: Health and Safety Code 1796.12 defines an affiliated home care aide as one employed by the organization. The Division of Workers’ Compensation is clear that one employee is enough to require a policy in California. The injuries in this work are physical ones, from lifting and transfers, slips in wet bathrooms, dog bites and car accidents between clients’ homes. Our workers’ compensation page covers the basics of a California policy.
The Workers’ Compensation Insurance Rating Bureau (WCIRB) puts in-home personal care, such as help with meals, dressing, hygiene, housekeeping and companionship, in class 8827(1), Home Care Services. An agency that sends registered nurses, vocational nurses or nursing assistants to deliver in-home nursing care is classified 8827(2), Nursing Care in private residences. Report the payroll for each kind of work separately, so the classification matches what your aides and nurses actually do.
Client property and the dishonesty bond
Caregivers work around jewelry, cash, medication, checkbooks and bank cards, and a theft accusation can come from a relative who notices something missing months later. The license’s bond has to include third-party coverage, so it answers for clients’ losses and not only the agency’s own. On the crime insurance side, ISO’s Clients’ Property endorsement, CR 04 01, pays for a client’s money, securities and other property lost through theft by an identified employee.
That word identified matters. The endorsement leaves out a loss that cannot be tied to a named caregiver, so good records are part of the protection: no aide access to client bank cards, receipts for every purchase made for a client, and a log of who worked which shift. For clients with significant assets, consider a limit well above the $10,000 state minimum. The crime bonds page explains how the crime policy and the bond differ.
What home care agency insurance costs
Published industry figures give a starting point, not a Mithril1 quote. Insureon, drawing on the median cost of policies caregivers buy through it, reports $30 a month for general liability for personal care aides at $1 million per occurrence and $2 million aggregate, $12 a month for professional liability at $1 million per occurrence and $3 million aggregate, $12 a month for a fidelity bond and $211 a month for workers’ compensation. Its professional liability figure for home healthcare providers is $56 a month. These numbers describe solo caregivers and the smallest agencies at standard limits, and an agency with a full roster of aides pays well above them.
Workers’ comp is where the price grows fastest, because it is priced per $100 of payroll and caregiving is a payroll business. The WCIRB’s advisory pure premium rate for class 8827(1) is $2.794 per $100 of payroll from September 1, 2026. An agency with $400,000 of caregiver payroll starts from about $11,176 for workers’ comp before the insurer adds its own expenses, which pure premium rates leave out. Liability pricing grows with the size of the operation too, measured by revenue, client hours and the number of aides.
Expect a higher premium for skilled nursing, clients with advanced dementia, client transportation, high aide turnover and any past abuse or theft allegation. Expect a lower one with steady staffing, documented supervisor visits, a clean loss history and a higher deductible. Send your license type, payroll by class, client count and current policies, and the quote sets the actual price.
A few useful answers
Common questions
What insurance does a California home care organization license require?
Health and Safety Code 1796.37 asks for general and professional liability of at least $1,000,000 per occurrence and $3,000,000 aggregate, a workers’ compensation policy covering affiliated aides, and an employee dishonesty bond with third-party coverage of at least $10,000.
Is a home health agency the same as a home care organization?
No. CDSS oversees non-medical home care organizations, while CDPH oversees home health agencies that provide skilled nursing at home. CDPH stopped issuing new home health agency licenses as of June 29, 2026, apart from exception requests it accepts.
Do caregivers who drive their own cars need the agency to carry auto coverage?
The agency needs hired and non-owned auto liability, which responds when an aide’s crash on agency business leads to a claim against the agency. The aide’s personal policy still comes first and still pays for damage to the aide’s own car.
Does a standard liability policy cover abuse allegations against a caregiver?
Often not. Many liability forms carry a sexual abuse exclusion, and favorable versions keep only a defense. Ask for abuse and molestation coverage by name and check its limit.
Which workers' comp class applies to home care aides?
WCIRB class 8827(1), Home Care Services, for in-home personal care, and class 8827(2) for agencies that send nurses or nursing assistants to provide in-home nursing. Both carry a pure premium rate of $2.794 per $100 of payroll from September 1, 2026.