Medicare’s annual open enrollment period typically lasts about two months in the fourth quarter of the preceding year, usually from October to December. But even after enrollment is over, help is available in the form of federally funded “navigators” to help seniors make sense of the complicated world of Medicare. Additionally, grant money for these programs significantly increased during the last enrollment period.
In which states are navigators available?
Resources are available for Medicare customers all over the country, but federal grant-funded navigators are found in 30 states. The online marketplaces where people can sign up for Medicare differ state to state: 20 states (plus the District of Columbia) have their own state-run Medicare marketplaces, and the other 30 use a federal marketplace, launched in 2013, where customers can compare and select Medicare plans.
In each state with a federally facilitated marketplace (FFM), the federal government provides one or more nonprofit organizations with grant money to make Medicare navigators available to the public. In all, 59 organizations receive funding for navigators—money that’s authorized under the Affordable Care Act. According to the U.S. Department of Health and Human Services, approximately 1,500 navigators are available nationwide.
What can a navigator do for me?
Navigators exist to help potential Medicare customers know what programs and possible discounts they may qualify for while working through the online Medicare marketplace.
“[Navigators] provide outreach and education to raise awareness about the Marketplace, and refer consumers to health insurance ombudsman and consumer assistance programs when necessary,” reads a write-up on navigators from the Centers for Medicare and Medicaid Services. “Navigators operate year-round—increasing awareness among the remaining uninsured about the coverage options available to them, helping consumers find affordable coverage that meets their needs, and assisting consumers beyond the enrollment process to ensure they’re equipped with the tools and resources needed to utilize and maintain their health coverage all year.”
Navigators operate year-round—increasing awareness among the remaining uninsured about the coverage options available to them…
Navigators must also pass background checks and go through federal and state training before working with customers.
More funding than ever for navigators
The Kaiser Family Foundation reports $80 million in funding was distributed for navigators nationwide before the previous enrollment period—more than has ever been made available. The previous high bar was $63 million in 2016, and from 2018 to 2020, only $10 million was budgeted for navigators each year.
According to an HHS statement, the extra money means there will be significantly more navigators and will allow navigators to better reach underserved communities—for example, by training navigators to work in languages other than English and placing more navigators in rural communities. In the statement, Chiquita Brooks-LaSure, administrator of CMS, said navigators “build relationships and trust” within their communities.
“These Navigators consistently help consumers understand their options, helping with potential language and other barriers, so they can find health coverage that best fits their needs,” she said. “With this additional grant funding, even more Navigators will be able to provide comprehensive assistance through customized educational and outreach activities, especially to underserved communities.”