Specialized non-emergency medical transportation coverage for New York operators contracted with NY Medicaid NEMT managed through Mainstream Managed Care plans and MLTC plans; NYC market additionally regulated by NYC TLC.
New York is the highest-cost NEMT market in the United States. The combination of NYC TLC licensing requirements, New York Medicaid Managed Care oversight, Managed Long-Term Care (MLTC) programs, and the state's aggressive plaintiff litigation environment drives premiums significantly above national averages. Operators outside NYC must still comply with NY Medicaid MCO requirements and often serve a dense population of dialysis, oncology, and behavioral health members.
Market Snapshot: New York Medicaid covers 8.5 million members — the second-largest Medicaid program in the country. New York City alone generates enormous NEMT trip volume through managed care plans and the NYC TLC-regulated paratransit market.
New York Medicaid (NY Medicaid Managed Care, Managed Long-Term Care)
$100,000/$300,000 BI + $200,000 SUM minimum for NYC TLC-licensed FHVs; $1,000,000 CSL for NY Medicaid MCO contracts statewide
$10,000 minimum (NYC TLC); included in CSL for statewide Medicaid contracts
$1,000,000 CSL minimum for NY Medicaid Managed Care; NYC TLC has separate split-limit requirements
Important: NYC TLC requires insurance through a TLC-approved carrier only. NY Medicaid MCOs (Fidelis, Molina, MetroPlus, HealthFirst) require $1M commercial auto, $1M general liability, abuse and molestation, and workers' compensation. New York's Supplemental Uninsured Motorist (SUM) endorsement is required by TLC.
We write coverage for operators contracting with the largest brokers and Medicaid managed care plans in New York:
Managed Long-Term Care plans (VillageCareMax, RiverSpring, Elderplan) contract NEMT for long-term care members in NYC
Large NY Medicaid MCO statewide including NYC, Long Island, Upstate NY
NY Medicaid managed care plan across multiple regions
Major NYC-area Medicaid plan serving all five boroughs
NYC Health + Hospitals-affiliated plan serving NYC Medicaid members
Upstate NY Medicaid and commercial plans
Our team writes NEMT insurance across New York. Here are the markets where we see the highest demand:
Knowing what claims happen most often in New York helps you prevent losses and choose the right coverage:
Yes — any for-hire vehicle operating in the five boroughs of New York City must be licensed by the NYC TLC and insured through a TLC-approved carrier. Standard commercial auto carriers are not TLC-approved and cannot write NYC FHV coverage.
NY Medicaid Managed Care plans outside NYC (Fidelis, Molina, Excellus) require $1M commercial auto CSL, $1M general liability, abuse and molestation coverage, and workers' compensation. Proof of insurance is required for MCO credentialing.
NYC NEMT operators typically pay $8,000–$14,000 per vehicle per year — among the highest rates in the country. Upstate NY NEMT is somewhat less expensive at $6,500–$11,000 per vehicle.
TLC-approved markets for NYC FHV and paratransit operators
NY Medicaid MCO credentialing support for statewide operators
SUM endorsements and TLC filings handled automatically
Specialists in high-exposure NY plaintiff environment
Programs for both NYC and Upstate NY markets
Coverage for ambulettes, gurney vans, and broader patient transport.
ADA paratransit and accessible transit coverage.
Auto liability and physical damage for your NEMT fleet.
Statutory workers comp for drivers and patient-care attendants.
State-specific NEMT insurance programs with the limits and filings required by Medicaid Managed Care Plans and broker networks.
Explore other commercial transportation insurance programs we write for fleet operators across the United States.
Luxury limo, sedan, and chauffeured fleet coverage.
TCP and CPUC-filed coverage for executive black car services.
ADA paratransit and accessible transport coverage.
Coverage for ambulettes, gurney vans, and patient transport.
Auto liability and physical damage for commercial fleets.
Premises and operations liability for transportation businesses.
Statutory workers comp for drivers and dispatch staff.
Get a free quote in under 24 hours. We work with carriers who understand New York Medicaid contracting, broker requirements, and the unique risks of medical transportation.