Health Insurance Assistance

Navigator - Health Insurance AssistanceSAIL Navigators provide local, in-person assistance to explore and enroll in health insurance plans to individuals and small businesses including Medicaid, Child Health Plus and Qualified Health Plans. All plans are accessed through use of the NYS Department of Health Marketplace website.

The Navigator program also provides education on the Affordable Care Act (ACA); helps individuals know and understand enrollment eligibility deadlines and clarifies terminology in determining qualifying events (job loss, divorce, birth of a child, etc.).

Woman helping a man with the computer

Woman helping a man with the computer

Navigators provide assistance to explore, plan for, and obtain needed services and supports. SAIL HELPS with:

  • Accessing Health Insurance for Individuals
  • Accessing Health Insurance for Small Businesses
  • Accessing Health Insurance for Self-Employed
  • Planning for Open Enrollments
  • Determining Qualifiying Events

Community Health Advocate (CHA): Provides post-enrollment support to individuals and small businesses regarding health insurance concerns. Also provides assistance with applications for Medicaid, solving problems with current plan providers (doctors, hospitals, pharmacies), mediation and other items not specifically covered through the Marketplace.

Facilitated Enrollment for Aged, Blind and Disabled (ABD): Provides Medicaid Application assistance for those individuals: (a) Working with a Disability, (b) Over the age of 65, (c) Having Long Term Care needs, (d) In a spend-down situation or need assistance with a trust, (e) MSP applications.

Independent Consumer Advocacy Network (ICAN): This service provides assistance to people enrolled in Managed Long-Term Care plans or receiving long-term care in Medicaid Managed care. Additionally, ICAN can offer help to those not yet enrolled in a long-term plan, as well as the families and/or representatives of any of the above.

With these additional Health Insurance Related Programs, SAIL HELPS with:

  • Planning for Open Enrollments
  • Medicaid Spend Downs
  • Medicare Savings Plans
  • Working Individuals with Disabilities
  • Accessing Long-Term Care Needs
  • Exploring Managed Long-Term Care Options

SAIL SUCCESS STORY: A consumer with diabetes who recently lost her job came to SAIL for assistance accessing health insurance. Navigators were able to assist in completing an application and accessing insurance, ensuring there would be no gap in coverage and that she could receive needed medical supplies.

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