A Health Care Navigator Plays A Critical Role For Helping The Uninsured

By Beryl Dalton


As with many new laws before it, the Affordable Care Act has created a great deal of confusion in the marketplace. There are many ordinary Americans who have found the law's new mandates that they acquire health insurance a source of frustration, since they are generally unfamiliar with the medical coverage market. The good news is that a competent health care navigator can help in that process.

The Act's designers anticipated the confusion and included the provisions for navigators as a means of addressing it. They knew that consumers might in some cases need the assistance of these guides to help them work their way through the complexities inherent in the new system. That's why these navigators have been given such a critical role in the implementation of the Act at the point where consumers need help the most.

As this law currently stands, navigators have several key duties that must be carried out. First and foremost among those duties is their obligation to provide the public with information about the availability of medical coverage plans that meet the requirements set out by the Act. At the same time, they are charged with facilitating consumer enrollment in plans that meet those requirements.

To accomplish those goals, the guides must provide critical information to the communities they serve. This involves helping to match consumers to the policies that best serve their needs. It also involves helping citizens to calculate the government assistance they may be eligible for in the form of subsidies. And, of course, all of this communication should be delivered while being sensitive to the language used by the community and its unique culture.

There are times when these helpers are unable to assist their customers with aid packages or enrollment concerns. At such times, the navigation program requires that consumers be directed to various government offices or private assistance. In most cases, such referrals end up with consumer assistance or an ombudsman. These agencies and officials are uniquely qualified to deal with a variety of problems and complaints.

The law details a variety of individual and group types that can qualify as navigators. These include various community non-profit organizations, trade and professional associations, local chambers of commerce, and unions. Licensed insurers can also qualify under certain circumstances, though strict guidelines are in place to prevent any agents from profiting from these policy acquisitions.

As the government selected the qualifications for these positions, it also set specific rules in place to determine how grant money is distributed for these positions. The proponents of this law made it clear that their ultimate goal in setting up these grant guidelines was to prevent the possibility of any conflicts of interest that might have otherwise easily crept into this system.

It is true that much of the country continues to debate the efficacy of the new law. Regardless of one's opinion on that matter, however, there is no disputing the critical role that the new navigators have in helping frustrated consumers locate the policies they need. For those citizens in desperate need of help to obtain those policies, that is very good news indeed.




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By Beryl Dalton


As with many new laws before it, the Affordable Care Act has created a great deal of confusion in the marketplace. There are many ordinary Americans who have found the law's new mandates that they acquire health insurance a source of frustration, since they are generally unfamiliar with the medical coverage market. The good news is that a competent health care navigator can help in that process.

The Act's designers anticipated the confusion and included the provisions for navigators as a means of addressing it. They knew that consumers might in some cases need the assistance of these guides to help them work their way through the complexities inherent in the new system. That's why these navigators have been given such a critical role in the implementation of the Act at the point where consumers need help the most.

As this law currently stands, navigators have several key duties that must be carried out. First and foremost among those duties is their obligation to provide the public with information about the availability of medical coverage plans that meet the requirements set out by the Act. At the same time, they are charged with facilitating consumer enrollment in plans that meet those requirements.

To accomplish those goals, the guides must provide critical information to the communities they serve. This involves helping to match consumers to the policies that best serve their needs. It also involves helping citizens to calculate the government assistance they may be eligible for in the form of subsidies. And, of course, all of this communication should be delivered while being sensitive to the language used by the community and its unique culture.

There are times when these helpers are unable to assist their customers with aid packages or enrollment concerns. At such times, the navigation program requires that consumers be directed to various government offices or private assistance. In most cases, such referrals end up with consumer assistance or an ombudsman. These agencies and officials are uniquely qualified to deal with a variety of problems and complaints.

The law details a variety of individual and group types that can qualify as navigators. These include various community non-profit organizations, trade and professional associations, local chambers of commerce, and unions. Licensed insurers can also qualify under certain circumstances, though strict guidelines are in place to prevent any agents from profiting from these policy acquisitions.

As the government selected the qualifications for these positions, it also set specific rules in place to determine how grant money is distributed for these positions. The proponents of this law made it clear that their ultimate goal in setting up these grant guidelines was to prevent the possibility of any conflicts of interest that might have otherwise easily crept into this system.

It is true that much of the country continues to debate the efficacy of the new law. Regardless of one's opinion on that matter, however, there is no disputing the critical role that the new navigators have in helping frustrated consumers locate the policies they need. For those citizens in desperate need of help to obtain those policies, that is very good news indeed.




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