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AHIP Certification

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What is AHIP Certification and How Do I Get It?

 ⍟ What is AHIP certification?

What is AHIPAHIP certification is an industry recognized method of proving that you have completed the required Medicare training courses, and you understand how to sell medicare in a way that is compliant with the Centers for Medicare & Medicaid Services (CMS).

AHIP (stands for America’s Health Insurance Plans) certification is accepted by all and required by most carriers if insurance agents want to legally sell Medicare Advantage (MA) or Prescription Drug Plans (PDPs) for the current certification year.

If you aspire to sell during the Medicare Annual Enrollment Period (AEP), fulfilling this requirement is of utmost importance. This certification should be integrated into your insurance continuing education program.

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.

 

AHIP Medicare Training

AHIP Medicare Training

In general, the training material will test your understanding of a wide variety of Medicare related topics.

Here’s a short list on what will be covered in the AHIP Course Modules:

  • 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

AHIP Medicare Fraud Waste and Abuse Training (FWA)                 How to take the AHIP test

Similarly, the FWA online course will teach you about:

  • 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

Regulations change in the Medicare space from year to year. As such, it is not a bad idea to take the training each year and ensure that you are up to date on all the changes.

 

How do I Get AHIP Certified?                

AHIP TestIn order to get certified you need to take and pass the AHIP Exam. To take the online exam you must register through the AHIP website.

AHIP’s 2024 certification season started on June 21, 2023

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 Ahip test is a 50 question open book test and is administered online with 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 plan year. If you don’t pass on the 3rd, and final exam, you would not be able to sell their products for that plan year, even if you did go on to pass the AHIP test.

There are a number of self-study insurance education 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:

Aetna

Certification Details

Anthem

Certification Details

Bright Health

Certification Details

Cigna

Certification Details

Clover

Certification Details

Devoted Health

Certification Details

Florida Blue

Certification Details

Humana

Certification Details

Molina

Certification Details

Mutual Of Omaha

Certification Details

UnitedHealthcare

Certification Details

WellCare

Certification Details


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. 

We wish you the best of luck on your continuing education.

 

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

More information can be found at AHIP.org

 

 

AHIP FAQ (Frequently Asked Questions)

 

What are the benefits of getting AHIP certified?

By obtaining AHIP certification, you gain the valuable ability to sell Medicare Advantage plans. This certification acknowledges your expertise and training as an insurance agent, specifically in FWA and other guidelines set by the Centers for Medicare & Medicaid Services (CMS). Additionally, you will acquire extensive knowledge about Medicare and Medicare Advantage plans, positioning yourself as a trusted advisor for the individuals you serve.

 

When is the AHIP training for the 2024 plan year available?

Training for the 2024 AHIP Medicare plan year commenced on June 21, 2023. This training, which includes the latest updates on Marketing Medicare and addressing Fraud, Waste, and Abuse (FWA), is crucial for compliance with CMS regulations and is updated annually.

 

What is AHIP's role in the healthcare industry?

AHIP (America's Health Insurance Plans) acts as a collective representative for the health care financing sector, striving to advocate for improved access to affordable, quality healthcare for all Americans at both federal and state levels.

 

What is the duration for completing the AHIP course?

AHIP offers online self-paced study courses designed by experts, providing a flexible timeframe of 90 to 180 days for course completion. This allows students to enroll and complete the course at their convenience, accommodating busy schedules.

 

Is the AHIP certification exam an open-book format?

Yes, the AHIP certification exam is an open-book test, allowing participants to reference their notes and the course modules during the examination process for better performance.

 

Can the AHIP certification exam be taken online?

Yes, the AHIP certification exam is conducted online, featuring 50 questions with a 2-hour time limit. The exam is open-book, and participants must pass both sections to achieve certification for the year.

 

How many attempts are allowed to pass the AHIP exam?

Participants are given three opportunities to pass the AHIP certification exam. If necessary, an agent can repurchase the AHIP course for a fee of $125 to gain additional attempts at passing all required courses and exams.

 

What are the prerequisites for achieving AHIP certification?

To obtain AHIP certification, one must successfully complete the AHIP training course and pass the associated online test. Registration for the test is facilitated through the AHIP website, where agents use their National Producer Number (NPN) and last-used password for login.

 

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* For Agent use only. Not affiliated with the US government or federal Medicare program.