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What is a Health Enrollment Navigator?

Posted by Simone Isadora Flynn, PhD, NPA Project Manager-Leveraging Social Media February 6, 2014 at 5:24 PM

NPA board member Rachel DeGolia serves as a health navigator in Ohio, helping consumers understand and access their insurance options.

On February 3rd, DeGolia spoke at a news conference in Cleveland with Health and Human Services (HHS) Secretary Kathleen Sebelius and Cleveland Mayor Frank Jackson to help raise awareness of enrollment navigators and to underscore the availability of assistance.

U.S. Department of Health and Human Services Secretary Kathleen Sebelius speaks to a Cleveland audience with Mayor Frank G. Jackson and CHAP Navigator Rachel Rosen DeGolia

U.S. Department of Health and Human Services Secretary Kathleen Sebelius speaks to a Cleveland audience with Mayor Frank G. Jackson and CHAP Navigator Rachel Rosen DeGolia

Here are DeGolia’s remarks from the news conference:

I am an ACA Enrollment Navigator. I’ve been working as a Navigator since last fall, but I’ve been involved with our health care system a lot longer than that.

I’ve helped my daughters get health care as young adults when they had to do it on their own and it was still legal for insurance companies to deny for pre-existing conditions. I’ve helped my elderly parents steer through the system as they coped with illness and aging.

I am married to a physician who takes care of low income elders who often could not afford all their medications and tests. I have been a patient in our health care system for all my 60 years, and for the last 35 I have had to change doctors every time my husband changed jobs. And, I have been working in a health care advocacy organization for over 20 years.

So, when I hear the criticisms about how complicated the Affordable Care Act is, here’s the way I see it: The American health care system has been complicated since the day I was born. This is the first time there have ever been unbiased navigators to help guide people through purchasing and using their health insurance.

Hardly anybody understood the insurance they had, if they had insurance, BEFORE the ACA. The navigators are the first chance anybody has ever had to get someone who is unbiased and trained to help them walk through the process to get the best coverage they can get.

Right now there are Navigators like me in health care clinics all over Northeast Ohio. People make appointments to see us or just walk in. We sit down with you and depending on your income, we help you sign up for either Medicaid or private insurance in the Marketplace. Sometimes it takes more than one visit if there is more information needed or decisions that require a little extra time for you to think about.

We also help people understand how their insurance will work after they’ve signed up – the premiums and deductibles and co-pays. It’s your choice what to sign up for, but we try to make sure you have all the information you need to make the best decision for yourself and your family.

In Cleveland people live around the corner from some of the best health care institutions in the world, but many have not been able to get in the door. This law – the ACA – is going to get a lot more people a lot more health care. I see it every day in my work as a Navigator.

We all know it’s the moms who pay the most attention to health care in their families. I’ve had mothers bring their 20-something sons in to see me to get them signed up for insurance for the first time in their lives.

I’ve helped people who work hard at jobs like roasting peanuts in a nut factory and providing child care and working for a temp agency until they can get a permanent job. We can help people whose jobs don’t provide health insurance and we can even help people whose jobs do provide insurance, but it’s insurance they can’t afford.

We’re here in this wonderful library. If you are someone who doesn’t have health insurance, please go online to healthcare.gov – ask your librarian to help you if you don’t have a computer – and type in “Local Help” to find a navigator near you. Or, even easier in Northeast Ohio, just call 211 anytime, 24 hours a day, seven days a week, and trained staff will help you find a navigator or education and enrollment event near you. You might be surprised to find out that there is health insurance you can actually afford.

My main point is that getting health insurance is still more complicated than any of us would like, but for the first time, thanks to the Affordable Care Act, there’s help.

I hope that 5 or 10 years from now, or maybe sooner, we won’t need navigators in a wealthy country like ours. But as long as we do, I’m proud to be one.

The event was widely attended by media and DeGolia was quoted in an article in the Plain Dealer:

“In Cleveland, people live around the corner from some of the best health care institutions in the world, but too many have not been able to get in the door,” Degolia said. “Getting health insurance is still more complicated than any of us would like, but for the first time, thanks to the Affordable Care Act, there’s help.”

In 2012, Rachel DeGolia received the Families USA Consumer Health Advocate of the Year Award.

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