Health insurance navigators are ready to help those eligible navigate HealthCare.gov
Raleigh, N.C. – The health insurance navigators of the NC Navigator Consortium are providing free help for North Carolinians that qualify for a Special Enrollment Period (SEP) on the Health Insurance Marketplace® at HealthCare.gov currently open to families who make 100% to 150% of the Federal Poverty Level (FPL). The SEP was opened earlier this year to low-income individuals and families who may benefit from low costs through the American Rescue Plan. The NC Navigator Consortium’s federally qualified health insurance navigators are scheduling appointments (by phone, in person or virtually) at ncnavigator.net or 1-855-733-3711.
The SEP is available to eligible people who have applied for HealthCare.gov coverage since Open Enrollment ended and who didn’t have access to another SEP from a qualifying life event. The new SEP will allow eligible consumers to enroll in HealthCare.gov coverage at any time, and possibly qualify for more savings. The FPL annual household income varies by state and household size. According to the Assistant Secretary for Planning and Evaluation (ASPE), in North Carolina:
|For a household/family size of:||150% of the FPL is:|
“Last year’s Open Enrollment period was very busy for our statewide network of local health insurance navigators,” said Mark Van Arnam, director of the NC Navigator Consortium. “We know uninsured North Carolinians need and want this coverage, but don’t know they can apply now to get coverage that is more affordable than ever.”
Started in 2014, the NC Navigator Consortium is a nonpartisan, nonprofit group of organizations whose health insurance navigators give peace of mind to those seeking free, unbiased help finding quality, affordable coverage. Navigators connect consumers to qualified health plans that provide essential health benefits and preventive care, in addition to mental health care, ER care and maternity coverage, not limited by caps or pre-existing conditions. These benefits are covered in all policies available on HealthCare.gov, the federal Health Insurance Marketplace® established by the Affordable Care Act. Tax credits and subsidies made possible by the American Rescue Plan have lowered premiums, making Marketplace plans very affordable.
Though the Marketplace has increased access to health insurance coverage for millions, trying to enroll or update one’s coverage through the Marketplace can be confusing and overwhelming. Health insurance navigators help North Carolinians maximize their coverage by:
- Taking time with them to help avoid mistakes
- Showing all options, ensuring their providers are in-network
- Explaining terminology and processes, increasing health insurance literacy
- Assisting them with estimating their income for the year ahead, one of the most difficult parts of the HealthCare.gov application process
Navigators are available year round for questions and to address other issues like qualifying life events, special enrollment periods and income adjustments.
The NC Navigator Consortium is the only federally funded entity of its kind in North Carolina, supported in part by the Centers for Medicare & Medicaid Services. Learn more at ncnavigator.net, and follow on Facebook, Twitter and Instagram. Members of the Consortium are Access East, Charlotte Center for Legal Advocacy, Council on Aging of Buncombe County, Cumberland HealthNET, HealthCare Access, HealthNet Gaston, Kintegra Health, NC FIELD and Pisgah Legal Services. The Consortium is led by Legal Aid of North Carolina.
Legal Aid of North Carolina is a statewide, nonprofit law firm that provides free legal services in civil matters to low-income people in order to ensure equal access to justice and to remove legal barriers to economic opportunity. Learn more at legalaidnc.org and follow on Facebook, Twitter, Instagram, LinkedIn and YouTube.
The project described was supported by Funding Opportunity number CA-NAV-21-001 from the Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies.
Legal Aid of North Carolina’s Medical-Legal Partnership (MLP) project brings together physicians, nurses, social workers, attorneys and paralegals to address social and environmental determinants of poor health that may have a legal remedy, including: substandard housing conditions; domestic violence; food, income, and housing insecurity; improper denials of Medicaid and disability benefits; and failure to provide children with the special educational services to which they are entitled. Our Medical-Legal Partnership project is expanding across the state. Here is a list of our current partnerships:
- North Carolina Cancer Hospital
- North Carolina Community Health Center Association
- UNC Children’s, Transitions Care Clinic
Legal Aid of North Carolina is the leader of the NC Navigator Consortium, a group of health care, social service and legal aid organizations that provides free, in-person help to North Carolina consumers seeking to enroll in affordable health insurance plans on HealthCare.gov, the Health Insurance Marketplace established by the Affordable Care Act.
