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What is AHIP Certification and How do I Get it?

About AHIP                    

ahip-logo-blueIn 2013, two organizations merged to create what is known today as America’s Health Insurance Plans (AHIP). Those organizations were, the Health Insurance Association of America (HIAA) and the American Association of Health Plans (AAHP).

AHIP’s vision is to shape and drive market‐based solutions and public policy strategies to improve health, affordability and financial security by:

  • Promoting consumer choice and market competition
  • Simplifying the health care experience for individuals and families
  • Supporting constructive partnerships with all levels of government
  • Partnering with health care providers on the journey from volume to value
  • Addressing the burden of chronic disease and social factors that impact health
  • Pursuing the promise of clinical innovations while ensuring value
  • Harnessing data and technology to drive quality, efficiency, and consumer satisfaction

 ⍟ What is AHIP certification?

What is AHIPThe purpose of the certification is to prove that an agent has completed the necessary Medicare training courses and is aware of the most up to date compliance requirements and regulations from the Centers for Medicare & Medicaid Services.

AHIP certification is accepted by all and required by most carriers if you want to legally sell Medicare Advantage (MA) or Prescription Drug Plans (PDPs) for the current certification year.

Be aware that while most carriers will require AHIP certification, it will only serve as a pre-requisite to completing additional carrier specific certifications.  Check our carrier specific certification page for more details.

What’s covered in the test?                     

How to take the AHIP testIn general, the certification material will test your understanding of a wide variety of Medicare related topics, as well as Fraud Waste and Abuse (FWA). Here’s a short list on what will be covered.

Medicare:

  • The basics of Medicare fee-for-service eligibility and benefits
  • The different types of Medicare Advantage and Part D prescription drug plans
  • Eligibility and coverage
  • Nondiscrimination training
  • Marketing and enrollment under the Medicare Advantage and Part D program requirements


Fraud Waste & Abuse:

  • How to identify FWA
  • Industry efforts in detecting fraud
  • Legal tools to combat FWA
  • The human and financial cost of FWA
  • Medicare Parts C and D Fraud, Waste, and Abuse and General Compliance requirements
  • Who commits FWA
  • Reporting FWA; loopholes and obligations

 How do I take the AHIP Test?                

AHIP TestTo take the online test you must register through the AHIP website. If you have registered any time after June 2012 then you won’t need to register again. The 2019 test will be available until June, and then will be replaced by the 2020 test.

Simply login through the AHIP website using your National Producer Number (NPN) as your user name and the password you used when you logged in last.

The 50 question open book test is administered online and has a 2 hour time limit. You must pass both parts of the test to be AHIP certified for the current year.

PSM is proud to offer our agents a discount for AHIP certification at $125. The test normally costs $175 for 3 attempts and you must score a 90% to pass. If you fail all 3 attempts you will need to apply again (and pay again) for 3 more attempts.  

Once you have completed the AHIP certification you must then upload it to the website of each carrier you wish to work with.

Upon uploading the certification, the carrier will normally have additional carrier specific training listed in order to satisfy their requirements to sell.

Be aware that many carriers will not accept 3 failures in a given year. If you don’t pass on the 3rd attempt, you would not be able to sell their products for that year, even if you did go on to pass the AHIP test.

There are a number of self-study courses available to help prepare you for the test. We strongly recommend you take training courses that cover the same material, to ensure you’re prepared to take the test.

You can access the carrier specific certification instructions from the links below:

 
If you have any questions regarding carrier certification requirements or how to obtain the PSM discount for AHIP certification please contact one of our dedicated marketers for help. 

Thank you for reading.  Don’t forget to give us a like and a share.  We wish you the best of luck on your certification.

 

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