08/16/2013 09:09 AM EDT
Source: Centers for Medicare & Medicaid Services
Related MedlinePlus Page: Health Insurance
Related MedlinePlus Page: Health Insurance
The Center for Consumer Information & Insurance Oversight
In-Person Assistance in the Health Insurance Marketplace
Background
Starting October 1, 2013, consumers in all states will be able to choose new affordable health insurance options through a new Health Insurance Marketplace. Some states are setting up a State-based Marketplace, other states will work with the federal government in a State Partnership Marketplace and the remaining states will have a Federally-facilitated Marketplace.No matter what state they live in, consumers can get help as they apply for and choose new insurance options. You can help provide that assistance in a number of different ways: by becoming Navigators, in-person assistance personnel, or certified application counselors. In addition, agents and brokers can also help consumers enroll in new insurance options.
- Fact Sheet: Helping Consumers Apply & Enroll Through the Marketplace (PDF – 213 KB)
- CMS-9955-F: Patient Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non-Navigator Assistance Personnel; Consumer Assistance Tools and Programs of an Exchange and Certified Application Counselors - Opens in a new window
Navigators
Navigators have a vital role in helping consumers prepare electronic and paper applications to establish eligibility and enroll in coverage through the Marketplaces and potentially qualify for an insurance affordability program. They also provide outreach and education to raise awareness about the Marketplace, and refer consumers to health insurance ombudsman and consumer assistance programs when necessary. Navigators play a role in all types of Marketplaces, are funded through state and federal grant programs, and must complete comprehensive training.On August 15, 2013, CMS awarded $67 million in Navigator Cooperative Agreements to 105 entities to serve in the 34 Federally-facilitated and State Partnership Marketplaces.
Certified Application Counselors
The Federally-facilitated Marketplace will designate organizations to certify application counselors who perform many of the same functions as Navigators and non-Navigator assistance personnel—including educating consumers and helping them complete an application for coverage. An online application will be available at the end of July 2013 for organizations who want to become Marketplace-designated organizations that can certify application counselors. These groups might include community health centers or other health care providers, hospitals, or social service agencies. To be notified when the online application is available, visit Marketplace.cms.gov and sign up for email notifications and updates. A sample application is posted on this website in the meantime.- Guidance on Certified Application Counselor Program for the Federally Facilitated Marketplace including State Partnership Marketplaces [PDF, 78KB]
- Apply to be a Certified Application Counselor (CAC) Organization
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