In-Person Assistance in the Health Insurance Marketplaces

In-Person Assistance in the Health Insurance Marketplaces


Starting October 1, 2013, consumers in all states were able to access affordable health insurance options through the Health Insurance Marketplace. Some states set up a State-based Marketplace and the remaining states opted for the Federally-facilitated Marketplace (FFM).

No matter what state they live in, consumers can receive help as the apply for and enroll in coverage through the Marketplace.

Open Enrollment for the 2024 plan year begins November 1, 2023 and individuals will again be able to provide assistance to consumers in a number of different ways: by becoming Navigators of certified application counselors. In addition, agents and brokers will still be able to help consumers enroll in health insurance through the Marketplace.

Key Resources


Each year, the Centers for Medicare & Medicaid Services (CMS) makes grant awards to organizations who serve as Navigators in FFM states. Navigators play a vital role in helping consumers prepare applications to establish eligibility and enroll in coverage through the Marketplaces and potentially qualify for an insurance affordability programs. They also provide outreach and education to raise awareness about the Marketplace, and refer consumers to health insurance ombudsman and consumer assistance programs when necessary. Navigators operate year-round—increasing awareness among the remaining uninsured about the coverage options available to them, helping consumers find affordable coverage that meets their needs, and assisting consumers beyond the enrollment process to ensure they're equipped with the tools and resources needed to utilize and maintain their health coverage all year. Navigators must complete comprehensive federal Navigator training, criminal background checks, and state training and registration (when applicable), prior to assisting consumers.

On August 25, 2023, CMS awarded $98.6 million in Navigator cooperative agreement awards to 57 returning organizations who will continue serving as Navigator awardees in states with a FFM. These awards support the work of organizations that offer assistance to consumers navigating, shopping for, and enrolling in health insurance coverage for plan year 2024.

Note: This year’s awards included partial funding for the three (3) returning Navigator organizations serving as Navigator awardees in the state of Georgia for the remainder of PY 2023 to support Medicaid unwinding efforts in the state. The state of Georgia has received conditional approval from CMS to transition from an FFM to a State Based Marketplace on the Federal Platform (SBM-FP) for PY 2024. As such, CMS will not fund Navigator organizations operating in the state of Georgia for PY 2024.

A list of 2023 Navigator grant recipients can be found here: 2023 Navigator Grant Recipients (PDF). The 2023 Navigator awards are for the third and final 12-month budget period of a 36-month period of performance, which runs August 27, 2021 through August 26, 2024. Entities and individuals cannot serve as Navigators in the FFM without receiving federal grant funding from CMS to perform Navigator duties.

Additional Resources for Navigator Applicants

Archived Resources for Navigator Grantees

Navigator Grant Recipients

Certified Application Counselors (CACs)

Certified application counselor designated organizations (CDOs) are a vital component of the assister community. In the Federally-facilitated Marketplaces (FFMs), CDOs oversee certified application counselors (CACs) who are trained and able to help consumers seeking health insurance coverage options through an FFM. Organizations that wish to become CDOs designated by the Centers for Medicare & Medicaid Services (CMS) to serve in an FFM must submit an online application and enter into an agreement with CMS. These groups might include community health centers or other health care providers, hospitals, or social service agencies.

Additional Resources for CACs

Enrollment Assistance Personnel (EAP) Program

The Centers for Medicare & Medicaid Services (CMS) has implemented a multi-pronged approach to improve Medicaid coverage transitions, including a ramped-up direct outreach effort to streamline the consumer experience. CMS has reestablished and revamped the Enrollment Assistance Personnel (EAP) program, with EAPs serving as "mobile assisters' and helping consumers navigate coverage transitions from Medicaid into Qualified Health Plans (QHPs) through the Federally-facilitated Marketplace (FFM). EAPs operate under a contracted assistance model under which Cognosante LLC has been retained to conduct direct assister-to-consumer outreach alongside Navigator grantees in FFM states to help consumers maintain continuity of coverage.

Through ongoing training and resources, EAPs are prepared to help consumers who lose Medicaid coverage to facilitate a seamless transition to Marketplace coverage. CMS is also ensuring the EAPs' efforts are coordinated with other assisters in the community to help consumers understand basic concepts and rights related to health coverage, provide enrollment assistance, and work with individuals to link coverage to care. EAPs will maintain a critical physical and virtual presence in target areas of the following states: Arizona, Florida, Illinois, Louisiana, Michigan, Montana, North Carolina, Oklahoma, Tennessee, Texas and Utah. The EAP target areas were identified by CMS as areas of greatest need for enrollment assistance and are referenced in the table below.

State EAP Target Locations To Schedule an Appointment
Arizona Maricopa County, Arizona

Schedule an appointment with an EAP in Arizona

(480) 420-0280




Miami-Dade County, Florida




(877) 864-4370

Broward County, Florida
Hillsborough County, Florida
Orange County, Florida
Illinois Cook County, Illinois

Schedule an appointment with an EAP in Illinois

(312) 724-9946

Louisiana LaSalle Parish, Louisiana

Schedule an appointment with an EAP in Louisiana

(318) 408-2729

Michigan Wayne County, Michigan

Schedule an appointment with an EAP in Michigan

(313) 572-1452

Montana Silver Bow County, Montana

Schedule an appointment with an EAP in Montana

(406) 272-3295

North Carolina
Mecklenburg County, North Carolina

Schedule an appointment with EAP in North Carolina

(336) 310-8874

Guilford County, North Carolina
Oklahoma Oklahoma County, Oklahoma

Schedule an appointment with an EAP in Oklahoma

(405) 212-9444

Tennessee Shelby County, Tennessee

Schedule an appointment with an EAP in Tennessee

(901) 244-3886

Harris County, Texas







(877) 864-4370

Dallas County, Texas
Bexar County, Texas
Tarrant County, Texas
El Paso County, Texas
La Salle County, Texas
Hidalgo County, Texas

Utah County, Utah

Schedule an appointment with an EAP in Utah

(801) 415-9572

Salt Lake County, Utah

Agents and Brokers

Agents and brokers also play a key role in the Health Insurance Marketplace. To the extent permitted by states, agents and brokers play an important role in educating consumers about Marketplaces and insurance affordability programs, and helping consumers receive eligibility determinations, apply for premium tax credits and cost-sharing reductions, compare plans, and enroll in coverage. In particular, agents and brokers play a critical role in helping qualified employers and employees enroll in coverage through the Small Business Health Options Program (SHOP). Consumers may want to obtain professional advice from agents and brokers when applying for and selecting a qualified health plan. Below is a link to the CMS webpage for agents and brokers choosing to participate in Federally-facilitated Marketplaces.

Additional Resources for Agents and Brokers


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Page Last Modified:
09/15/2023 05:10 PM