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 Act's designers anticipated the confusion and included the provisions for navigators as a means of addressing it. They knew that consumers might in some cases need the assistance of these guides to help them work their way through the complexities inherent in the new system. That's why these navigators have been given such a critical role in the implementation of the Act at the point where consumers need help the most.

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.

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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