A navigator is trained and certified to help people apply through NY State of Health. Two features matter: the help is free, and navigators are not paid by insurers, so they have no financial stake in which plan you choose.

How they differ from a broker. A broker is licensed and often genuinely useful, but is compensated by carriers. That does not make the advice bad; it makes the compensation worth knowing when you weigh a recommendation.

What a navigator actually does:

  • screens you for Medicaid, the Essential Plan and Child Health Plus at once
  • explains which documents you need, including what to do if you are paid in cash
  • helps compare plans and asks the network questions most people skip
  • sits with you through the application instead of handing you a link

Where to find one: NY State of Health at 1-855-355-5777, and community organizations across the five boroughs, often in the languages the neighborhood actually speaks.

In New York: certified navigators work through NY State of Health, are free, and earn no commission on what you choose. Brokers are licensed, can be genuinely useful for a complicated household, and are paid by the plans they sell. Neither arrangement is disqualifying; not knowing which one you are talking to is. The state line is 1-855-355-5777 and has interpreters. One sentence settles it: “Are you a certified navigator or a broker, and do you get a commission if I enroll through you?”

Also called: certified application counselor, enrollment assistor. Reference: Navigator on Wikipedia — general definition, not New York specifics.

More in Glossary of health coverage and billing terms

  • Allowed amount — The number a plan treats as the price of a service, which is almost never the number on the bill and is what your percentage share is actually taken from.
  • Tax household — The group whose income is counted together for coverage eligibility, decided by who files a tax return with whom rather than by who lives in the apartment.
  • Qualified health plan — A plan certified for sale on a health insurance marketplace, which guarantees a floor of benefits and protections and tells you nothing about the network.
  • Sliding scale fee — A sliding scale fee is a price set by household income and size. How the scales at NYC community health centers and NYC Care work, and what to bring.
  • Balance billing — Balance billing is a provider billing you the gap between its charge and your plan's allowed amount. When New York bars it, including Medicare's 5% cap.

This page explains how the system works. It is not medical advice. More.