The Important Role Played By The Health Care Navigator

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 navigator system was an integral part of the law, and designed to ensure that millions of previously uninsured citizens would not be confused as they acquired their new medical insurance policies. These navigators were intended to serve as guides through what can be a complex and frustrating process. As such, they have a very critical role to play in the implementation of the law as it moves forward.

The duties of these navigators are clearly laid out by the new law. Their primary obligation is to ensure that customers have access to all the necessary information about the various medical policies available to them. These guides also help consumers navigate the enrollment process, including obtaining any financial assistance for which they might be eligible.

That requires that navigators distribute critical information to the communities they serve. They are to let customers know about qualifying policies, identify the requirements for financial aid, and direct citizens to the appropriate exchanges. As part of that duty, they must also ensure that the delivery of this information is consistent with the language needs and cultural sensitivities of those communities they serve.

In the event that any of these guides are unable to assist their customers in the enrollment process or with payment assistance, they have a duty to refer those consumers to the appropriate government or private entity. This usually involves a referral to an ombudsman, consumer assistance service, or some other governmental agency that can assist with any grievances or problem resolution.

There are several different types of people or associations that can serve in this role. Non-profits in the community are eligible, as are unions and various trade groups. The local chamber of commerce can even provide this service, as can insurance agents if they adhere to the law's dictates. Those requirements are there so that agents cannot profit in an unethical manner.

The exact requirements asked of any of these guides was clearly set out by the government before implementation began. There are also guidelines that detail which navigators are eligible for the many grants that can be provided for this service. As a general rule, all of these guidelines are set up to prevent profiteers and avoid the conflicts that often arise when various interests collide in the servicing of any marketplace.

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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