Saturday, February 7, 2015

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

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.

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.

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.

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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