Health Insurance Navigators: What you need to know

Kean Bauman

Photo: Video by ktnv.com

Health Insurance Navigators: What you need to know

CREATED Nov. 18, 2013

Las Vegas, NV (KTNV) -- There's more rough waters rolling out the Affordable Health Care Act: Problems with the employees who are supposed to navigate you through the system but it's possible they could have a criminal history. Is your personal information safe and are you getting the right answers?

"We've been so careful all our working lives to protect ourselves from identity theft and scams and things like that," said Judy Doerksen. She’s concerned about her privacy while shopping around for new health insurance.

She has her own insurance, but feared it might be canceled so she started looking for options on the Silver State Health Insurance Exchange.

"I've had to give them my social security number. I've had to give them our income."

That information was taken by Navigators. In Nevada, Navigators are required to take a course to become licensed.

All state approved Navigators have a security badge that can help you verify whether or not a navigator is legitimate and licensed.

Judy couldn't believe it when we told her it takes Navigators 20 hours to complete the course work.

"That's not much. I have 25 hours or more on the site navigating it and still have trouble," she explains.

Larry Harrison agrees. He's an independent broker who's been in the insurance industry for 24 years. He worked with the state to have the Navigators licensed.

"This is not about just about buying an airline ticket. This is about, 'Is my doctor in the network? How are they going to pay the claims? What is my maximums out of pocket?'"

Those are critical questions consumers will need answered.

John Hager Executive Director at Nevada Health Link is confident Nevada's Navigators are on the right track.

"They are licensed and certified by the Division of Insurance. They have had a 20 hour course. They have had test they had to pass at 80% pass rate."

With 42 options in Clark County to choose from on the exchange, that can be overwhelming for any consumer.

But Hager said the Navigators are trained to answer your questions.

"There are a lot of similarities between many of the plans. Many of the plans differ mostly by their cost sharing, deductibles, co-insurance and co-pay. So there's not a whole lot to learn about between 1 plan offered by the CO-OP and plan B by the CO-OP."

And then there's the question of security.

Contact 13's Tricia Kean asked, "A lot of people have been very critical, nationwide, of the Navigators. Some who've been convicted felons. Some have been accused of trying to commit fraud. Why is Nevada different?"

Hager responded, "Nevada is different because do the criminal back ground checks. So that does not happen in Nevada. If there is something like that, it will show up on a background check and they will not be certified or licensed."

But even with that certification both the state and Larry Harrison say it's up to you not the navigator to make the final decision.

"The more the consumer knows, the more they're going to get exactly what they want."

And while Harrison wants to see more training for Navigators and protection for consumers he tells us some states have less than we do.

That provides some peace of mind for Judy.

"I'm glad that Nevada's at least done that, ‘cuz I got some protection then."

Here's the Contact 13 bottom line:

If you're shopping for insurance on the exchange, remember, it's incumbent upon you to do the research on your health plan and not just listen to what a navigator tells you.

Once you sign up you're stuck with that health plan for an entire year before you can re-enroll in a new plan.

If you feel you've been misled by a state navigator there is a formal appeals process you can go through the state of Nevada.

For more information and to speak to a broker visit National Association of Health Underwriters by clicking here.

If you're having a problem with the state health exchange we want to hear about it send us an email 13investigates@ktnv.com.

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