Important Opioid Information for Medicare Members

Important Information Regarding Medicare & Opioids

CMS Is Now Limiting Opioid Prescriptions to 7 Day Quantities & More Starting effective 2019, the Center for Medicare and Medicaid Services has implemented new changes in regards to opioid prescriptions. The biggest changes include - Limiting prescriptions to no higher than 90 morphine milligram equivalents per day Flagging patients as high-risk if taking benzodiazepines + opioids Adopting a 7-day limit on initial fills of opioids to treat acute conditions These changes are exempt for palliative care, hospice, cancer, and long term pain management This change is in an effort to help combat the opioid epidemic, however, many patients with chronic pain are now worried they will not be receiving the care they need. If you are being denied your medication, we recommend you coordinate with both your pharmacist and doctor/specialist. The pharmacist can then indicate that the prescriber was consulted so the prescription claim can pay. For more detailed information, please read report of these new regulations on CMS.gov below - https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE18016.pdf  Questions?

Tired of Dealing with Insurance Agents?

We get it, insurance agents can be annoying. And maybe you prefer to do things on your own. Good news, simply click the images below to instantly quote & apply with the various insurance companies we're affiliated with. No agent nor consultation required. Stress free, risk free, and quick! 

Don't see what you're looking for? It probably requires us to submit an application or get the quote for you. Simply call, text or email us (909) 746-9127 // info@aacefs.com with what you're looking for. We promise to be quick and treat you like a human, not a sale.

When Drivers Should Check Other Car Insurance Quotes

When it comes to the premium drivers pay on their car insurance, certain events can affect the amount they pay. Whether if those events affect their car insurance rates in a positive or negative way, drivers can find out by checking the car insurance market at least once every six months.

Drivers are recommended to check the online insurance market in the following situations: 

• Driver's credit score changed. Insurance companies are allowed to take drivers credit score into consideration when determining their premium rates. Drivers with a good score will pay less, while drivers with bad credit score will pay more on their premium rates.
• State's laws have changed. The car insurance laws and the requirements are different in each state. These laws and requirements can change at any time, so it's important for the policyholders to be vigilant.
• Driver's has maintained coverage. If the policyholder is a new driver or a more experienced driver that has a coverage lapse, then the policyholder is considered a high-risk driver. High-risk drivers pay more on their premiums, and in order to get rid of the high-risk label, they need to maintain coverage for at least six months.
• Major life events. Several events that happen in the life of a policyholder can affect their premiums. Events, like getting married, moving to a low-crime neighborhood, or buying a safer car, can make the policyholder premium rates to decrease. Events, like getting divorced, moving to a high-crime neighborhood, or buying an unsafe vehicle, will make the policyholder premium to increase.
• Policy renewal time is getting closer. This the best time for a policyholder to shop for online quotes. Many rival insurance companies will try to lure the policyholder to their companies, by offering him all sorts of discounts and offers.

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Thursday Motivational

NEW CALIFORNIA LAW - Gender Can No Longer Be Considered in Setting Car Insurance Rates

California joined about a half-dozen states this month in banning the use of a person’s gender when assessing risk factors for car insurance, a change that could potentially alter rates for scores of drivers across the state.

The state, which is the country’s most populous, requires insurers to prioritize criteria like drivers’ safety records and years of experience behind the wheel when setting auto rates, but it also allows them to weigh other factors, like marital status. Gender had been among the optional criteria until the beginning of this year, when a new regulation went into effect prohibiting the practice.

In announcing the change, the departing state insurance commissioner, Dave Jones, said the new regulations “ensure that auto insurance rates are based on factors within a driver’s control, rather than personal characteristics over which drivers have no control.”

Mr. Jones’s term as commissioner ended in early January, and the new regulation was one of his final acts. The state’s Insurance Department, in explaining its reasoning for the change, noted that the industry had inconsistently — and perhaps unfairly — applied gender weighting in pricing.

Some insurers found that female drivers were a higher risk while others claimed the inverse, the department concluded, and the factoring of gender on rates varied widely by location.

“Gender’s relationship to risk of loss no longer appears to be substantial,” the department noted, saying the rationale for using it was “suspect.”

“Charging drivers different rates by their gender might have seemed like a good idea decades ago,” Ricardo Lara, the new state insurance commissioner, said in an emailed statement. “Gender, race, ethnicity or sexual orientation are beyond your control, and it is not a fair or even an effective way to predict risk.”

The specific impact on someone’s insurance rates in California remains uncertain. Insurers have until at least July to submit gender-neutral auto rating plans to the Insurance Department for review.

Removing the gender factor could in effect equalize rates for inexperienced drivers: Younger men, who have typically paid higher rates, on average might see declines, while younger women could see increases. In an economic analysis of the change, the Insurance Department estimated that female drivers with three or fewer years of driving experience were expected to see the biggest impact, with rates going up 6 percent on average. Male drivers with similar driving experience could have a corresponding decrease of about 5 percent.

The department’s analysis, based on 17 companies that make up about two-thirds of the state’s consumer car insurance market, estimated scant effect on rates over all.

The impact for any given driver, however, could “vary considerably” by the individual, by the insurer and by the type of coverage chosen, the state noted.

Janet Ruiz, a spokeswoman for the Insurance Information Institute, an industry group, said she didn’t expect California drivers over all to see a big impact on premiums, because gender wasn’t one of the top factors used in setting rates anyway.

