High School

Neither the ACA nor state laws require any minimum formal educational level (such as a high school diploma or college degree). Nevertheless, a review of many employment advertisements and offerings for past and current available positions as navigators with agencies and organizations suggests that a high school diploma or equivalent is almost always a minimum requirement.  

Postsecondary Education

Associate's degrees and bachelor’s degrees are a minimum requirement to fill some positions, and are preferred in other employment offerings, but such requirements are set by the employer to recruit the most appropriate candidates, rather than by statute. Useful classes focus on topics such as health insurance, the health care industry, communication skills, foreign languages, and computer science. 

Certification or Licensing

Certification is required for all health insurance navigators under the Affordable Care Act. The specific certification training depends on the type of marketplace in which the navigator will work. The type of marketplace is determined by each state.

States with their own marketplace may use federal training programs and standards, though some states (such as New York, Texas, and California) have developed more rigorous state training and certification programs. Where a state does not have its own marketplace, residents participate in a federally facilitated marketplace; in those states, navigators obtain training and certification through federal programs.

The federal standards require navigators to complete eight online courses, each with  accompanying assessments that must be passed. While state-based health insurance exchanges may adopt the federal standards, most have added training and certification requirements. While these training and certification requirements vary, most require a minimum of 40 hours of training. In Texas, for example, in addition to the federal training, navigators must have 20 additional hours of training including five hours on Texas-specific Medicaid and Children's Health Insurance Program provisions, five hours on applicable privacy requirements, five hours on ethics, two hours on basic insurance terminology and how insurance works, two hours of exam preparation, and an hour allotted for completion of a final examination.

The Texas certification training permits classroom courses, self-study, one-time training events and other training opportunities. Federal and most state certification programs require annual or semi-annual recertification, including additional certification training. 

Other Requirements

Fingerprinting and criminal background checks are required for certification as an ACA health insurance navigator. Some positions require a valid driver’s license. Some positions require bilingual candidates to serve diverse communities. 

Aspiring health insurance navigators must complete mandatory web training and certification. 

Navigators need excellent verbal and written communication skills in order to engage consumers and explain available health care options. Many navigators go out into the community to encourage and assist in insurance enrollment and must present a professional and appropriate appearance and gain the trust of consumers. Navigators will benefit from experience with under-served populations and knowledge of diverse community needs.

In certain markets, bilingual navigators will be more employable. Individuals serving as navigators must have high ethical standards and understand their obligation to maintain confidentiality. They must also have experience in navigating the Internet and the Health Insurance Marketplace Web site and be able to input data into applicable computer databases. Knowledge of public health programs such as Medicaid and child health programs will be beneficial.