Getting certified for Medicaid assistance

[Turambar]

In my line of work I meet a lot of individuals who live in poverty, and too often they have no idea where to start in obtaining health coverage. For a couple of years now I've considered putting together a small team of people and reaching out to these people to guide them through the application process in the healthcare marketplace.

Since I can't sleep tonight, I decided to look into it and I leaned it's called navigation assistance - I'd need to get certified, along with everybody who joins me. I'd need to register as a nonprofit organization and apply for funding. There's a training program I'd need to complete, but I'm not sure how long it takes or how much it costs.

This is clearly more effort than I had conceived; I admit I was naive in thinking I could just drive through low-income neighborhoods and do this. But is this larger endeavor something a premed student has any business doing? Are there people, already doing this, who I could be volunteering my time to help? I just want to do something without diverting my undergraduate degree more than I already have.

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[osckey]

Sounds like an awesome experience and something your passionate about. Pursue it and see where it goes.

 

[NicksMD]

Sounds like social work.


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[LizzyM]

Patient navigator is a job. It doesn't require a masters degree, like a social worker, or even a college degree. The idea is similar to peer health educators. Someone can be comfortable talking about very personal matters (like income and health status) with someone who comes from their community, knows how to communicate with them, and is familiar with the environment. Hospitals, federally qualified health centers and other not-for-profit community development agencies are employing patient navigators. What you propose to do is a huge undertaking. First, investigate whether there are agencies in the communities you are interested in who already have patient navigators in place.

 

[thatwouldbeanarchy]

Health Leads does similar work (https://healthleadsusa.org/). They offer paid internships where students connect patients with social services like food assistance, help paying utilities, etc.

Starting your own program is a laudable idea but would probably involve a tremendous amount of work. Starting a nonprofit is requires a ton of paperwork, financial planning, creation of a board of directors, etc. And getting grant funding is a full-time job. If you're interested in doing this work, I think you should start by seeing if anyone in your area is doing it already. Check out Community Action Programs, homeless shelters, free clinics, DHHS, and other places that already provide services to low-income folks in your community.

 

[raiderette]

I admit I was naive in thinking I could just drive through low-income neighborhoods and do this

You can be employed as a navigator, but those people tend to come from the neighborhoods and work within their own community. It is possible through your contacts you could partner with an existing group to bring people together for events. A friend of mine mentors a girl scout troop and for a Gold Award one of the girls got several community groups together to do a health fair, with screenings, outreach from various non-profit groups and a few navigators as well as a representative from the city and a group of interpreters as an outreach. A local church or community center was used. Maybe you could do something like that. It need not be a permanent event, but you could make it an annual or semi-annual event.

 

[MatthewDamon]

Patient navigator is a job. It doesn't require a masters degree, like a social worker, or even a college degree. The idea is similar to peer health educators. Someone can be comfortable talking about very personal matters (like income and health status) with someone who comes from their community, knows how to communicate with them, and is familiar with the environment. Hospitals, federally qualified health centers and other not-for-profit community development agencies are employing patient navigators. What you propose to do is a huge undertaking. First, investigate whether there are agencies in the communities you are interested in who already have patient navigators in place.

+1. Echoing what others have said about starting a group of your own navigators. I'd suggest joining as a volunteer at an FQHC or other organization who is willing to train you. If I'm not mistaken the online training for becoming a navigator is free, but there are some things to learn aside from the online curriculum that you will only be able to pick up from Googling issues your clients present as they come up, or learning from colleagues who have already been navigators before (much quicker). Online training should take a few days, while becoming knowledgeable to the point where you can assist people by yourself may take some practice.

Also just for reference, insurance enrollment is something a lot of people (not just low-income people) need help with. For those who make a certain amount of $ above a cutoff relative to the FPL, they would need to enroll through the exchange and the enrollment period is early November-late January. For Medicaid, you can enroll people anytime of the year, assuming they make under the established threshold, which varies from state to state depending on whether or not there's Medicaid expansion, etc. I think you'd end up enrolling both populations if you do pursue this further. With that said, becoming certified to enroll people in the exchange pretty much only allows you to submit referrals to Medicaid unless you work for the DPSS. You'd basically be doing an application for clients so they don't need to fill it out, but ultimately the DPSS would be the ones processing it. With the plans in the exchange, you'd actually be enrolling people. Becoming a navigator in the exchange is what gives you the ability to refer applications for Medicaid in the first place though.

Lastly, you need to renew your certification each year. That, in combination with each application taking 30 minutes-1.5 hours (plus the limited window of the year in which you can enroll people into the exchange) makes it kind of unfeasible to make a huge impact by hosting an short event once or twice a year. Not to say you need to do it full time, but you should commit yourself continuously a few hours a week (at least) if not more, in order to make the biggest impact and optimally benefit the organization you're working for.