How Much Does NEMT Insurance Cost in Texas?

One of the most common questions from NEMT business owners is simple: how much does NEMT insurance cost in Texas?

The answer depends on several factors, including vehicle type, coverage limits, and whether your business works with Medicaid brokers or private contracts. In this guide, we break down monthly and annual NEMT insurance costs in Texas so you know what to expect before buying coverage.

Average NEMT Insurance Cost in Texas

NEMT insurance is a specialized type of coverage designed for medical transportation providers, and policies must meet strict vehicle and liability requirements that standard commercial auto policies do not address.

For a full breakdown of required coverages, limits, and compliance considerations, you can learn more about non-emergency medical transportation insurance for Texas-based providers.

For most Texas-based non-emergency medical transportation businesses, insurance costs typically fall within these ranges:

• $450 – $900 per vehicle per month

• $5,000 – $12,000+ per vehicle per year

New NEMT businesses often pay more during their first year, especially if they have limited operating history or are required to carry higher liability limits for broker or Medicaid contracts.

NEMT Insurance Cost per Month (Texas Breakdown)

Ambulatory NEMT Vehicles

• Lower risk profile

• Fewer patient-handling exposures

• Typically lower premiums

Estimated cost:
$400 – $700 per month per vehicle

Wheelchair-Accessible NEMT Vans

• Higher passenger liability

• Loading and unloading risk

• Often required by Medicaid contracts

Estimated cost:
$600 – $1,000+ per month per vehicle

Wheelchair vans almost always require higher liability limits, which directly impacts insurance pricing.

What Factors Affect NEMT Insurance Cost in Texas?

Several key factors influence how much you’ll pay for NEMT insurance:

Vehicle Type and Usage

Wheelchair vans cost more to insure than standard transport vehicles due to increased injury exposure.

Required Liability Limits

Many Texas NEMT contracts require:

• $1M Commercial Auto Liability

• $1M General Liability

• Additional insured endorsements

Higher limits = higher premiums.

Driving Records

Poor driver history can significantly increase NEMT insurance costs or limit carrier options.

Service Area

Urban areas such as Houston, Dallas, and San Antonio typically have higher premiums than rural Texas regions.

Why Is NEMT Insurance So Expensive?

NEMT insurance is priced higher than standard commercial auto because it involves:

• Passenger injury exposure

• Medical-related transportation risks

• Regulatory and contract compliance

• Higher claim severity potential

Using personal auto insurance or basic commercial auto will not cover these risks properly and often leads to denied claims.

Does Medicaid Affect NEMT Insurance Cost?

Yes. If your business contracts with Texas Medicaid brokers, insurance requirements often include:

• Higher liability limits

• Specific policy wording

• Additional insured listings

Failing to meet these requirements can delay approval or prevent contract execution altogether. You can learn more about full coverage requirements in our NEMT insurance guide for Texas businesses.

How to Lower Your NEMT Insurance Cost in Texas

While NEMT insurance is not cheap, there are ways to control costs:

• Work with an agency experienced in NEMT insurance

• Bundle commercial auto and liability policies

• Maintain clean driver records

• Avoid buying minimum coverage that fails contract requirements

The cheapest policy often becomes the most expensive mistake.

Get the Right NEMT Insurance Coverage in Texas

Understanding NEMT insurance cost is only one part of the equation. Having the right coverage structure is what keeps your business compliant, protected, and contract-ready.

If you operate a non-emergency medical transportation business in Texas, make sure your policy meets Medicaid, broker, and operational requirements before binding coverage.

If you are operating a non-emergency medical transportation business in Texas and want an accurate estimate, you can request a NEMT insurance quote based on your vehicles, service area, and contract requirements.