What is Transportation Insurance?

Insurance for NEMT is more than just a legal requirement; it is a necessity to keep your business protected and secure.

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What is Transportation Insurance?

Non-emergency medical transportation (NEMT) businesses, like any other healthcare provider or transportation service, have a fairly high risk involved with their business. As such, insurance for NEMT is more than just a legal requirement; it is a necessity to keep your business protected and secure. 

Before you start filling out a non-emergency medical transportation insurance application, you need to have the full picture of the types of insurance your business needs to carry and the specific function of each. For example:

  • General liability insurance: will protect your business from incidents not related to vehicles in motion or traffic incidents.
  • Automobile liability and physical damage coverage: will protect your fleet and passengers in the event of a traffic incident.
  • Professional liability insurance: also known as business insurance, is to protect your business and commercial property in the event of an accident. This is distinct from general liability, which is designed to protect third parties involved in incidents involving your business. 
  • Workers' compensation coverage: is also required in most states. This policy will pay out in the event that one of your drivers or other employees are injured in a work-related incident. When you look at NEMT insurance requirements in California and other highly regulated states, this type of coverage is extremely important.
  • SAM coverage: provides specific protections and coverage for legal fees if a patient or customer of your company files asexual abuse or molestation charge against one of your employees. 

Given these requirements, it is no surprise that NEMT insurance cost is a large portion of your operational overhead. There are, however, several ways to reduce NEMT insurance costs while keeping your business protected.

First, make sure your coverage limits are sized correctly for your needs and your local requirements. Before purchasing any insurance policy, do a bit of research into the minimum coverage limits required for each type of insurance. Keeping your insurance coverage within the state's limits is also a requirement to maintain your NEMT license. 

Next, many insurance providers will provide discounts for businesses that maintain continuous coverage without filing any claims. When renewal time comes around, discuss your costs and operations with your insurance provider before renewing. While you might be tempted to jump ship and switch to another insurance company, it might be cheaper overall to stick with your current company. 

Average Cost for NEMT Insurance

To meet all the NEMT insurance requirements, you will need to dedicate a significant portion of your budget to paying for insurance. 

Let us start with vehicle insurance, as this is the largest insurance cost for any fleet. Your average cost for NEMT insurance on your vehicles alone can range anywhere from $2,000 to $12,000 per vehicle, per year. Where your insurance cost falls in that range will depend on state regulations for minimum coverage limits, the location of your business, crime rates in your area, the age and type of vehicles you use, and any incidents reported on your company record or on the individual driving records of your employees. Your insurance company will also look at the radius of operations for your NEMT service and your garaging location, to help determine an exact cost for NEMT automobile insurance. 

For general liability insurance, workers compensation, and other coverages, you will need to consult your local NEMT insurance requirements. Non-emergency medical transportation insurance carriers will be able to provide specific advice for your business, letting you know how much you need to spend to remain in compliance. Beyond state and local regulations, you might also have additional insurance requirements for specific contracts, especially those with transit authorities and Medicaid. By nature, these organizations are risk-averse and will want to make sure that any contractors they work with are well protected before awarding a contract. 

When talking to your insurance carrier, you will also be able to ask them about things your business can do to reduce insurance costs, such as offering additional training to your drivers, improving your vehicle maintenance procedures, adjusting your hiring practices to focus on more experienced drivers and managers, and bundling coverages and policies under a single contract. While some of these things might have an upfront cost, in many cases, the insurance savings will more than pay for any changes to operational costs. 

Cheapest NEMTInsurance

Finding the cheapest NEMT insurance is just like finding any other business service. You need to shop around, meet with several carriers and brokers, and discuss your needs. Each carrier is going to have different ways to help your NEMT business make the most of your insurance coverage while reducing costs.

You might be wondering, why is NEMT insurance so expensive? Well, there are two key factors. One is the nature of the business. Any operation that involves moving vehicles — especially an entire fleet of them —faces significant risk. Even if your drivers have completely clean records and the highest standard of training, there are so many factors on the road outside of your control that might cause an accident. Second is the nature of your passengers. When you are dealing with patients who have mobility issues, visual or hearing impairments, or other medical needs, they are already at higher risk. Many of them also have expensive medical equipment and wheelchairs that might be damaged in transit. Your insurance must cover both your patients and their medical devices so that in an accident, both you and they are fully protected. 

Several carriers offer NEMT insurance. In many cases, a large provider will be able to offer cost-effective coverage based on an economy of scale. Berkshire Hathaway NEMT insurance, for example, is offered by subsidiary companies but underwritten by the larger umbrella that is Berkshire Hathaway. Progressive NEMT insurance is also a popular option that offers specialized, low-cost coverage for non-emergency medical transportation businesses. 


When making decisions about your insurance, remember that the cheapest NEMT insurance is not necessarily the best. If your business has gone for a long time without a claim, you might feel compelled to reduce your coverage to the absolute minimums required in your area. Before stripping your coverage, keep in mind that no business is impervious to accidents. You might also rob yourself of the opportunity to win major contracts with higher liability coverage requirements. 

NEMT Commercial Auto Insurance

Of all the non-emergency medical transportation insurance requirements, commercial auto insurance is by far the largest and most costly. Taking a deeper look at this insurance is worth it to keep your costs in line. 

The first question you must ask is, “what kind of insurance do I need for medical transportation?” The answer is that you need coverage specific to for-hire livery fleet vehicles. This differs from other types of commercial auto coverage because it is designed to include liability for passengers in addition to your vehicles and drivers. 

NEMT commercial auto insurance is provided by most commercial auto carriers. Non-emergency medical transportation insurance carriers will have specific knowledge of NEMT insurance requirements for specific states and municipalities, which will help ease the burden of research on your end. They may also be able to offer simple discounts for paying in full for the policy year, paying electronically, or other simple administrative things. 

First, take a hard look at your fleet itself. Factors like vehicle age, seating capacity, and specialized medical equipment like oxygen tanks can all make your insurance more expensive. Your travel radius and claims history on a specific vehicle can also increase your costs. In some cases, if a vehicle has been in one or more accidents, it might be more cost-effective to retire from your fleet and replace it with a newer vehicle. 

You can reduce your non-emergency medical transportation insurance costs with some operational additions to your training and procedures. If your drivers take additional safety training on a regular basis or carry a commercial driver’s license (CDL), you can qualify for insurance discounts. Incentivizing CDL carriers to apply to drive for you and/or offering paid CDL training might be more cost-effective than paying full price for the insurance. 

Balancing Costs to Meet Non-Emergency Medical Transportation Insurance Requirements

While non-emergency medical transport insurance is a large cost for your business, it is not the only one. Even if you have compared policies and minimized your costs, you might still be paying more than you feel you can afford. If that is the case, looking for cost savings elsewhere in your business to offset your NEMT insurance costs is the best solution. 

Improving your operation and maximizing efficiencies can easily reduce your costs and help you take on some additional business. With real-time dispatching and optimized scheduling, you can make sure that your business is making the best use of time and fuel at any given moment, and reducing operational overhead. 

Additionally, you will want to start looking at data around your trips and drivers so that you can identify risky driving behaviors. If you notice repeated issues with a driver, you can remind them of better driving behavior that will reduce the risk of an accident (and the subsequent insurance cost increases). 

MediRoutes offers affordable software solutions designed specifically for NEMT businesses interested in improving their operations and reducing costs. Reducing risky driver behavior certainly helps reduce your risk and, in turn, your insurance costs. With cost savings and capacity for additional contracts, you will be able to dramatically improve your profit margins and offset steep insurance costs. Get in touch to learn how MediRoutes can help you. 

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