The Important Role Played By The Health Care Navigator

By Beryl Dalton


Many people are still struggling to deal with the process of acquiring the medical coverage policies mandated by the passing of the Affordable Care Act. In many instances, enrollment can be extremely confusing, especially for those who were previously uninsured. To help with that confusion, a health care navigator can be absolutely indispensable.

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.

This entails the distribution of information to all who need it. This information is supposed to include details about the types of plans that currently qualify, as well the various types of credits and financial assistance that can be found in the various exchanges. In addition, all of the information must be presented in a manner comporting with the language and cultural needs of the relevant community.

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.

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.

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.

Even in the midst of an ongoing national debate over the details and merits of the Affordable Care Act, the importance of these navigators is clear. The issue of medical care and insurance remains a complex subject for most people, and becoming insured is often no easy task for many disadvantaged individuals. Thankfully, this system of guidance was designed to ease any difficulties and assist everyone in more easily obtaining the policies the law requires.




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