Navigators are trained to help consumers understand the details of plans available on the Health Insurance Marketplace, determine which plan will best meet their needs, determine eligibility and apply for financial assistance, and complete the enrollment process.
Navigators meet with consumers in free, in-person, one-on-one, confidential sessions at convenient locations throughout the state. Strict security and privacy standards are in place to ensure that consumers’ personally identifiable information is protected.
Thanks in large part to the efforts of the consortium, North Carolina has the third-highest number of enrollments out of the nearly 40 states that use the Health Insurance Marketplace. Only Florida and Texas, states with more than double the population of North Carolina, have more enrollments.
The NC Navigator Consortium is funded by the Centers for Medicare & Medicaid, part of the U.S. Department of Health and Human Services.
Members of the consortium are Access East, Charlotte Center for Legal Advocacy, Council on Aging of Buncombe County, Cumberland HealthNet, HealthNet Gaston, and Legal Aid of North Carolina, which leads the consortium.
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Attend our FREE Medicaid Managed Care Clinic to learn about NC Medicaid’s transformation to managed care. On July 1, 2021, approximately 1.6 million North Carolinians who receive Medicaid benefits were enrolled into Prepaid Health Plans (PHPs) due to NC Medicaid’s transformation from fee-for-service to managed care. We will be discussing these recent changes, how they may impact you, your rights, and how to get the information and help that you need. At the clinic, you will view a live presentation. An attorney from Legal Aid of North Carolina’s Medicaid Appeals Technical Team project will be available to answer general questions. Sign up for the clinic using the form below.
The clinic will provide you with general legal information and guidance only. The clinic will not provide you with specific, individual legal advice. If you need more help after the clinic, call our Helpline at 1 (866) 219-LANC (5262) to apply for help.
If you have questions about getting the care that you need through NC Medicaid, contact the NC Medicaid Ombudsman. The NC Medicaid Ombudsman is an independent organization that provides education, guidance and referrals to ensure that the more than two million North Carolinians with Medicaid coverage are able to access the health care and services they need.
You can contact the Ombudsman when:
- You are not getting the care that you need.
- You have questions about a notice or bill you have received.
- You have already talked with your health care provider or health plan and have not been able to solve the problem.
- You have general questions about the complaint or appeal process.
To contact the NC Medicaid Ombudsman:
- Visit their website and fill out their online application, or
- Call them at 877-201-3750 (TTY: 711 or RelayNC.com) from 8 a.m. to 5 p.m., every Monday through Friday except for state holidays, or
- Email them at firstname.lastname@example.org.
Additional Helpful Links
How do I apply for Medicaid?
- You apply by contacting your local Department of Social Services (DSS). Click here to find your local DSS.
- You can also apply online at North Carolina ePASS.
Who do I contact if I have a problem and don’t know what to do?
- You can contact the NC Medicaid Ombudsman. To contact them:
Who do I call if I need help choosing a managed care plan or need to change plans?
- You can call the Enrollment Broker (Maximus) at 833-870-5500 (TTY: 833-870-5500).
- You may also mail or fax a completed Health Plan Change Form. Here is the form: NC Medicaid Managed Care, Health Plan Change Request (ncmedicaidplans.gov)
Who do I call if I want to change my Primary Care Provider?
You should call Member Services for your Prepaid Health Plan. Here is their contact information:
- Amerihealth Caritas: 855-375-8811
- Carolina Complete Health: 833-552-3876, extension 2
- Healthy Blue: 844-594-5070
- United Healthcare Community Plan: 800-493-4647
- Wellcare: 866-799-5318
Who do I contact if my health care services have been denied, changed, reduced, or terminated?
- You can call Legal Aid of North Carolina’s statewide Helpline at 866-219-5262 (toll-free).
- You may also apply online.
For your convenience, we hold all of our clinics electronically using Facebook Live and Zoom. All of the clinics are completely free and open to the public.
- Facebook Live: To participate using Facebook, visit our Facebook Live page when the clinic starts. You do not need a Facebook account to watch the presentation, but you do need an account to send questions to the presenters. Sign up for a free Facebook account.
