With the passage of the Affordable Care Act (ACA), also known as ObamaCare, health insurance options changed for many Americans. However, because of technical difficulties and the complexity of health insurance, many citizens may have difficulty understanding their available options and correctly applying for health insurance.

Fortunately, ObamaCare provides $67 million in funding to form a group of people called “navigators” to assist with informing those who apply through the Federal exchange. (Individual states that are running their own exchanges have their own funds and grant funding from HHS to help pay for their own navigators.)

ACA navigators are individuals who are trained to understand the complexities of the insurance laws and help people understand the federal Marketplace or the marketplace in their state, the insurance options available, and how to enroll in a plan that is right for them.

Responsibilities of Navigators

According to the ACA, individuals who are trained as ACA navigators have several responsibilities. They must:

  • Have appropriate training and have no conflict of interest with any element of the health insurance marketplace
  • Maintain expertise in eligibility, enrollment, and health insurance program specifics
  • Provide information to consumers about the full range of available Qualified Health Plans (QHP) in the state in a fair and impartial manner
  • Inform consumers about options regarding insurance affordability, including premium tax credits, cost-sharing assistance, and Medicaid or Children’s Health Insurance Plan (CHIP) eligibility
  • Help citizens select and enroll in an appropriate health insurance plan
  • Provide information in a manner that is culturally and linguistically appropriate, including helping those with limited English skills and those with any disability

The Effect of Navigators

With the difficulties that the Healthcare.gov and various state sites have experienced since their launch in October of 2013, ACA navigators have been even more vital than expected. WebMD reports that navigators were able to help citizens of many states to submit paper applications or apply by phone. This in-person assistance put to rest people’s fears and helped people who could not access Healthcare.gov understand their full range of options. At present, many Americans are not ready to choose a health plan immediately, and navigators in many states are scheduling follow-up meetings at a later date, when technical issues are less of a problem.

Some states have had concerns about the role of ACA navigators. Florida officials debated what information navigators would have access to, and Ohio created regulations that made it harder for ACA navigators to get certified.

Finding an ACA Navigator Near You

It’s easy to be overwhelmed by the number of options available, especially if you’ve never had health insurance before. If you have any questions or concerns about the federal Marketplace or the marketplace in your state, there are trained ACA navigators available to help you. To find navigators near you, you can visit the Healthcare.gov Local Help page. This site will provide all of the organizations that can assist you with your application and help answer other questions you may have. In addition, answers are available online and through the toll-free call center set up to help Americans with questions and health insurance enrollment.

ObamaCare gives Americans additional options for health insurance coverage, but understanding these options can be confusing. Provisions were made in the law to provide funding for trained navigators to walk people through the application and purchase process to combat this confusion.

 

Sources

http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/navigator-foa.html

http://www.webmd.com/health-insurance/20131030/health-care-navigators-bypass-glitches

https://localhelp.healthcare.gov/

https://www.healthcare.gov/contact-us/