The Important Role Played By The Health Care Navigator

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.

Under the current version of this law, there are a number of duties resting on the shoulders of the navigators. The chief obligation involves the dissemination of information about the Act and the medical plans that fulfill that law's basic mandates. They are also given the responsibility of making the enrollment process as convenient and easy as possible.

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.

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.

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 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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