- Zoom: To participate using Zoom, use the listing below to register for the clinic you are interested in. You do not need a Zoom account to participate in the clinic. Once you register, you will receive an email containing a link to the Zoom presentation. When the clinic starts, click the Zoom link to join.
RALEIGH · August 30, 2021—The Centers for Medicare and Medicaid Services (CMS) has awarded the NC Navigator Consortium $4,951,640 per year for the next three years to enroll North Carolinians in affordable health insurance on HealthCare.gov, the federal Health Insurance Marketplace established by the Affordable Care Act.
This grant is the second largest in the country awarded by CMS for the 2021-2024 grant period.
The grant was announced last week by CMS, a part of the U.S. Department of Health and Human Services. Legal Aid of North Carolina, a statewide, nonprofit law firm that provides free civil legal aid to low-income North Carolinians, is the leader of the consortium and will administer the grant.
The grant will fund a corps of Navigators, who are trained to help consumers understand the details of plans available on the Health Insurance Marketplace at www.healthcare.gov, determine which plan will best meet the needs of their family, apply for financial assistance, and complete the enrollment process.
“We are thrilled to be able to continue the work that we started back in 2014,” Mark Van Arnam, director of the NC Navigator Consortium, said.
“We are honored that we were chosen to receive the second largest award among all the grantees. This really fuels our Navigators as it reflects on the amazing work done by Legal Aid Navigators and our sub-grantees over the last eight years,” said Van Arnam. “We’ll be able to help more North Carolinians connect to coverage through application assistance and enrollment education. We’ll help more of our community understand health insurance by providing free health insurance literacy events and free appointments, year-round, to talk with a Navigator about any questions they may have.”
The NC Navigator Consortium is a group of nine health care, social service and legal aid organizations that helps North Carolina consumers enroll in affordable, comprehensive health insurance plans on HealthCare.gov, the Health Insurance Marketplace established by the Affordable Care Act. Members of the consortium are Access East, Charlotte Center for Legal Advocacy, Council on Aging of Buncombe County, Cumberland HealthNet, HealthNet Gaston, Kintegra Health, NC Field, Pisgah Legal Services, and Legal Aid of North Carolina, which leads the consortium. Learn more at ncnavigator.net and follow us on Facebook, Twitter and Instagram.
The project described was supported by Funding Opportunity number NAVCA210405-01-00 from the Centers for Medicare and Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.
Having secure housing makes all the difference to individuals and public health. Throughout the COVID-19 pandemic, elected officials and local leaders stressed the importance of everyone having a safe and secure place to call home to prevent viral spread. The federal and state governments passed moratoria on evictions, thus ensuring that families and residents could remain housed and thereby slow viral transmission. Our unhoused neighbors, however, were unable to safely isolate, quarantine, or even wash their hands. Even before the COVID-19 pandemic, those living without housing experienced higher rates of hospitalization, medical emergency, and injury.
Rocky Mount—Congratulations to the Community Economic Development (CED) team in our Wilson office, which was honored by OIC Rocky Mount at its recent Vision Award ceremony for the team’s work on racial justice and health equity in Rocky Mount.
OIC recognized the team for its contribution to the “Transforming Rocky Mount” cohort, a group comprised of Legal Aid attorneys, the NC Association of Community Development Corporations, OIC’s federally qualified health clinic, and the Steering Committee of the Community Academy, a grassroots group.
Our CED team addressed racial housing segregation, which the cohort had identified as a social determinant of health, by helping Rocky Mount residents address inequitable housing policies and change the way patients are treated at the OIC clinic.
Members of Legal Aid’s CED team in Wilson include Yolanda Taylor, managing attorney of our Wilson office; Alecia Amoo, CED and housing attorney; Jocelyn Bolton-Wilson, CED and housing attorney; and outreach paralegal India Silver.
Special thanks to David Sobie, a paralegal and data expert in our Winston-Salem office, who works with the IT team from the City of Rocky Mount and OIC to overlap our client data with OIC’s patient data.
Need health coverage for 2021? Open enrollment on HealthCare.gov, the Health Insurance Marketplace established by the Affordable Care Act, runs through December 15. In this video, Mark Van Arnam, the director of our NC Navigator Consortium, tells you everything you need to know to #GetCovered. Learn more about the NC Navigator Consortium and schedule your free appointment at www.ncnavigator.net.