Press release

Grants Awarded for the Federally-Facilitated Exchange Navigator Program

Grants Awarded for the Federally-Facilitated Exchange Navigator Program

Today, the Centers for Medicare & Medicaid Services (CMS) awarded $10 million in Navigator grant awards to 39 organizations who will serve as Navigators in Federally-facilitated Exchange states. These awards will support the work of organizations that offer assistance to consumers navigating, shopping for, and enrolling in health insurance coverage for 2019. 

“We are committed to making sure that consumers have a positive experience. The grants announced today mark a new direction for the Navigator program aimed at providing a more cost-effective approach that takes better advantage of volunteers and other community partners,” said CMS Administrator Seema Verma.  “This new direction will increase accountability and ensure the grants are effective in helping consumers find health coverage that meets their needs. We will continue to monitor the impact of these changes with the primary goal of ensuring consumers have the resources to select a health plan that best fits their needs.” 

Navigators are one of many ways individuals can get help shopping for, and enrolling in, health insurance coverage; CMS continues to expand options for individuals to enroll in coverage through partnerships with the private sector, including agents and brokers and health insurance issuers.

Applicants to the 2018 Navigator Funding Opportunity Announcement (FOA) were encouraged to leverage volunteers and enter strategic partnerships with public and private organizations in their work targeting “left behind”[1] consumers who could benefit from individual market coverage. Applicants were also directed to use more cost-effective strategies to meet their enrollment goals. The organizations selected for an award will:

  • Partner with public and private organizations in their community to provide more efficient, targeted outreach, such as coordinating outreach activities with local Medicaid/CHIP outreach or providing more virtual or mobile assistance to consumers.
  • Target the “left behind” population, defined in the FOA to include those individuals who are disproportionately without access to health insurance coverage or care and who may be unaware of the full range of coverage options available to them, including coverage options in addition to QHPs, such as association health plans and short-term, limited-duration insurance.
  • Utilize innovative and cost-effective strategies for reaching consumers, intended to maximize the impact on communities while ensuring efficient use of federal funds.

The grants awarded today will have a period of performance of one year from the award date, September 12, 2018, to September 11, 2019. Entities and individuals cannot serve as Navigators in the Federally-facilitated Exchanges without receiving federal grant funding from CMS to perform Navigator duties.

For a list of 2018 CMS Navigator grantees or more information about the Navigator program, please visit:  https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Marketplaces/assistance.html.

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[1] Examples of “left behind” populations may include: hourly wage workers, including restaurant and retail workers; variable income workers, including workers with unpredictable annual incomes who fluctuate in and out of eligibility for financial assistance when purchasing health insurance; and persons who did not get health insurance because of a lack of affordable coverage options in their area, or because they lacked a general knowledge about affordable health insurance options and how to enroll.