Health Care Insurance Navigators

Health care insurance navigators are part educator, part adviser, and part facilitator. By law, their primary function is to provide public education about qualified health plans in the health insurance marketplace. This is generally facilitated by agencies (termed “navigator entities”) which apply for and are awarded federal grants to fulfill the intent of the ACA and employ the individual navigators. The ACA obligates the navigator to act in the unbiased, best interests of the consumer, and not any insurer. Though the navigators must have knowledge of the insurance industry and products, they are considered separate and distinct from insurance agents and brokers, who have vested interests in guiding consumers to certain products or plans.

Navigators meet with individuals or small business representatives to provide information about available health insurance plans offered by the marketplace, both private insurance plans and public benefits (such as Medicaid and low-cost family or child health plans offered by some states) including information and comparisons about benefits, costs, tax credits, and enrollment. The navigator must have the ability to present the information to the population being served and therefore must be skilled and sensitive to language and cultural differences among consumers. After providing relevant information which allows a consumer to make an educated choice about a specific health insurance plan, the navigator assists with the enrollment process and the completion of paperwork or online forms.

Navigators also refer consumers to appropriate resources to address problems and grievances. By law, there can be no costs or fees assessed to any consumers for the assistance of a navigator. Navigators are held to strict ethical standards with respect to confidentiality, avoidance of conflicts of interest, and lack of bias.