What a Surety Bond Is and Which Home Care Agencies Need One
Most states do not require a surety bond for a home care license. Where one is required, by licensing or Medicaid, the amounts run from $5,000 to $50,000 and up.
By Caregiver Scheduling Team ·
A surety bond is a guarantee from a bonding company that your agency will meet an obligation to the state or a payer, such as following licensing rules or repaying Medicaid overpayments. Most states do not require one for a non-medical home care license. Where a bond is required, it comes from one of two places: a state licensing law, or Medicaid provider enrollment. You pay a yearly premium, and if the surety pays a claim, you repay the surety.
How is a surety bond different from insurance or a fidelity bond?
A surety bond protects the state or payer, and you pay back any claim. Insurance protects you, and the insurer absorbs the loss. A fidelity bond is really insurance against employee theft, and clients often ask for it.
| Topic | Surety bond | Fidelity (employee dishonesty) bond | Liability insurance |
|---|---|---|---|
| Protects | The state, payer or public | Your clients and agency | Your agency |
| Covers | Your agency failing an obligation | Theft by employees | Injury, property damage, negligence claims |
| Who requires it | Some licensing laws and Medicaid programs | Clients, some payers, prudence | Almost every state license |
| If a claim is paid | You repay the surety | Insurer pays | Insurer pays |
For the insurance side, see home care agency insurance requirements.
Which states require a bond for a home care license?
Only a few, and the amounts vary a lot. Two verified examples:
| State | Who | Bond amount | Source |
|---|---|---|---|
| Ohio | Non-medical home health services license applicant | $20,000 (or proof the agency was providing care before Sept. 30, 2021) | Ohio Rev. Code 3740.03 |
| Ohio | Skilled home health services license applicant | $50,000 | Same |
| Nevada | Agency to provide personal care services in the home | $5,000 under 7 employees, $25,000 for 7 to 25, $50,000 over 25 | NRS 449B.185 |
Nevada lets an agency deposit approved securities instead of buying a bond (NRS 449B.190), and suspends the license by operation of law if the bond lapses. Ohio’s bond is a one-time condition for new applicants. Look up your state in the surety bond requirements tool and the licensing tool. If your state is not on the list, the license probably asks for insurance instead of a bond.
Does Medicaid require a surety bond?
For home health agencies, yes under federal rule. For personal care agencies, only if your state adds one. Federal regulation 42 CFR 441.16 requires each Medicaid-participating home health agency to post a bond of at least $50,000, or a higher amount the state sets. States write that into their own rules:
| State | Who | Amount | Source |
|---|---|---|---|
| Texas | Medicaid home health services providers | No less than $50,000 | 1 TAC 354.1033 |
| Florida | Medicaid providers paid fee-for-service, when AHCA requires it | Up to the greater of $50,000 or the provider’s calendar-year billings | Fla. Stat. 409.907(7) |
Florida sets a new provider’s bond from its estimated billings and can raise it if first-year billing runs higher. Managed care contracts sometimes add their own requirement, so read the provider agreement before you sign. See how to become a Medicaid home care provider.
What does a surety bond cost?
A yearly premium that is a small percentage of the bond amount, set mostly by the owner’s personal credit. Strong credit means a low rate; weak credit means a higher rate or collateral. A $20,000 or $50,000 bond is a modest line in a startup budget next to insurance and licensing fees. Get quotes from two or three sureties, and make sure the quote is for the exact bond form your state uses. See home care agency startup costs.
How do I get one and keep it in force?
- Confirm the required amount and the exact bond form from the state or payer.
- Apply through a surety company or a licensed insurance agent. Expect a credit check and basic business documents.
- Pay the premium, sign the bond, and file the original with the state or payer by the application deadline.
- Put the renewal date on your compliance calendar. A lapsed bond can suspend a license or a Medicaid enrollment.
How Caregiver Scheduling handles this
Caregiver Scheduling does not sell bonds, but it does keep the records a bonded, licensed agency has to produce: who worked each visit, verified by geofenced check-in, and, on Growth and up, whether their credentials were current, since an expired credential blocks the assignment. Those records are what a licensing surveyor or Medicaid auditor asks for first. $199/month for up to 10 caregivers or $299/month for up to 50, free for 30 days.
FAQ
Is a surety bond the same as insurance? No. If the surety pays a claim, your agency has to repay it. Insurance pays and does not ask for the money back.
Do most home care agencies need a surety bond? No. Most state licenses require insurance, not a bond. Bonds appear in a few licensing laws and in Medicaid home health enrollment.
How much is a home care surety bond? The bond amount is set by the state or program, from $5,000 in Nevada’s smallest tier to $50,000 for Medicaid home health. The premium is a fraction of that.
Does the bond cover theft by a caregiver? No. That is a fidelity bond or employee dishonesty coverage, which clients often ask about separately.
This article is general information, not legal advice. Check your state’s licensing and Medicaid enrollment rules.