Moonlighting and Locum Tenens Malpractice Insurance for Physician Assistants (What’s Covered, What’s Not, and How to Avoid Gaps)

Fast links:

• PA Insurance Guide

• PA Cost by State (2025) data

• Claims-Made vs Occurrence for Physician Assistants

• Arizona Physician Assistant Insurance

• Florida Physician Assistant Insurance

• Pennsylvania Physician Assistant Insurance

• New York Physician Assistant Insurance

• California Physician Assistant Insurance

• Texas Physician Assistant Insurance

• Tennessee Physician Assistant Insurance

• North Carolina Physician Assistant Insurance

• New Jersey Physician Assistant Insurance

moonlighting and locum tenens malpractice insurance for physician assistants

If you work extra shifts, travel assignments, or independent telemedicine consults, your employer policy probably doesn’t follow you. Moonlighting and locum tenens malpractice insurance for physician assistants fills that gap—protecting you across multiple worksites or states while keeping your retroactive date intact.

There are two main coverage paths:

1. A personal PA policy you control (your limits, states, defense structure).

2. A locum-agency policy written for each assignment (site-specific, temporary).

Why employer coverage usually doesn’t fit side work

Employer policies protect the facility’s risk, not the individual. Most exclude non-employer activities like moonlighting, med-spa work, or telemedicine platforms. They also:

• Use shared limits that can be depleted by other clinicians.

• Offer little to no tail if you leave.

• Control defense counsel and settlement decisions.

Your own policy gives you portability and control over limits, endorsements, and defense quality.

Agency policy vs personal policy vs employer policy

Multi-state reality: coverage follows the patient

For telemedicine or locums, coverage typically keys to the patient’s location, meaning you must:

• Be licensed in each patient’s state, and

• Have those states scheduled on your policy.

If you rotate among several states per quarter, update your schedule before you start care.

For local guidance, link to your state page. Tip - replace the state at the end with your state: https://www.careproinsurance.com/physician-assistant-insurance/new-york

Claims-made vs occurrence for moonlighting and locum tenens

• Claims-made: Covers claims filed while the policy is active for incidents on or after your retro date. If you stop or switch and the new carrier won’t carry prior acts, you need tail coverage.

• Occurrence: Covers incidents that occurred during the term, even if reported later—no tail for those acts. Availability may be limited and cost higher.

Deep dive: Claims-Made vs Occurrence for Physician Assistants

Part-Time vs Full-Time Rates: How to Lower Costs

Here’s where many PAs overpay. Most carriers offer part-time rates for clinicians averaging fewer than 20 hours per week or with reduced patient volume. If you’re moonlighting occasionally—or your locum schedule includes off-months—you can often qualify for discounted premiums without compromising coverage.

Key points:

• Declare accurate weekly hours or encounter volume when applying.

• Carriers may prorate exposure into tiers (e.g., 0-10 hrs, 11-20 hrs, 21+ hrs).

• Even at part-time, you can keep the same limits (1M/3M or 2M/4M).

• A part-time endorsement does not reduce your defense rights or retro date—it only adjusts your rating factor.

• If you increase hours later, notify your broker; carriers can re-rate mid-term.

Illustrative range (example only):

Classification	Hours/week	Approx. Annual Premium	Notes
Full-time PA (40+ hrs)	Standard	$2,000 – $2,300	Typical rating for general outpatient work
Part-time PA (≤20 hrs)	25–35% lower	$1,300 – $1,600	Common for moonlighters or locums with downtime

(Actual premiums vary by state, specialty, and carrier.)For reference, see PA Cost by State (2025) data

Tail, retro dates, and assignment timing

When switching agencies or taking a break, confirm whether your next policy will carry your retro date. If not, buy tail coverage within the required window. Align dates precisely—same-day bind/cancel—to prevent even a one-day lapse.

Defense structure and consent to settle

Prioritize defense outside limits (legal costs in addition to limits) and pure consent-to-settle language. Avoid “hammer” clauses that penalize you for declining a recommended settlement. When comparing 1M/3M vs 2M/4M limits, start here: Claims-Made vs Occurrence for Physician Assistants

Common moonlighting scenarios

1) Weekend urgent-care shifts outside your hospital

• Employer policy likely excludes outside shifts.

• Solution: Personal PA policy listing the urgent-care site(s) + state; verify board defense + HIPAA/privacy defense.

2) Med-spa aesthetic work one evening a week

• Clarify scope (injections, lasers, prescriptive skincare).

• Solution: Personal policy with procedure-appropriate endorsements; ensure consent forms and supervision/collab documents are tight.

3) 13-week locum in another state

• Agency requires its policy. Confirm limits, defense structure, and tail.

• Solution: Keep your personal policy active (portable retro date); schedule the new state if you’ll also see patients outside the agency’s site.

4) Telemedicine platform + in-person moonlighting

• Dual exposure: cyber/HIPAA + in-person procedures.

• Solution: Personal policy with telemedicine endorsement and scheduled states + consider cyber liability for first-party breach costs. See your cyber deep-dive: Physician Assistant Cyber Liability Guide

Contract language to negotiate

Include:

• Coverage responsibility (agency vs you) and limits

• Tail cost or prior-acts carry obligations

• Part-time definition and notification duties

• Consent to settle and defense structure

• Procedures & supervision spelled out

• State/site scheduling process

FAQs — moonlighting and locum tenens malpractice insurance for physician assistants

Can I buy a personal policy just for 10 hours/week? Yes. Many carriers rate by hours and classify under a part-time endorsement. You’ll typically retain identical limits and endorsements.

Can part-time coverage switch to full-time mid-term? Yes. Notify your broker; most carriers re-rate from the date of change.

Do part-time discounts affect my retro date or tail? No. Rating status only affects premium, not coverage structure or continuity.

Does an agency policy count as “proof of insurance”? Yes for that site only. Keep your personal COI for all other work.

Do I need separate policies for two part-time employers? If both allow personal coverage, you can often list both locations/states on one policy, saving cost and maintaining continuity.

What to do next

1. Know your price context: PA Cost by State (2025) data

2. Choose structure wisely: Claims-Made vs Occurrence for Physician Assistants

3. Get definitions & a shopping checklist: PA Insurance Guide

4. Localize & quote: Swap the state at the end to your state → https://www.careproinsurance.com/physician-assistant-insurance/new-york

Compliance note

Coverage descriptions are illustrative only. Each situation is underwritten. Availability and pricing vary by state, specialty, procedures, limits, carrier, and claims history. Common benchmarks include $1,000,000 per claim / $3,000,000 aggregate and $2,000,000 / $4,000,000 aggregate. Tail, prior acts, board defense, and HIPAA/cyber may be subject to endorsements and sub-limits.