Good Samaritan and PACE Community Action Agency have recently started working
together to provide a Health Care Navigator to patients at Good Samaritan’s
Primary Care Clinic.
Health Care Navigators are certified by both the state and federal government
through training and testing. Once certified, navigators are competent
to assist consumers to obtain insurance by evaluating their individual
needs, usually through the Marketplace, Medicaid, or HIP 2.0. Individuals
sign a consent form to release their information to the navigator. No
personal information, other than name and telephone number, is kept by
the navigator for enrollment purposes only.
Patients of the Primary Care Clinic can be assisted, with no fee, by the
navigator through the enrollment process after their appointment at the
clinic. The navigator explains the options available to the consumer based
on their information. The consumer then chooses which plan they feel will
meet their needs and enroll. The navigator will then tell the consumer
what to expect next, such as receiving an eligibility notice. Consumers
are directed to contact their navigator if they have any questions with
any post enrollment issues.
“We partner with most organizations throughout our service area” stated
Bertha Proctor, CEO of PACE Community Action Agency. “While in discussion
with Rob McLin, we agreed that this service is beneficial for individuals
in our community. Good Samaritan and PACE serve some of the same individuals,
and both organizations work to improve the lives of those in our community.”
Navigators play a vital role in helping consumers prepare paper and electronic
applications to establish eligibility and to enroll in health insurance
coverage through the Marketplaces and potentially qualify for an affordable
insurance program. Patients have someone they can go to for accurate and
timely information; someone they can go to for assistance in the application
process as well as application follow-up. “Many of the patients
seen at the Primary Care Clinic are underinsured or do not have any health
insurance at all,” stated Rob McLin, President and CEO of Good Samaritan.
“We want to help our patients understand everything they need to
know about their health care benefits. The Navigator is able to sit with
patients one-on-one and discuss all the options that are available.”
The PACE Navigator provides assistance to those who enroll in insurance
and HIP. Most individuals will receive “the letter” from Indiana
Medicaid requesting additional information for verification purposes.
If this information is not returned to Medicaid within a set time frame,
that application is denied and it is as though they never applied. The
Navigator helps the consumer understand what is being requested in “the
letter”, where they can obtain this information if they do not have
it, how the individual can mail or fax it to Medicaid at no charge.
“Our patients have really benefited from having the Navigator at
the clinic once a week,” said Jane Russell, Director of Continuum
of Care. “We are still in the early stages of this partnership with
PACE, but I am excited to see what the future holds.”