Navigating the New Health Insurance Marketplaces: In-Person Assistance Options for Consumers

Click here to download the publication as a PDF.

September 2013

The new health insurance marketplaces (also known as exchanges) provide consumers with a wide variety of ways to learn about and enroll in affordable health coverage. Consumers can create their marketplace accounts and complete the enrollment process online, by phone, in person, or through a traditional mail-in application. This fact sheet discusses four types of helpers consumers can contact when they need in-person enrollment assistance from a trained and certified person in their community.

1. Navigators and In-Person Assisters (IPAs)

Navigators and in-person assisters (IPAs) will be available in every state to help consumers with the new application and the enrollment process. These individuals and organizations are trained, certified, and paid by the new marketplaces to provide assistance in a fair, accurate, and impartial manner. They will also conduct public education activities to raise awareness about the new, affordable coverage options and provide referrals to other consumer assistance resources when appropriate. In most states, consumers can find out who in their community is participating in these enrollment assistance programs by going to their marketplace’s website.

2. Certified Application Counselors (CACs)

In an effort to increase the number of people who are prepared to provide in-person enrollment assistance, every health insurance marketplace is training and certifying organizations called certified application counselors (CACs) to help consumers apply for coverage. Many of these CAC organizations are already trusted sources of information for people who are uninsured. None of them will be paid by the marketplace for their work as a CAC. CACs are required to act in the best interests of applicants and to disclose any conflicts of interest to both the marketplace and to the consumers they serve. In most states, consumers will be able to find out which organizations are trained and certified as CACs by going to their marketplace’s website.

3. Community Health Centers

Community health centers have historically played an important role in providing enrollment assistance. Most have experienced staff members who are trained to help patients understand their health coverage options. In preparation for the opening of the new marketplaces, 1,159 health centers received a total of $150 million in federal funding to expand their enrollment assistance work and to prepare to help consumers with the new health coverage options. Many community health centers across the country are also providing enrollment assistance as navigators, in-person assisters, and CACs. To find the nearest community health center, consumers can go to findahealthcenter.hrsa.gov.

4. Insurance Agents and Brokers

Health insurance agents and brokers are licensed professionals who can help consumers and small employers select and enroll in health plans that are offered through the marketplaces. Each marketplace has the flexibility to determine the specific roles that agents and brokers will play in providing consumer assistance. Nearly all of the marketplaces plan to list on their websites the agents and brokers who are prepared to assist consumers with enrollment.

Download the publication as a PDF to see a table breaking down the differences between the four types of in-person assistance options.

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