Finding Better Health Engagement and Member Satisfaction with Navigation

It should be simple for members to access and fully utilize their health benefits ecosystem, but as we all know, understanding healthcare options and navigating benefits can be complex and stressful. From January 1, 2024 through April 11, 2025, our Connect team handled more than 17,000 calls from members in need of assistance in navigating their health benefits and finding care. More than 2,000 of those calls came from members looking to find the right provider, while nearly 5,800 were calls made to verify benefits and find out about out-of-pocket costs.



Members have all sorts of questions. “Where do I go to find the best bariatric surgeon?” “What about cardiac care, or maternity support?” Imagine you’re a member in need of spinal surgery or an organ transplant. How much of your mental energy can you afford to spend tracking down providers in your network, let alone determining which offers the highest quality of care?

Without the right support, even the most straightforward task can become a confusing and exasperating exercise. At Luminare Health, we believe no one should have to navigate this journey alone. That’s why our Navigation solution is designed to provide personalized, high-touch guidance to help members make informed healthcare decisions while optimizing costs and quality of care. Our Navigation solution helps members find in-network medical care and specialty solutions for the best possible support. This solution also engages members more actively in their own health outcomes by optimizing the utilization of all available benefits. 

What Is Navigation?

Luminare Health’s Navigation solution goes beyond traditional customer support by proactively guiding members toward high-quality, cost-effective care for needs such as bariatric surgery, advanced imaging, maternity care, knee and hip replacement, and much more. Through a combination of data-driven insights and compassionate, member-focused support, we help individuals who need care access the care they need—efficiently and affordably.

Our Navigation model is built on three key pillars:

1. Empowerment: We equip members with the knowledge and resources to make informed decisions about their health.
2. Accessibility: We simplify the healthcare experience by providing a single point of contact for care coordination.
3. Affordability: We help direct members to in-network providers and lower-cost care options to reduce out-of-pocket expenses.

How Navigation Supports Members 

Health concerns, such as bariatric surgery and organ transplants require consistent management, specialized care, and ongoing treatment adjustments. Without guidance, members may struggle to access the right providers or end up in costly emergency care situations.

Through our Navigation service, we provide:

• Network Optimization: We redirect members to high-quality, lower-cost providers, reducing unnecessary spending while maintaining excellent care.
• Proactive Outreach: Instead of waiting for members to call us, we reach out to individuals to ensure they’re utilizing their benefits effectively. We proactively connect with members undergoing bariatric surgery, cardiac care, knee and hip replacements, spinal surgery, and organ transplants, as well as those in need of maternity care and advanced imaging.
• Personalized Care Coordination: We help members schedule specialist visits, understand their treatment plans, and connect with disease management programs for increased member engagement and satisfaction.
• Behavioral Health and Wellness Support: Health concerns don’t just impact physical health—they take a toll on mental well-being. Our Navigation solution aligns with behavioral health programs and wellness initiatives, supporting whole-person care.

Service Excellence at the Core of Navigation

At Luminare Health, service excellence isn’t just a goal—it’s a commitment embedded in every interaction. Our Navigation team is trained to engage with empathy, clarity, and efficiency, ensuring that each member’s unique healthcare journey is met with expert guidance and unwavering support.

By leveraging technology while maintaining a human-centered approach for complex cases, we create an experience that is both seamless and personal. Members trust us because we prioritize their well-being and advocate for their best interests—not just in the moment, but throughout their entire healthcare journey.
 

The Future of Navigation at Luminare Health

As we continue to expand our Navigation solution, we remain focused on enhancing accessibility, affordability, and member empowerment. In the coming months, we will introduce: 

• 24/7 Member Support, including nurse line access
• Additional digital tools for self-guided care journeys
• Expanded behavioral health navigation and proactive outreach

By prioritizing service excellence and member advocacy, Luminare Health’s Navigation solution is shaping the future of personalized healthcare guidance.

Let’s Navigate Healthcare Together

Health care concerns shouldn’t force members to navigate the healthcare system alone. With Luminare Health Navigation, members gain a trusted partner in their wellness journey. We simplify the process, optimize costs, and most importantly—empower members to get the health care they need.

If you, or your client, are interested in joining the Navigation pilot program, of if you want to learn more about our Navigation solution, connect with us through the contact form below.