Navigator

What are Navigators?

The Navigator position was created by the Affordable Care Act to provide helpers for people to enroll in coverage through the health insurance exchange, and refer or assist with Medicaid enrollment.

Navigators are not licensed health insurance producers (agents/brokers), so they cannot recommend one plan over another or direct consumers toward a particular policy. Instead, they provide consumers with general information that can make it easier to understand what’s available, in terms of coverage and financial assistance. Navigators are paid by state and federal grant programs, and they cannot be compensated by the insurance companies.

What training and qualifications do Navigators have?

Navigators must meet cultural competency standards and go through training and certification. Standards and regulations for the Navigator program are outlined in 45 CFR 155.210 and CFR 45 155.215.

State-run exchanges do their own certification and training for Navigators. CMS conducts the certification and training for Navigators in states that use HealthCare.gov; you can see specific training information and requirements here. (Note that state-run exchanges that use the HealthCare.gov enrollment platform — Arkansas, Illinois, and Oregon for 2025 coverage — are required to operate and fund their own Navigator programs.)

Although Navigators are not the same as state-licensed agents and brokers, states can impose stronger requirements for Navigators than the federal minimums, and this is true in both states that run their own exchanges as well as states that use the federally-run HealthCare.gov platform.

For example, Louisiana requires Navigators to be licensed and regulated by the state insurance commissioner. In other states, such as Ohio, Navigator Organizations are certified by the state and then people who are interested in becoming Navigators must do so directly through the Navigator Organizations.

What assistance can Navigator provide?

Navigators provide enrollees with unbiased information about the health insurance exchange and the health plans that are available. They can help applicants determine whether they qualify for subsidies or Medicaid, and assist with the enrollment process.

(Most Navigators do assist with Medicaid enrollments, whereas the majority of brokers do not.¹ This makes sense, as brokers' only compensation comes in the form of commissions paid by insurance companies, so they would have to work for free to enroll someone in Medicaid. Navigator organizations, on the other hand, receive government funding that doesn't depend on the type of coverage utilized by the people they're assisting.)

As of 2018, HHS enhanced the requirements for Navigators. The new requirements, detailed in 45 CFR 155.210(e)(9), ensured that Navigators would provide targeted assistance for underserved and uninsured populations, and post-enrollment assistance for things like eligibility appeals, subsidy reconciliation, and health insurance utilization questions.

In the guidelines for 2020, HHS reversed course somewhat on this, making those duties optional, rather than required, for Navigator organizations. But in the rules for 2022 and beyond, HHS reinstated the previous requirements. This means that Navigators in the states with federally-run marketplaces are once again required to provide post-enrollment assistance with things like eligibility appeals and how to utilize health coverage after a person has already enrolled.

Previous federal regulations prohibited Navigators from providing enrollment assistance by going door-to-door, cold-calling, or using "other unsolicited means of direct contact," but those rules have changed for 2024. Navigators were already allowed to use these methods to conduct general outreach and education — they just couldn't enroll people via unsolicited contact.

But in the rulemaking guidance for 2024 and future years, HHS has repealed that prohibition. So Navigators are allowed to initiate direct contact with potential enrollees and help them enroll without having to wait for the people to reach back out to the Navigator organization for help with the enrollment process. HHS noted that this rule change "will allow Navigators and other assisters in the FFEs to help more consumers."

How are Navigators funded?

Navigators are funded by the federal government in states that use the federally-run exchange (HealthCare.gov) and by the states that run their own exchange platforms (states that run their own exchanges but use HealthCare.gov for enrollment are responsible for funding their own Navigators).

How can I find a Navigator in my area?

You can enter your zip code on HealthCare.gov's "find local help" tool. If you're in a state that runs its own exchange, you'll be directed to your state's exchange website. If you're in a state that uses HealthCare.gov (31 states as of 2025), the tool will show you who can help you enroll in your area.

You'll need to select the "assisters" filter to see only Navigators and enrollment counselors (if you don't limit it, the tool will show you everyone who is certified to help you, including brokers and agents; note that brokers and agents are licensed by the state and are allowed to provide specific plan recommendations, whereas Navigators are not).