AHIP (America’s Health Insurance Plans) Certification

Are Medicare Agents prepared to sell once their carrier contracts have been signed? Almost. Did the agent complete the AHIP certification yet?

The government establishes the rules for selling Medicare Advantage plans, and AHIP training and certification are available to assist agents in doing things the right way and protecting senior citizens.

Background Information

In 2013 when the American Association of Health Plans (AAHP) and Health Insurance Association of America (HIAA) merged the America’s Health Insurance Plans (AHIP) was formed. AHIP is a national health insurance trade association that represents nearly 1300 companies. https://www.aha.org/system/files/content/00-10/0704-uhp-ahip.pdf

Most insurance companies require agents to complete AHIP’s Medicare training courses in order to sell Medicare Advantage plans during the Annual Enrollment Period (AEP). AHIP is generally required by insurance companies to ensure that Medicare agents selling their plans are in compliance with the most recent CMS regulations and guidelines.

How can Medicare agent get AHIP certified?

Because the Medicare industry is anything but static, AHIP certification should be renewed every year.

On June 21, 2021, the AHIP certification for the upcoming 2022 became available. If you have previously completed AHIP training, you should be aware that you will need to reset your password when you access the site for the first time as of May 10, 2021.

Medicare and FWA training courses are required for AHIP certification (Fraud, Waste& Abuse). The AHIP training focuses on the various types of Medicare Advantage and Part D prescription drug plans, as well as the fundamentals of eligibility and benefits, marketing guidelines, and proper enrollment procedures.

The training on Fraud, Waste, and Abuse covers industry efforts and tools for detecting fraud in the Medicare Program, and the federal government takes fraud very seriously. This course also covers proper fraud reporting techniques, as well as the human and financial costs of FWA.

In addition to AHIP, most Medicare Advantage carriers require their own product certifications. Medicare agents can complete the carrier certifications through the broker portals of the carriers.

AHIP test requirements

If you passed AHIP last year, you must pass it again this year because it is required annually in order to sell. However, you already have an advantage because you have demonstrated a solid foundational knowledge of Medicare sales.

The AHIP certification test costs $175, but many carriers offer a $125 discount. The AHIP exam is an open-book exam, which means you can print the training modules and take notes while taking the exam. The final exam is a timed test with 50 questions, and agents have two hours to complete it. The training modules for each section preceding the final exam may take several hours and are not timed.

To pass the AHIP exam, you must achieve a score of 90%. Agents should plan on spending about a week preparing using the training modules. Agents should make use of technology by opening useful tabs, using split screens, searching with keywords, and quickly jumping to the section required to answer the question. Make sure to study, take notes, relax your mind, and maintain a positive attitude in order to pass the test with a score higher than 90%.

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