Marketplace Optimize at Amberwell
Through its Market Optimize Service Amberwell provides healthcare benefits navigation to assist Marketplace patients. Healthcare navigation plays a vital role in helping those eligible for Marketplace plans to gain access to affordable health insurance coverage through the Health Insurance Marketplace and to understand their healthcare options
At Amberwell, our commitment is to provide comprehensive and accessible healthcare services tailored to the needs of the communities we serve. Offering Marketplace Optimize reflects our dedication to empowering you with the knowledge and tools to make informed healthcare decisions.
Navigators provide education on the benefits and limitations of the health insurance plans available on the Marketplace. They explain key terms and concepts related to coverage, such as essential health benefits, preventive services, prescription drug coverage, and out-of-pocket costs. This helps individuals make informed decisions about the coverage that best meets their healthcare needs.
If individuals encounter issues with their Marketplace coverage, such as claim denials or billing disputes, navigators can act as advocates on their behalf. They can help individuals navigate the appeals or grievance process, communicate with insurance companies, and resolve problems to ensure they receive the benefits they are entitled to.
Navigators assist Marketplace patients with the annual renewal process. They provide guidance on renewing coverage, updating personal information, and reviewing plan options for the upcoming year. They help patients understand changes in premiums, benefits, or network providers and assist with re-enrollment to ensure uninterrupted coverage.
Navigators inform individuals about SEPs, which allow for enrollment outside of the regular open enrollment period. They explain the qualifying life events that make individuals eligible for an SEP, such as marriage, birth or adoption of a child, loss of other coverage, or relocation. They help individuals understand the requirements, timelines, and documentation needed to take advantage of an SEP.
