By Melanie Wallis, NH Navigator
Health insurance is confusing. There are so many different terms to learn: copayment, coinsurance, deductible, premium…and so many different insurance companies and plans to choose from. How does one even begin to comprehend all of this?
Well, when you don’t know where you’re going, but you have an end location in mind, you can use navigational tools like a GPS to find your way there. Did you know there are also tools for navigating the complexities of public health insurance? That’s where we come in at NH Navigator.
An initiative of the Foundation for Healthy Communities, NH Navigator’s mission is to offer free and unbiased navigation services for people in New Hampshire looking to obtain public health insurance coverage through the ACA Marketplace and Medicaid. While every day looks a little different, here is a glimpse into what it looks like to assist and educate people about public health insurance options as part of the NH Navigator team.
Day in the Life of a NH Navigator
No two days are exactly the same in my work as a Health Insurance Navigator in New Hampshire—but at the heart of it all is one constant: connecting people with the coverage, care and the support they need. Whether it’s through education, outreach, or one-on-one assistance, every day is about making health insurance more accessible and understandable for individuals and families across the state.
My mornings usually start early, coffee in hand and my car packed with partner resource kits—flyers, info cards, brochures and NH Navigator materials—everything needed to spread the word about affordable coverage options. My first stop might be a food pantry in Laconia, a church in Concord or a rural pharmacy. Sometimes I walk into a hospital lobby or a NH Department of Health and Human Services office to drop off resources. Wherever I go, the goal is always the same: to empower community partners with the tools and information they need to help the people they serve.
Throughout the day, I visit a wide range of places—health centers, schools, libraries, mental health clinics, homeless shelters or even public events like resource fairs and enrollment sessions. These spaces are where I meet individuals face-to-face, offering guidance and support to those navigating the complexities of health insurance. I often explain things like what a deductible is, how copays work, or what it means for a doctor to be “in-network.” Insurance can feel like a different language, and my job is to translate it.
When I’m not meeting people in person, I’m on the phone or online, guiding someone through their Medicaid or ACA Marketplace application. I help them create accounts, walk them through every screen, double-check their eligibility and explain their plan options. We talk about APTCs (Advanced Premium Tax Credits), cost-sharing reductions and how to make sure their preferred doctors and prescriptions are covered. If someone’s dealing with high prescription costs, I’ll point them to alternatives like GoodRx, Cost Plus Drugs or local charity care programs.
Navigating health coverage in New Hampshire comes with its own unique challenges. Many families fall into mixed-eligibility situations—adults qualifying for Marketplace plans while their children qualify for Children’s Health Insurance Program (CHIP) through Medicaid. These cases require extra time and care to ensure families understand the coverage options available and can make informed decisions that work for their needs and budgets.
My work also involves strong collaboration. I partner with Certified Application Counselors, brokers, case managers, social workers, parole officers—you name it. Together, we create a network of support to reach underserved and vulnerable populations throughout the state.
Evenings often take me to community meetings or networking events—maybe a seminar focused on immigrant health care access or a panel about rural health equity. These gatherings allow me to connect with others doing vital work and to raise awareness about the NH Navigator program.
By the time I get home, I’m usually exhausted—but it’s the kind of tired that comes from knowing you made a difference. Every flyer dropped off, every conversation held, every family supported brings someone one step closer to better health and peace of mind. And that’s what keeps me going.
Consumer Case Example
Maria is a single mother living in Manchester, New Hampshire, with her two children—Leo, age 9, and Sofia, age 6. She works full-time as a receptionist at a local community clinic, earning just enough to cover the basics. Although her income is modest, it’s just above the cutoff for Granite Advantage (expanded Medicaid) eligibility for herself. Unfortunately, health insurance is not offered through her employer, as they are a small non-profit clinic. They encourage their employees to sign up online through the ACA Marketplace.
Maria’s financial situation is further strained by her children’s health needs. Leo has been diagnosed with autism spectrum disorder (ASD). His care involves weekly speech and occupational therapy sessions, regular visits with a developmental pediatrician and in-school behavioral support. Meanwhile, Sofia was recently diagnosed with Type 1 diabetes. She now depends on using an insulin pump and continuous blood sugar monitoring system and requires care from a pediatric endocrinologist.
With the rising cost of care, Maria has been juggling far more than any one person should have to manage. She’s been paying out of pocket for some services, skipping others entirely and avoiding medical care for herself. Between doctor’s appointments, IEP meetings and everyday life, she’s overwhelmed and unsure where to turn for help.
One day, a social worker at Sofia’s elementary school told Maria about NH Navigator – a free service that helps individuals and families understand their health coverage options. Maria decided to reach out. A Navigator arranged to meet her in person at the local public library, a quiet and accessible location that fit into Maria’s busy schedule.
During their meeting, the Navigator carefully reviewed Maria’s household income, expenses and medical needs. They discovered that both Leo and Sofia qualify for the New Hampshire Children’s Health Insurance Program (CHIP), based on Maria’s income and family size. For Maria herself, the Navigator found that she qualifies for a subsidized health insurance plan through the ACA Marketplace, made more affordable with the help of Advanced Premium Tax Credits (APTCs) and potential cost-sharing reductions.
The Navigator walked Maria through the CHIP application process for her children and helped her select a Managed Care Organization (MCO) that covered the pediatric specialists and services Leo and Sofia rely on. They confirmed that many of the children’s current providers were in-network and helped identify alternatives where needed.
For herself, Maria received help comparing ACA Marketplace plans that fit her budget and covered her preferred providers and prescriptions. The Navigator explained key insurance terms—deductible, copay, coinsurance—and showed Maria how the tax credits would reduce her monthly premium. They also connected her with affordable mental health resources, and tools like GoodRx to reduce medication costs.
Before the meeting ended, the Navigator made a follow up appointment with Maria for a check-in after 30 days, to ensure that Maria received her insurance cards from her insurance carrier and MCO, understands how to pay her bills and to ensure she is satisfied with her coverage options. They also helped her make a plan to stay on top of annual renewals and update her applications if her income or household situation changed.
Thanks to the Navigator’s guidance, Maria was able to enroll her children in CHIP and secure an affordable Marketplace plan for herself. Now, she no longer has to choose between paying for therapy and buying groceries. Her children can continue receiving the care they need, and she finally has access to preventive care and mental health support for herself.
More than just health coverage, Maria found something deeper—peace of mind. With newfound confidence and knowledge, she can now navigate the health care system with clarity, knowing help is available when she needs it. For Maria, this wasn’t just about filling out forms. It was about restoring balance and hope for her family’s future.
Click for more information on NH Navigators.
*This project is supported by the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $1.5 million with 100 percent funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government.*
