Navigating Health Care

BayCare Health Care Navigators offer free assistance to help people understand their health care insurance options. The Department of Health and Human Services recently announced a new Marketplace Special Enrollment Period (SEP) from Feb. 15 through May 15, 2021 in response to the COVID-19 public health emergency. The SEP is available to all Marketplace-eligible consumers who are submitting a new application or updating an existing one.

Learn more about this SEP and BayCare’s health care navigators and the services and programs offered.
Navigating Health Care
Featured Speaker:
Maxine Ambrosino
Maxine Ambrosino is a licensed BayCare Health Care Navigator serving Hillsborough County. With BayCare since 2004 and a Health Care Navigator since 2017, Ms. Ambrosino is an integral part of the community she serves. She is one of 11 BayCare Health Care Navigators dedicated to helping patients and consumers with the Health Insurance Marketplace as well as providing community resources to anyone in need. Ms. Ambrosino has an extensive background in patient financial solutions at BayCare. Her commitment to sharing her knowledge of health care options has paved the way for many in the community to have access to health care. She is a dedicated wife and mother of five and enjoys serving her community.

Learn more about BayCare’s health care navigators and the services and programs offered
Transcription:
Navigating Health Care

Introduction: Here's another edition of the BayCare Health System’s podcast series, BayCare HealthChat with Melanie Cole.

Melanie Cole: Welcome to BayCare HealthChat. I'm Melanie Cole, and today we're discussing navigating the health care system. Joining me is Maxine Ambrosino. She's a Health Care Navigator with BayCare and a Licensed CMS Marketplace Navigator. Maxine, it's a pleasure to have you join us today. So, tell us what is a licensed health care navigator? What do you do?

Maxine Ambrosino: A licensed health care navigator are licensed under the Center for Medicare and Medicaid Services or CMS. Trained to provide unbiased information about health care options to people as they look for health insurance options through the marketplace, including completing eligibility and enrollment forms. Navigators are also able to assist with other coverage options such as Medicaid and children's health insurance programs (CHIP). Navigators offer free one-on-one assistance year-round to help find a plan that is suited to meet your needs and your budget based on your household size and income.

Host: Wow. So, what an important job that you have, is this a very popular field that you're in? How many navigators are there across the country and states, is this a burgeoning new field? Has it been around a while? Tell us a little bit about it.

Maxine Ambrosino: Well, there are about 25 CMS navigators in Florida and 34 grantees across 31 states. USF or University South Florida, is the only grantee recipient in the state of Florida and has five lead community organizations, including the Family Healthcare Foundation. That's the community organization that our BayCare Health Care Navigators are a part of.

Host: Tell us how you serve the community. How do you help people? Because we all know the health care system is difficult to navigate, even for those of us that know what we're looking at. So, how do you help the community and tell us how you work for them?

Maxine Ambrosino: Well, we're able to assist the community, whoever reaches out to us and provide resources and information to help guide them through their insurance or to guide them in any kind of barrier that they're actually going through at that moment. We're able to help them connect to access to care, find doctors, locate primary medical home, as well as locate community clinics. Access to care means different things to different people. So, they may not be able to get access to their medications and we're able to connect them to many different programs that they're able to receive their medications and continue staying healthy.

Host: Sure. I mean, that's what it's mostly all about. So, what kind of help is available for someone who has health insurance, either from job-based coverage, the marketplace, commercial insurance, how do you help them navigate whatever treatments they need with their insurance? Which again, can be one of the most confusing things ever.

Maxine Ambrosino: Having health insurance doesn't mean that you have all the answers. So, we are able to help whoever needs that assistance, understand what their insurance means, understand what a co-pay is or co-insurance is or a deductible. And all of that can be really confusing. Not to mention locating an in-network doctor. A navigator can help you understand all of the insurance benefits and help you troubleshoot your questions about your insurance or find better insurance. There are a lot of people that have insurance right now, and they just don't know how to navigate it. Or they have a large out-of-pocket expense that they can't handle. So, as navigators, we're able to sit down with our community and work out those barriers and make sure that they're able to understand what's out there as far as insurance. Navigating the insurance coverage should not be a time of concern for your family. And that's what we wanted to put out there, that we're here to help you. We're here for the community.

Host: Well, that's so comforting to know, and for people that may have lost health insurance, and right now is a time of a lot of anxiety and stress. How can a navigator help someone who's recently lost their health insurance that may need health care?

Maxine Ambrosino: Losing health insurance, especially during a time like this is very scary. A lot of people don't know that they are actually eligible for other health options. If they've lost health insurance within the last 60 days or about to lose their health insurance within the next 60 days, they have an option to look for health insurance elsewhere. Whether it's in the marketplace or we can guide them to other qualifying health coverage through health care clinic or local partners, we can get them connected to those resources so that they don't have to go without coverage and they can continue their care. We can help with an application process. We can help with the eligibility forms and enrolling in a plan that works for them. They can also visit www.healthcare.gov and complete an application. And as a navigator, we walk our consumers through that application process and help them understand the logistics of all of the application requirements. They can also call the call center that's available 24 hours, seven days a week, and they can talk to a consumer representative, a call center representative at 1-800-318-2596. And they can also walk through the application with them. If they're not able to enroll in a marketplace plan, we can also help them and connect them. Like I said, to federally qualified health centers or local health programs like Florida Medicaid or CHIP programs.

Host: That's such important information for people to know. So how does someone get in touch with a health care navigator? What do they do? What's the first step?

Maxine Ambrosino: Well, the first step is that navigators are able to provide phone assistance for all appointments, they can call our BayCare Navigator line. We can also connect to our community partners to schedule a virtual appointment. We'll even conference in a third party to get the job done when in-person meetings are not possible at this time. Anyone that's in need of contacting a health care navigator or BayCare Navigator can call (855) 404-3334.

Host: Well thank you for that information. And as a health care navigator with BayCare, Maxine, what's the best part about being a health care navigator? What's the best part about doing what you do?

Maxine Ambrosino: The best part about being a health care navigator is we’re able to help other people. We're able to help the community and be there for the community by offering free one-on-one assistance, guidance, support, education, to anyone who reaches out. We are partners in the community and partners in their care. Navigators are your one-stop shop to community, to vital resources and we will continue to be a beacon of hope and guidance to our neighbors. Staying with the BayCare mission, navigators are here to support and advocate for you and your family. Our goal is to help you overcome the barriers in accessing healthcare and empower you with the information and resources for a better healthier you.

Host: Thank you so much. What a great job you have, Maxine. Thank you for joining us today. To learn more about BayCare's Health Care Navigators and the services and programs offered, please visit www.baycare.org, or you can call (855) 404-3334 to reach a BayCare Navigator. That concludes this episode of BayCare HealthChat. Please remember to subscribe, rate, and review this podcast and all the other BayCare podcasts. I'm Melanie Cole.