How long does it take to get an NEMT quote?

Most NEMT quotes turn around in 24–48 hours; new providers or A&M claim accounts can run 3–5 business days.

Do I need abuse & molestation coverage?

Yes — and at the limit your Medicaid contracts require, not a $25K sublimit. We confirm before binding.

What if I’m a new NEMT venture?

A small panel writes new NEMT authority. Pricing is rated up and steps down after 12 clean months.

OPERATION · SPECIALTY

Non-Emergency Medical Transport

Casey places commercial insurance for Non-Emergency Medical Transport providers — wheelchair vans, ambulettes, stretcher vans, and gurney transport. We know the Medicaid contract requirements, the per-passenger limits state DOTs require, and which carriers actually write abuse & molestation coverage as a meaningful endorsement.

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Coverage you’ll typically need

What goes on an NEMT policy.

01
Auto Liability
Per-passenger limits vary by state and contract — typically $1M–$1.5M CSL. Medicaid MCO contracts often require $1M minimum auto liability.
02
Physical Damage
Coverage on the wheelchair vans, ambulettes, sedans, and stretcher vans. Wheelchair lift mechanisms typically need a stated-value endorsement.
03
Abuse & Molestation
Defends and pays claims of abuse during transport. Most NEMT contracts require $1M–$2M; many policies sublimit at $25K–$100K. We confirm the limit matches your contracts.
04
Accident & Medical (Passenger)
Medical payments coverage for passenger injury during transport, including non-collision incidents (wheelchair tip-over, transfer injuries).
05
General Liability
Off-the-vehicle exposures — premises liability at your dispatch office, slip-and-fall on the way to the van.
06
Professional Liability
Some Medicaid contracts require professional liability covering driver/attendant care decisions. Narrow market.

What drives your premium

Pricing factors for NEMT.

▼
Documented driver training
Passenger Assistance, Safety, and Sensitivity (PASS) certification or equivalent training earns credits and is often required by Medicaid MCOs anyway.
▼
Driver background-check program
Written background check, drug screen, and re-screen procedures help with renewal pricing.
▼
Wheelchair securement standards
Documented WTORS (wheelchair tiedown and occupant restraint system) procedures and equipment reduce tip-over claims.
▼
Dashcam and GPS tracking
In-cab cams and route monitoring earn credits and resolve A&M allegations faster.
▲
Stretcher / bariatric transport
Higher severity loss class — narrower carrier panel and higher base rates.
▲
Prior A&M claims
Even closed claims with low settlements affect rates for 5+ years.
▲
High per-passenger limits
Some contracts require $1.5M or $2M per-passenger — rates step up at thresholds.
▲
High driver turnover
Turnover signals training and screening gaps; underwriters weight it.

Quote in 24–48 hours

What you’ll need to send to get a real quote.

—DOT Number (if applicable) and state TNC/livery licensing
—Currently-effective dec page
—Loss runs (3 to 5 years, current within 60 days)
—Driver list with CDL/DL #, DOB, background-check completion
—MVRs (we can pull if you authorize)
—Schedule of vehicles (year, make, model, VIN, wheelchair lift configuration)
—Copy of active Medicaid contracts or MCO agreements
—Annual passenger trip volume (last 12 months)

FAQ

Most providers get a real quote in 24–48 hours. New providers and accounts with A&M claim history can run 3–5 business days because we’re submitting to specialty markets that underwrite manually.

Yes — and you need it at the limit your Medicaid contracts require, not the $25K–$100K sublimit many policies default to. We confirm the A&M limit matches the contract before binding.

A small carrier panel writes new authority for NEMT. Pricing is rated up but after 12 months of clean experience your rates step down materially.

Modivcare, MTM, Veyo, and state Medicaid agencies set the requirements. They typically include $1M auto liability, $1M A&M, accident/medical, and sometimes professional liability. We confirm against your active contracts.

Not always. CDL requirements depend on vehicle GVWR and passenger count. Most wheelchair vans don’t require CDL. Stretcher vans and shuttle buses may. State and Medicaid contract may also require additional driver certifications.

Up sharply over the last three years. Retroactive-statute-of-limitations laws in several states (NY, CA, NJ) opened the door to historical A&M claims and tightened markets across the class.

Yes — Medicaid MCO COIs are routine. We also help with contract renewals and limit changes when MCO requirements change.

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Quote your non-emergency medical transport operation

Send your DOT and a few details. A broker will reach out within 1 business hour.

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OperationsSpecialtyNon-Emergency Medical Transport

NEMT insurance

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Overview

What NEMT operators actually need.

NEMT isn’t freight insurance. The exposures are different, the carrier panel is different, and the contract requirements (Medicaid managed care organizations, state Medicaid agencies, brokers like Modivcare and MTM) drive the limits more than FMCSA does.

