National NEMT insurance · A division of Thrive Risk Management CA License #6012320
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Texas · Medical Transportation Program (MTP)

Texas NEMT insurance, built for Texas Medicaid.

Coverage for Texas MTP providers — built for TxDMV livery plates, DPS inspections, and the Modivcare, MTM, and SafeRide networks navigating a fast-changing 2025–26 broker landscape.

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Structured for Modivcare, MTM, SafeRide Health (2026 changes) credentialing
$500K livery floor by statute; $1M–$1.5M CSL via brokers
Specialty & E&S markets that write TX livery risk

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Texas NEMT, in plain terms

Texas delivers Medicaid transportation through a hybrid of regional managed-transportation organizations, full-risk brokers, and the health plans’ own NEMT vendors — and the broker landscape changed materially in 2025–26. If you run MTP trips, who you credential with (and at what limits) is a moving target. Here is how it works and what your coverage needs to do.

How NEMT works under the Medical Transportation Program (MTP)

Texas’s Medicaid transportation benefit is the Medical Transportation Program (MTP), run by the Health and Human Services Commission (HHSC). Delivery is a hybrid: NEMT flows through managed-transportation regions, with HHSC contracting Managed Transportation Organizations (MTOs) and, in the Dallas–Fort Worth and Houston/Beaumont areas, Full-Risk Brokers — and, increasingly, through the managed-care plans’ own NEMT vendors. Providers enroll in Texas Medicaid through TMHP’s PEMS system and then credential separately with each plan’s NEMT broker.

A broker landscape in flux (2025–2026)

Texas has seen unusual broker movement that directly affects which network you contract with:

  • SafeRide Health became the NEMT vendor for UnitedHealthcare Community Plan of Texas effective January 1, 2026, adding to its Texas Children’s Health Plan and Superior HealthPlan STAR+PLUS work.
  • Modivcare and MTM remain major contracted networks across the regions.
  • Each network sets its own limits and credentialing — Modivcare, for example, typically looks for roughly $1.5M CSL commercial auto, $1M/$2M GL, workers’ comp, and a SAM rider, with the broker as additional insured.

Texas livery licensing and the $500K floor

Texas sets a higher for-hire floor than its standard commercial-auto minimum. Livery (for-hire passenger) operations must carry $500,000 liability — above the ordinary 30/60/25 commercial-auto minimum — and NEMT broker networks routinely push that to $1M–$1.5M CSL. On the vehicle and driver side, Texas requires TxDMV registration in the business name, TxDMV livery plates, annual DPS commercial safety inspections, and an extensive driver file: a clean three-year MVR pulled annually, DPS and FBI fingerprint-based background checks, sex-offender and exclusion-list screening, a drug screen, and PASS or NEMTAC driver certification.

Texas NEMT — Frequently Asked

Questions Texas operators ask.

How much commercial auto liability does Texas require for NEMT?
Texas requires for-hire/livery passenger operations to carry $500,000 in liability — higher than the standard 30/60/25 commercial-auto minimum. That is the legal floor, but it is rarely the operative number: the Medicaid broker networks you credential with (Modivcare, MTM, SafeRide) typically require a $1M to $1.5M combined single limit, often with CSL language rather than split limits, plus general liability, SAM, and workers’ comp. We structure to the broker requirement, not just the state floor, so your certificate clears credentialing the first time.
My broker is changing in 2026 — does my insurance need to change too?
Possibly. Texas saw real broker movement in 2025–26 — SafeRide Health picked up UnitedHealthcare’s Texas NEMT effective January 1, 2026, among other shifts — and each network can require different limits, additional-insured wording, and a SAM rider. When the network you contract with changes, the certificate of insurance usually has to be re-issued to name the new broker correctly and meet its specific limits. We re-cut COIs to match whichever network you’re moving to so there’s no gap in your credentialing.
Why won’t my regular commercial auto policy cover NEMT?
Standard personal and most standard commercial fleet policies specifically exclude “for-hire livery” — carrying passengers for payment. NEMT is a livery operation, so insurers treat it as a separate, higher-risk class that needs a for-hire passenger endorsement on a commercial auto policy. On top of the exclusion, NEMT carries exposures most standard carriers avoid: medically fragile passengers, constant high-mileage use, and loading/unloading assistance. As a result, much of the market is written through specialty and Excess & Surplus (E&S) carriers. Running NEMT on a standard policy risks a denied claim and won’t satisfy Medicaid or broker credentialing requirements.
What insurance do brokers like Modivcare, MTM, and Verida require?
Requirements vary by broker and by state contract, but a typical credentialing stack is commercial auto liability, general liability, sexual abuse & molestation (SAM) coverage, and workers’ compensation if you have employees. Many state Medicaid programs and brokers treat $1M combined single limit (CSL) as the practical floor for auto — some networks require $1.5M — and they often require CSL language rather than split limits, plus continuous (no-lapse) coverage and a certificate naming the broker as additional insured. We confirm the exact limits in your broker’s current provider manual and build the certificate to match.
Other States

NEMT insurance in other states.

California · Medi-Cal NEMT & NMTFlorida · Statewide Medicaid Managed Care (SMMC) — NETNew York · Medicaid Transportation via MASPennsylvania · Medical Assistance Transportation Program (MATP)Georgia · Non-Emergency Transportation (NET)

Need a Texas certificate that clears credentialing?

Tell us your vehicles, your broker, and your loss history — we’ll confirm we can write Texas and structure the limits to match.

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