Massachusetts medical transport
🗣 Falamos português · Hablamos español · English — call (617) 913-4859
NEMT insurance is for-hire commercial auto coverage for vehicles that transport patients to pre-arranged, non-emergency medical appointments. In Massachusetts most NEMT work arrives through a human-service transportation broker such as MART or GATRA, and the broker contract — not the state minimum — sets the limits, the endorsements, and the certificate deadlines your policy has to satisfy.
MART's contract states that, effective May 1, 2026, it will not accept new provider applications from May 1 through July 31 each year. That leaves a nine-month application window running August 1 through April 30. If you intend to apply, getting your insurance and credentialing in order before the window opens is the difference between applying this cycle and waiting for the next one. Confirm current dates with MART directly.
MassHealth members do not usually book transport themselves. The member's medical provider submits a transportation request — the PT-1 — on the member's behalf. Once approved, the trip is assigned to the regional human-service transportation broker, which in turn assigns it to a contracted transportation provider. That is you.
Massachusetts is divided between regional brokers, with MART brokering Western, Central, and Northeastern Massachusetts — Berkshire, Franklin, Hampden, Hampshire, Worcester, Middlesex, Essex, Suffolk, and Norfolk counties, including Greater Boston — and GATRA brokering Southeastern Massachusetts and Cape Cod. Confirm which broker covers your service area, because the contract you sign is the contract that governs your insurance. The current program rules and the PT-1 process are published by the Commonwealth at mass.gov.
The practical consequence is simple and it is the thing most new operators miss: your customer is not the patient. Your customer is a contract with an insurance schedule in it. Everything below comes out of that schedule.
The FY25 HST standards set tiered auto liability minimums for Program-Based Transportation (§3.6.C), scaled by seating capacity including the driver. These are program limits, not state minimums, and even the smallest tier is roughly ten times the Massachusetts compulsory bodily-injury limit.
Check which category your work falls in before you buy to a tier. Demand-response trips are governed separately by §3.6.B, which sets a flat floor of $250,000 per person / $500,000 per occurrence bodily injury plus $50,000 property damage, with no capacity tiers at all — and the Enhanced Wheelchair Van (ECCS) standards carry the same flat floor. A demand-response or chair-car provider who reads the table below as their requirement can end up buying limits their contract never asked for.
| Seating capacity (including driver) | Minimum auto liability |
|---|---|
| 1–5 | Bodily injury $250,000 per person / $500,000 per accident, plus property damage $50,000 |
| 6–8 | $500,000 combined single limit |
| 9–15 | $1,000,000 combined single limit |
| 16 or more | $5,000,000 combined single limit |
Two things sit on top of that table. First, it is a floor, not a ceiling — a higher limit governs where one is required by an Agency, by the Broker, or by Massachusetts Department of Public Utilities regulation. 220 CMR 152.02 sets its own minimum financial responsibility for the carriage of passengers for hire at $1,500,000 for 15 or fewer passengers and $5,000,000 for 16 or more, and where it applies it overrides every contract tier below $1.5 million. Note that the two schedules count differently — the DPU rule counts passengers, the HST tiers count seats including the driver — so they do not line up at the boundaries. Whether the DPU rule reaches your operation depends on how you are licensed; bring that question to us and to your attorney before you set a limit.
Second, and this is the line worth money to you: at nine seats and above, the required limit may be met by combining your business auto policy with an umbrella or excess policy rather than buying the entire limit as primary auto. For a small operator running a couple of wheelchair vans, that difference is real.
The $5,000,000 tier applies to Massachusetts Program-Based Transportation work at 16-plus seating capacity — it is not limited to carriers crossing state lines.
The part nobody warns you about
An expiring certificate of insurance is not a grace-period situation. Under the MART brokerage contract, updated certificates are due to the contract department by 12:00 PM three business days before expiration. If compliance has not been met by that point, at 1:00 PM that day the work is reassigned and the provider is placed on hold until compliance is verified.
Read that again in terms of your bank account. Your policy has not lapsed. Your coverage is fine. You simply did not get a piece of paper to a compliance inbox by noon — and your trips are now someone else's, and stay someone else's until you fix it.
MART's own contract language says providers should have their insurance agents email updates directly to MART at its compliance address. That is a task with a due date and a consequence, and it belongs to your agent — which is why it is worth asking any agency you talk to how they track it.