The two coverages that matter most beyond the basics: passenger auto liability sized to the state’s per-passenger requirement, and a meaningful abuse & molestation endorsement. Many policies sublimit A&M to $25K — well below what most Medicaid MCO contracts require. We confirm the limit matches the contract before bind.

“If your A&M endorsement is sublimited at $25K and your Medicaid contract requires $1M, you don’t have the coverage you think you have.”

Coverage you’ll typically need

What goes on an NEMT policy.

NEMT policies look like passenger auto policies with a stack of specialty endorsements layered on top.

01Auto LiabilityPer-passenger limits vary by state and contract — typically $1M–$1.5M CSL. Medicaid MCO contracts often require $1M minimum auto liability.
02Physical DamageCoverage on the wheelchair vans, ambulettes, sedans, and stretcher vans. Wheelchair lift mechanisms typically need a stated-value endorsement.
03Abuse & MolestationDefends and pays claims of abuse during transport. Most NEMT contracts require $1M–$2M; many policies sublimit at $25K–$100K. We confirm the limit matches your contracts.
04Accident & Medical (Passenger)Medical payments coverage for passenger injury during transport, including non-collision incidents (wheelchair tip-over, transfer injuries).
05General LiabilityOff-the-vehicle exposures — premises liability at your dispatch office, slip-and-fall on the way to the van.
06Professional LiabilitySome Medicaid contracts require professional liability covering driver/attendant care decisions. Narrow market.

Why NEMT is harder than it looks

What gets NEMT operations declined.

NEMT decline reasons cluster around passenger exposure, A&M claim history, and the regulatory tangle of Medicaid contracting.

Abuse & molestation claim history

Even one open A&M claim narrows the market sharply. The class has been hit hard by retroactive-statute-of-limitations laws in several states.

Wheelchair tip-over claims

Passenger injury during loading or transit is the most common NEMT loss. Frequency above industry baseline triggers declines.

New providers (under 12 months)

Standard NEMT markets typically want 12+ months. A small panel writes new authority NEMT at rated-up pricing.

Stretcher transport / bariatric

Stretcher and bariatric transport carry higher loss severity — narrower carrier panel.

Driver background gaps

Medicaid contracts require background-checked, drug-screened drivers. Gaps in your HR documentation trigger underwriter concerns.

Long Medicaid claim cycles

Slow-paying state Medicaid programs are a financial-stability concern for some carriers. They underwrite to it.

What drives your premium

Pricing factors for NEMT.

NEMT premiums are driven by per-passenger limits, A&M exposure, vehicle type mix, and operator history. Costs moved up sharply through 2023–2025 across the class.

▼Documented driver trainingPassenger Assistance, Safety, and Sensitivity (PASS) certification or equivalent training earns credits and is often required by Medicaid MCOs anyway.

▼Driver background-check programWritten background check, drug screen, and re-screen procedures help with renewal pricing.

▼Wheelchair securement standardsDocumented WTORS (wheelchair tiedown and occupant restraint system) procedures and equipment reduce tip-over claims.

▼Dashcam and GPS trackingIn-cab cams and route monitoring earn credits and resolve A&M allegations faster.

▲Stretcher / bariatric transportHigher severity loss class — narrower carrier panel and higher base rates.

▲Prior A&M claimsEven closed claims with low settlements affect rates for 5+ years.

▲High per-passenger limitsSome contracts require $1.5M or $2M per-passenger — rates step up at thresholds.

▲High driver turnoverTurnover signals training and screening gaps; underwriters weight it.

Quote in 24–48 hours

What you’ll need to send to get a real quote.

NEMT submissions need a few items beyond standard trucking submissions — most around drivers and contracts.

DOT Number (if applicable) and state TNC/livery licensing
Currently-effective dec page
Loss runs (3 to 5 years, current within 60 days)
Driver list with CDL/DL #, DOB, background-check completion
MVRs (we can pull if you authorize)
Schedule of vehicles (year, make, model, VIN, wheelchair lift configuration)
Copy of active Medicaid contracts or MCO agreements
Annual passenger trip volume (last 12 months)

Federal & state compliance

DOT, state, and Medicaid requirements.

NEMT compliance is layered. FMCSA applies if you cross state lines or operate vehicles over 10,001 lbs. State DOTs regulate intrastate passenger transport. Medicaid agencies and MCOs add contract-specific limits and procedures.

State passenger limits. Most states require $1M–$1.5M CSL auto liability for paid passenger transport. Some (NY, FL, CA) require higher per-passenger limits.

Medicaid MCO contracts. Modivcare, MTM, Veyo, and state Medicaid agencies typically require $1M auto liability, $1M abuse & molestation, and accident/medical payments. We verify against your actual contracts before bind.

ADA accessible vehicle standards. Wheelchair-accessible vehicles must meet ADA requirements for ramp/lift performance and securement. Non-compliance can trigger contract loss and shouldn’t be discovered at claim time.

Common questions