If you're starting a hospice in Florida or already running one, you know the regulatory landscape feels like navigating a maze blindfolded. Between AHCA requirements, Medicare standards, and contract obligations, figuring out exactly what insurance you need can be overwhelming. Here's the thing: Florida doesn't mandate specific insurance amounts for hospice providers the way it does for, say, contractors. But that doesn't mean you can skip it. Your insurance coverage directly impacts your ability to get licensed, sign contracts, and protect your business from devastating liability claims.
Let's break down exactly what insurance requirements apply to Florida hospice providers, what's actually mandatory versus recommended, and how to make sure you're covered without overpaying.
Getting Licensed: Insurance as Part of Your AHCA Application
Before you can operate a hospice in Florida, you need two things from the Agency for Health Care Administration: a certificate of need (CON) and a license. The CON comes first, and it's essentially Florida's way of controlling how many hospice providers operate in each region. Once you've got your CON, you can move forward with the licensing application.
During the licensing process, AHCA reviews your financial stability and insurance coverage. While they don't publish a specific dollar amount you must carry, they want to see that you're adequately insured to operate safely and meet your financial obligations. This means having general liability coverage, professional liability (also called errors and omissions), and workers' compensation if you have employees. Think of it as AHCA making sure you won't collapse financially the first time someone files a claim against you.
Your license renewal happens every two years, and as of recent rule changes, everything must be submitted through AHCA's online portal. Paper applications are no longer accepted. You can submit your renewal up to 120 days before your license expires, and you definitely want to get ahead of this deadline. A lapsed license means you can't operate, and restarting that process is a nightmare nobody wants to deal with.
Workers' Compensation: The Four-Employee Threshold
Workers' compensation is where Florida law gets specific. Once you have four or more employees on your payroll, you're legally required to carry workers' comp coverage. This is different from construction businesses, which need coverage from employee number one, but hospice providers fall under the general four-employee rule.
Here's what surprises some hospice owners: there's no universal minimum dollar amount for workers' comp in Florida. Instead, your policy needs to cover Florida's statutory benefits, which include medical care for work-related injuries, wage replacement if an employee can't work, and death benefits for families if the worst happens. The premium you pay depends on your payroll size and the risk classification of your employees. Nurses and home health aides have different risk profiles than administrative staff, and insurers price accordingly.
If you're a sole proprietor or you operate as a corporation with yourself as the only officer, you might be able to exempt yourself from workers' comp requirements by filing the appropriate forms with the Florida Department of Financial Services. But once you hire that fourth employee, the exemption won't protect you from the mandate anymore.
General Liability Insurance: Not Required, But Basically Mandatory
Florida doesn't legally require general liability insurance for hospice providers. But here's the reality: try signing a contract with a nursing home, assisted living facility, or even a commercial landlord without proof of general liability coverage. It won't happen. Most contracts require you to carry at least $1 million per occurrence with a $2 million aggregate limit.
General liability protects you when someone gets hurt on your property or when you accidentally damage someone else's property. Let's say one of your nurses trips on a patient's loose rug during a home visit and knocks over an expensive lamp. General liability covers the property damage. Or imagine a family member slips and falls in your office waiting area and decides to sue for medical expenses. That's exactly what this coverage handles.
Some cities and counties in Florida do impose specific general liability requirements for businesses operating in their jurisdictions, so it's worth checking with your local government offices. But even if your city doesn't mandate it, your business relationships will.
Professional Liability and Additional Coverage Considerations
Professional liability insurance (also called errors and omissions or malpractice coverage) protects you when someone claims your care or services caused harm. For hospice providers, this is critical coverage. If a family believes their loved one received inadequate pain management or that your staff made a medical error, professional liability is what protects you from a lawsuit that could bankrupt your business.
Many states and Medicare require additional coverages for hospice providers, including hired and non-owned auto liability (for when your employees use their personal vehicles for work) and sexual abuse and molestation coverage. While Florida's state requirements may not explicitly mandate these, Medicare certification often does, and you'll want that certification to receive Medicare reimbursements.
Since October 2025, Florida hospice providers have also needed to submit HOPE assessments (Hospice Outcomes and Patient Evaluation) through the iQIES system. This isn't insurance-related, but non-compliance triggers a 4% payment penalty starting in fiscal year 2027. It's another regulatory requirement that impacts your bottom line, so keeping up with these deadlines matters just as much as maintaining proper insurance coverage.
Background Screening and Compliance Requirements
While not insurance, it's worth mentioning that Florida requires Level 2 background screening for anyone who provides personal care or services directly to clients, or who has access to clients' living areas, personal property, or funds. This screening includes state and nationwide criminal background checks, and it must be renewed every five years. Failing to maintain current screenings can jeopardize your license, which in turn affects your insurance standing and ability to operate.
How to Get Started with Your Hospice Insurance
Start by getting quotes from insurance brokers who specialize in healthcare and hospice coverage. They understand the unique risks your business faces and can package together the coverages you actually need. Don't just grab the cheapest policy—make sure it covers the specific exposures hospice providers face, from in-home care visits to medical equipment to employee injuries.
Before you submit your AHCA licensing application, have your insurance coverage in place and documented. You'll need to provide proof of coverage as part of your application, and having everything ready speeds up the approval process. Keep copies of all your insurance certificates organized and easily accessible—you'll need to provide them regularly for contract negotiations, facility partnerships, and license renewals.
Florida's hospice insurance requirements aren't as cut-and-dried as some other industries, but that doesn't make them any less important. Between AHCA licensing reviews, workers' comp mandates at four employees, and the practical necessity of general and professional liability coverage for contracts, you need comprehensive insurance to operate legally and safely. Don't wait until you're facing a claim or a licensing delay to get your coverage in order. Set it up right from the start, and you'll have one less thing to worry about while you focus on providing compassionate end-of-life care.