How Prevent will handle it: we calendar renewal certificates against the broker's deadline rather than the policy expiration date, and send them to the broker's compliance address directly. Chasing that paperwork should not be your job.
Insurance is one section of a longer compliance obligation. Expect the broker contract and the program standards to also require, in some combination and with details that vary by broker and service category:
There is a separate set of enhanced standards for wheelchair-van service. If you are running or planning chair-car work, read the enhanced wheelchair van standards alongside the general provider standards — they are a distinct document and they carry additional obligations.
Two practical points come up on nearly every wheelchair-van submission, and both are cheap to fix before an underwriter or an inspector asks:
Whether any specific carrier will write a wheelchair-equipped vehicle depends on that carrier's own appetite and vehicle rules, which differ between programs. We will not pretend otherwise on a web page — send us the vehicle schedule and we will find out for your actual fleet.
Here is a genuine conflict worth raising with your agent early. Broker contracts can permit drivers considerably younger than the standard livery insurance market is comfortable with, while standard livery programs commonly decline drivers under 25 outright.
If you staff to the broker's minimum, you need a market that will accept your actual driver schedule. That is a question to bring to an agent before you hire, not after your submission comes back declined.
Some operations need a specialty market rather than a standard NEMT program. Tell your agent up front if any of this describes you, because it changes where the submission goes:
If you read that list and recognised your own operation, that is not bad news. It means the submission needs to start in the right place.
For Program-Based Transportation, business auto liability at the tier matching your largest vehicle's seating capacity including the driver — from $250,000/$500,000 with $50,000 property damage at 1–5 seats up to $5,000,000 combined single limit at 16 or more. Demand-response work instead carries a flat $250,000/$500,000 plus $50,000 property damage floor. On top of that: workers' compensation and employer's liability covering drivers and monitors, usually an umbrella or excess policy, and specific additional-insured, primary and non-contributory, waiver-of-subrogation, and notice-of-cancellation endorsements. Verify the current schedule in your own contract.
The Commonwealth of Massachusetts, EOHHS, the HST Office, and the Broker, together with their officers, directors, and employees, and any covered Agencies of the brokerage and their agents — on the automobile and umbrella/excess policies, primary and non-contributory. Additional-insured status does not apply to the workers' compensation policy; that policy carries a certificate-holder requirement instead.
The workers' compensation and employer's liability policies only, in favor of the HST Office and the Broker. The waiver does not extend to the auto and excess policies — guidance that tells you to add one there is not matching the contract.
Under the MART brokerage contract, updated certificates are due to the contract department by 12:00 PM three business days before expiration. If compliance is not met, at 1:00 PM that day the work is reassigned and the provider is placed on hold until compliance is verified. Your coverage can be perfectly valid and you can still lose the trips.
For seating capacity of nine and above, the contract allows the required limit to be met by combining the business auto policy with an umbrella or excess policy. This is usually the most economical way to reach the limit. Confirm the wording in your own contract before relying on it.
MART's contract states that effective May 1, 2026 it will not accept new provider applications from May 1 through July 31 each year, leaving an application window of August 1 through April 30. Confirm current dates directly with MART before planning around them.
Yes. The contract requires workers' compensation covering drivers and monitors. If you staff attendants on wheelchair runs, make sure your policy and your payroll classifications reflect them.
Ask before you do it, not after. Your contract specifies the endorsements your certificate must carry, and your existing policy either supports them or it does not — that is a document question with a definite answer. Send us the policy and the insurance page of your contract and we will tell you where you stand.
Yes — Prevent serves clients natively in English, Spanish, and Portuguese. Contracts, endorsements, and certificate wording are hard enough in your first language. Call (617) 913-4859 or message us on WhatsApp and we will handle it in whichever you prefer.
The insurance page of your broker contract, your current declarations page, and your vehicle and driver schedules. That is everything we need to tell you whether your next certificate will pass — in English, Spanish, or Portuguese.
This page is general information for Massachusetts non-emergency medical transport operators. It is not legal advice, not a quote, and not a promise of coverage or of acceptance by any insurer or transportation broker. Coverage is subject to carrier underwriting, policy terms, and eligibility, and is bound only when confirmed in writing by an insurer. Program requirements are revised annually and vary by broker and service category — verify current requirements with the applicable broker and agency before relying on them.
Prevent Insurance Agency is an independent insurance agency. We are not affiliated with MassHealth, EOHHS, the HST Office, MART, or GATRA, we do not decide provider admission, and we play no part in trip assignment or claims steering.