Other states that ban the use of gender in setting rates include Hawaii, Massachusetts, Montana, North Carolina and Pennsylvania, according to the Consumer Federation of America, a nonprofit advocacy group. Most other states allow the practice, and insurers have long argued that the use of gender in setting premiums is sound actuarial practice.

The rule change in California followed the advent of a state law aimed at accommodating the concerns of transgender people when using identity documents. The Gender Recognition Act of 2017 in part allows Californians to choose, in addition to “male” or “female,” a third category of “nonbinary” on their state driver’s licenses. The law describes nonbinary as an umbrella term for people whose gender identities “fall somewhere outside of the traditional conceptions of strictly either female or male.” The option became available Jan. 1.

In Oregon, where drivers may select “not specified” as a third gender category on their licenses, insurers may continue to use gender as a factor in setting rates. However, insurers must submit documentation justifying how they rate those drivers.

Here are some questions and answers about auto insurance premiums:

What factors do insurers consider when setting auto insurance rates?

The rules vary by state, and some exclude or restrict certain criteria. Typical factors used by insurers to assess a driver’s risk and set premiums, in addition to your driving record and claims history, might include where you live, your age, education, occupation, marital status, credit history and the type of car you drive, according to the National Association of Insurance Commissioners.

What can I do if I think my auto premium is too high?

Industry representatives and consumer advocates alike advise people to seek quotes periodically from competing insurers. Contact us at Ample Insurance Services for free quotes from over 8+ auto insurance companies.We do the work for you, free of charge.

What else can I do to keep my auto rates affordable?

Consider raising your deductible, the amount subtracted from your check when an insurer pays a claim under your policy. Going from $500 to $1,000 can save between 10 and 15 percent annually on premiums. Also, make sure you don’t let your policy lapse; if you go without coverage even for a day, you’ll likely see your rates rise. And, she said, bundling your coverage for renter’s or homeowner’s insurance with your auto policy with the same insurer can save an average of 8 percent annually.

Renters Insurance in Chino Hills

Presentation in Chino Hills

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Out-of-Pocket Insurance Costs Challenge Pre-Medicare Patients

The out-of-pocket costs of health insurance coverage is daunting for older adults who don’t yet qualify for Medicare, posing insurance and treatment access issues for this population, according to a recent AARP/University of Michigan poll.

The poll, which included responses from just over 1,000 pre-Medicare-age patients ages 50 to 64, revealed that the high cost of health insurance that has not been provided by an employer presents a considerable hurdle for these patients.

Forty-five percent of respondents said they had little to no confidence in their ability to afford health insurance once they retire. Another 27 percent said they are unsure whether they will be able to afford their coverage over the next year.

As a result, patients are faced with a few options, none of which are ideal, the poll administrators suggested.

About 10 percent of respondents said they considered going without insurance because of high costs, although only 5 percent reported that they followed through on those plans.

Industry experts know that access to insurance is key predictor of primary and preventive care utilization. When a patient foregoes insurance coverage, they increase the risk of putting off care until their symptoms indicate more costly and intrusive interventions.

As it stands, poll respondents said they have delayed care at least until they had their desired type of health insurance. For example, 15 percent of those who began a new plan in 2019 said they would wait until that plan kicks in to access medical care. Eight percent said they are delaying medical procedures until they age into Medicare.

Individuals age 50 to 64 have also reportedly considered delaying retirement to keep their employer-sponsored healthcare packages. Nearly 14 percent said they have kept their jobs specifically to continue receiving affordable health insurance benefits. Eleven percent said they delayed or considered delaying retirement to maintain payer coverage.

The current debate surrounding healthcare and Medicare coverage is also causing stress for some patients, the poll revealed. Half of the adults surveyed said they keep up with healthcare policy news as it pertains to Medicare and payer coverage.

And although the poll was completed before the December 2018 Texas court ruling that the Affordable Care Act (ACA) is unconstitutional, 68 percent of respondents still expressed concern for the fates of their payer coverage.

The uncertainty around the ACA, coupled with patients’ concerns for out-of-pocket healthcare costs and insurance access, shows a deterioration of the system, said Preeti Malani, MD, director of the poll and a professor of internal medicine at U-M Medical School.

“The Affordable Care Act was intended to cut down on ‘job lock’, where a person feels trapped in their job by their need to preserve their health insurance,” Malani said in a statement. “We were surprised by the low percentage of these adults who bought their own coverage through the ACA exchanges, and the relatively high percentage who felt they had to keep a job or delay retirement in order to keep a plan. Innovative policy solutions are needed to help adults in this age group navigate their insurance options.”

What’s more, the survey revealed relatively low health literacy among patients age 50 to 64. One in five respondents said they had little to no confidence in their abilities to understand insurance plans. About 25 percent said they would not be able to understand what procedures their insurance plan covered or what out-of-pocket expenses they would face.

The healthcare industry needs to do a better job of guiding patients aging into Medicare to low-cost but comprehensive coverage options, said Renuka Tipirneni, MD, MSc, who conducts research at U-M and who helped lead poll design and analysis.

“As people age into the years when many chronic diseases begin to take hold, and when they’re still years away from Medicare coverage, it’s important to talk with someone knowledgeable about all the options for coverage to bring down out-of-pocket costs and better navigate health care in this critical period,” said Tipirneni, who is also a general internist.

Ultimately, price transparency regarding both different medical procedures as well as insurance coverage will be critical going forward. As more patients plan to access their coverage through Medicare in years to come, it will be essential for them to make informed decisions about their treatment and payer coverage.

Motivational Monday

Ditch your Old Insurance Rates in 2018