Navigator Notes is a Q&A series where we introduce our embedded navigators from across the state and have them share what moves them to help individuals and family access health coverage! This Q&A is with southwest Virginia navigator Lois Caliri, who has worked with Enroll Virginia for the last four years.

Area of service:

Cities of Bedford, Roanoke, and Salem, and the counties of Bedford, Botetourt, Craig, Franklin and Roanoke

How long have you worked as a navigator?

I’ve worked as a navigator for four years.

Why do you do what you do?

Meeting with people, listening to their stories, paving a clear path for them to understanding their health insurance options and enrolling them in affordable health coverage results is a fulfilling experience for all involved.

In the maze of the health insurance industry, it is easy for consumers to take a wrong turn and end up in a mess. When I encounter such situations, I enjoy peeling back the onion to help them identify the issues and get the full story. That research, coupled with conversations with all people involved, has let me to reach successful resolutions for the consumers.

Moreover, I never know what story I will hear and that ever-changing scenario keeps me on my toes. To that end, I’m always learning and I love sharing that knowledge with consumers.

Ultimately, I smile knowing I can guide and help those who need an advocate.

What is the most rewarding part of your job?

My rewards are multifaceted. The following are the first that come to mind:
• Earning the trust and respect of those whom I help.
• Seeing and hearing consumers’ heartfelt gratitude when they get affordable health insurance.
• Resolving issues and grievances.
• Advocating for those who say they have nowhere to turn for help.
• Navigating the complex health insurance system so consumers can make informed decisions and feel comfortable with their choices.
• Working with a professional team of navigators, supervisors and directors.

“I smile knowing I can guide and help those who need an advocate”

Why do you feel strongly about helping ensure that individuals and families have access to affordable health coverage?

I believe that affordable health insurance enhances one’s overall physical, social, mental health status and quality of life.

Is there one story from a person or family that sticks out to you as memorable and rewarding?

I’d like to share a story that will always stay with me. It exemplifies why I do what I do. A few years ago, the father of a little girl came to see me. He was scared because he didn’t know what to do.

The gentleman was taking his daughter to local doctors to treat her heart problems. The doctors accepted his Marketplace health insurance as ‘in-network,” until he was referred to an out-of-town hospital for his daughter’s heart surgery.

When the gentleman asked a hospital employee if it accepted his insurance plan, he was told it did. The gentleman accepted that person’s word on face value. It never occurred to him to ask about the ‘in network’, ‘out of network’ guidelines.

Following further conversations with the hospital, the gentleman learned he was out-of-network. The exorbitant costs for the surgery and follow-up visits were frightening. The gentleman panicked. He could not afford those bills. What’s more, he feared for his daughter’s life.

I started working with him at this point. A hospital employee told me I should steer the gentleman away from the Marketplace, suggesting the gentleman enroll in a private health plan. I did not respond to that suggestion. The gentleman wanted to stay in the Marketplace.

Following multiple meetings with the gentleman and phone conversations with the hospital, I found another insurer in the Marketplace. I explained the gentleman’s situation and the insurer’s rep assured me that it would apply its in-network prices to the situation at hand.

The gentleman chose a gold plan from that insurer. Ultimately, the gentleman’s daughter’s surgery was successful! To this day, I periodically see the gentleman in town and he always shows me pictures of his beautiful and healthy four-year-old daughter.