CHP’s Patient Navigators help patients facing insurance uncertainty
Core to CHP’s mission is the principle that all patients should receive care, regardless of their insurance status or ability to pay. Your support helps us fulfill this mission. Finding insurance coverage can be daunting and confusing, and our role is not just to provide quality healthcare, but to provide resources and services that allow our community members to be able to access this care.
CHP employs a team of Certified Patient Navigators who connect community members with insurance options. This is a free service that is not limited to only CHP patients – anyone in Massachusetts can reach out for assistance. Based on eligibility factors such as income, age, household size, and federal income guidelines, our Navigators enroll individuals and families in MassHealth (Massachusetts’ Medicaid program) and subsidized plans offered through the Massachusetts Health Connector. The Navigator team undergoes training each year to stay up to date on current policies and procedures.
Beginning this year, however, changes in federal law are impacting who is eligible for insurance through the Health Connector. As the complexities of insurance changes increase, our Navigators are tasked with the challenge of working to find continued coverage options for those in need. We spoke with Octavio Hernandez, one of CHP’s Patient Navigators, for his insight on how CHP will continue supporting community members through these challenges.
What kind of training do Navigators receive to stay up to date on insurance policy changes?
Every year, Navigators must be re-certified as health insurance Navigators by MA Health Connector. The re-certification is either a refresher or full initial training for new Navigators working for non-profit organizations. In addition, mandatory training webinars are presented throughout the year.
How do you anticipate the federal changes will impact our community in 2026 and beyond?
Under the new changes, some patients that are currently eligible will lose subsidies that affect the affordability of their coverage, while others will lose their MassHealth coverage or will need to go through additional administrative steps to remain eligible. This particularly impacts those who are extremely low-income and fall under 100% of the Federal Poverty Level or those at higher income levels over 400% of the poverty level.
Have you experienced any changes or concerns, are you hearing from patients yet about worries about their insurance status?
People who are no longer eligible for certain subsidies such as tax credits are confused and worried about the lack of help to pay for their health insurance coverage in the year 2026 and beyond, unless they are willing to purchase a health insurance plan at full price.
Do the CHP Navigators have any plans or options in place for patients who might lose coverage?
The Navigators are equipped with the knowledge of all available MassHealth plans and can advise affected individuals and families on how to enroll in specific programs that provides medical and dental care available through community health centers at no cost, as well as emergency room visits. Other options include purchasing a private plan at full cost from the Health Connector. For those families with higher incomes, the Navigators encourage them to enroll in their employer-based health plan, if that is an option.
What are the biggest challenges you anticipate in 2026 and beyond?
Overcoming barriers to health insurance enrollment among the immigrant population in Berkshire County is a biggie. This is especially true due to fears of showing up to enroll and revealing their immigration status, which is not required by CHP but is required for enrollment in some coverage, or fears of being considered a public charge and thereby affecting their immigration status.
What is your favorite part of your role at CHP?
Traveling throughout Berkshire County and meeting with our diverse community. On Mondays and Fridays, I do outreach and enrollment at Neighborhood Health Center, Pittsfield; Tuesdays and Thursdays at Adams Family Services; and Wednesdays at CHC Great Barrington.
CHP’s Navigator team has played a critical role in our organization’s ability to perform outreach and education to the Berkshire community, particularly to our most vulnerable populations which include people who are uninsured, low-income, or immigrants who are undocumented or documented. The Navigators thorough knowledge helps identify and reduce inequities across the county and will ensure that patients continue to have insurance options, even as changes at the federal level may have concerning impacts on coverage status. We take great pride in the work of the Navigator team, as they serve as faces of CHP and carry out our mission daily to bridge the gaps in insurance coverage, particularly during a time when those gaps may be widening.