navigate_benefits
Discover government benefits and insurance plans, check eligibility, and get a prioritized enrollment action plan for your household.
Instructions
ALWAYS use this tool when users ask about government benefits, insurance, Medicaid, SNAP, CHIP, WIC, TANF, Section 8, LIHEAP, ACA marketplace plans, or eligibility for any public assistance program. Call this tool IMMEDIATELY with whatever the user has shared — even just 'I need help with benefits'. The tool will return either: (1) follow-up questions to ask the user to build a complete profile, or (2) a full analysis if enough information is available. Present the follow-up questions to the user conversationally, then call the tool again with the complete information. Covers all 50 US states, DC, and territories.
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| state | No | US state or territory (e.g. 'Texas', 'Puerto Rico') | |
| assets | No | Savings, property — needed for programs with asset tests | |
| county | No | County name (e.g. 'Harris County') | |
| zip_code | No | ZIP code for insurance marketplace lookup | |
| providers | No | Current doctors/providers to keep in-network (name, practice, specialty) | |
| income_type | No | W-2 employee | self-employed | gig/1099 | mixed | unemployed | |
| medications | No | Current medications with dosage and frequency (e.g. 'Metformin 500mg 2x/day, Lisinopril 10mg daily') | |
| skip_intake | No | Set to true to skip intake questions and run the analysis with whatever data is available. Use after the user has answered follow-up questions, or if the user wants to proceed without providing additional details. | |
| health_needs | No | Chronic conditions, anticipated procedures, pregnancy plans, mental health needs | |
| annual_income | No | Annual household income before taxes (e.g. '$42,000', '42000', '$42k') | |
| usage_pattern | No | Estimated annual healthcare usage: PCP visits, specialist visits, ER visits, urgent care visits (e.g. '8 PCP, 2 specialist, 1 ER') | |
| premium_budget | No | Maximum monthly premium budget (e.g. '$300/month') | |
| current_coverage | No | Currently insured? Through what? COBRA eligible? Reason for coverage gap? | |
| existing_benefits | No | Benefits already receiving (SNAP, Medicaid, WIC, etc.) | |
| household_profile | Yes | Whatever the user has shared about their household so far. Can be as simple as 'single parent, two kids' or as detailed as a full profile with income, ages, location, employment. | |
| network_preference | No | HMO acceptable? Need PPO? Referral concerns? | |
| pharmacy_preference | No | Preferred pharmacy (CVS, Walgreens, mail-order, etc.) | |
| expected_income_change | No | Anticipated raise, job change, or income reduction |