Last year’s Open Enrollment Period, the first opportunity for many U.S. Americans to enroll for health insurance in the new Marketplace, was a learning experience for everyone involved. This time, MHP Salud’s Navigator knew from the start what it would take to offer consumers a path to health insurance.
“It has gone quite a bit smoother this time around,” said Program Director Cliff Clark. “We’ve had people walking into the office, and we haven’t even put our sign outside.”
The Navigator program employs Community Health Workers (CHWs) as bilingual educators and assistants for anyone seeking health insurance through the new Marketplace in south Texas. Of the nearly 9,000 people the team reached last year, some are coming back to re-enroll or renew their plans, and this year they’re bringing their friends.
“I think that’s pretty cool; it’s nice to have a reputation that we offer services where people know they can come in and at least leave with more information if we can’t get them health insurance for some reason,” said Clark.
Part of the way the team has gained credibility is the way they go the extra mile to help their consumers. The Navigator team has been holding one or two enrollment events every week since the enrollment period began, and the Weslaco, TX office is abuzz with the conversations between Navigators and walk-in enrollees all day. In the waiting room, they provide educational printed materials to consumers, and even if a consumer doesn’t qualify for discounted health insurance due to the Medicaid coverage gap in Texas, the team ensures the consumer doesn’t have to pay a penalty for being uninsured.
The program employs seven full-time Community Health Workers who go through 20 hours of Centers for Medicare and Medicaid Services training as well as 20 hours of Texas-specific training to become certified Navigators in the state of Texas.
One of those trained and certified Navigators is Aracely Gutierrez. She joined the Navigator team before open enrollment last November. She’s had a long history of serving her community, teaching at her local Migrant Head Start program, serving as a family service advocate and even driving bus routes.
“This year, I see there are more resources for us. At the beginning of the first Open Enrollment, everybody was learning at the same time, and there weren’t as many resources as we see now,” she said.
She uses the CMS webinars and fact sheets to stay up-to-date with her information. Even with all that preparation, however, the process can always be complex and take as long as a couple hours. She says the hardest part of being a Navigator is educating the consumer, when they’re getting health insurance for the first time.
“It takes a long time explaining what premium is, how a deductible works, people’s out of pocket expenses and setting them up with a primary doctor,” she said.
All the effort is worth it, says Gutierrez, when she sees that she’s made a difference.
She recalls one consumer whose parents were both recent immigrants in their 70s, and they didn’t have enough credits to apply for Medicaid or Medicare, so they had no insurance. She explained to him that they might qualify for a tax credit as dependents in the Marketplace, and they agreed to be led through the application process. In the end, both parents got enrolled in insurance for the first time.
“To me that was ‘wow.’ I really remember that story,” said Gutierrez. “When you do a full enrollment, and when they know they got insurance with an affordable plan, that’s very rewarding. It’s all part of being a Promotora, helping out the community and educating the consumers.”