Thursday 12 February 2015

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

By Beryl Dalton


As the Affordable Care Act continues to be implemented, many consumers are still struggling to navigate the new system and locate the right coverage to properly insure themselves. For some, this can be a frustrating experience as they try to comply with the law's requirements. For all of those people, a health care navigator can provide invaluable assistance.

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.

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.

Sometimes, problems will arise that the navigators cannot manage. This can involve anything from the actual choice of a policy to the availability of financial aid. In those instances, their duty is to send the customer to a private customer service or a government agency. Some grievances are relayed to an official ombudsman for more in-depth resolution of the problem.

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 government has established rules governing the exact details regarding who can qualify for these positions. In addition, there are specific criteria in place for determining which of these guides can qualify for grant money associated with enrollment activities. In principle, these requirements are designed to ensure that no conflicts of interest arise as the various communities are served by local navigators.

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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