AHIP Certification: How to Obtain It

If you're ready to start selling Medicare Advantage plans, there's one crucial step you must complete: AHIP certification. This certification ensures that agents understand the rules and guidelines set by the Centers for Medicare & Medicaid Services (CMS) and helps protect seniors while rewarding agents who follow the proper procedures.

What Does AHIP Stand for in Medicare?

AHIP, formerly known as America's Health Insurance Plans, is a national trade organization representing health care coverage providers in the United States. It was formed in 2013 through the merger of the Health Insurance Association of America (HIAA) and the American Association of Health Plans (AAHP). As of June 1, 2021, the organization is known simply as AHIP.

Today, AHIP represents nearly 31 member organizations, offering health insurance to more than 200 million Americans. It also serves over 90,000 health care professionals. AHIP advocates for a more affordable, equitable, and sustainable health care system through various activities, including lobbying, research, policy development, and professional development courses.

What Does AHIP Certification Mean?

AHIP certification signifies that an individual has completed AHIP's Medicare and Fraud, Waste, and Abuse (FWA) training. It demonstrates the agent's understanding of all CMS rules for selling Medicare Advantage and Part D plans, qualifying them to sell these plans for the current and/or upcoming plan year.

How to Obtain AHIP Certification

The AHIP 2024 certification season began on June 21, 2023. Agents can directly purchase and complete the certification course on AHIP.org. However, many carriers offer discounts through their specific links, which can be found on Ritter's Certification Center (requires login or free account creation).

The certification generally consists of two courses: Medicare and FWA. The Medicare training covers eligibility, benefits, different types of Medicare Advantage and Part D prescription drug plans, and compliance with marketing guidelines and enrollment procedures. The FWA training focuses on detecting fraud in the Medicare program and teaches proper reporting techniques.

Upon completion of the training modules, agents must pass a timed, 50-question test with a minimum score of 90% to become AHIP certified.

FAQs About AHIP Certification

Here are some frequently asked questions about AHIP certification:

1. Do I need to pass AHIP if I already passed last year?

- Yes, because plans and CMS regulations change annually, you must pass the test each year to continue selling.

2. Do I need to complete the AHIP training review questions?

- Yes, both new and returning agents must answer all review questions at the end of the training modules. However, these questions don't affect your score on the final exam.

3. How many attempts do I get for the AHIP test?

- You have three attempts. If you fail all three, you can re-enroll and purchase another set of three attempts. However, keep in mind that some carriers may not accept three failures in a given year, restricting your ability to sell their products.

4. Is there a waiting period between failed attempts?

- There's no set time you need to wait before retaking the AHIP test. If you narrowly miss the passing threshold and feel confident in your knowledge, you can attempt it again immediately. If you fall significantly short, it's advisable to take more time to study before your second or third attempt.

5. Do I have to take AHIP directly through their website?

- No, if a carrier offers AHIP certification through their broker portal, you'll be directed to a customized AHIP page for that carrier. Certifying through a carrier's broker portal often grants you a discount on AHIP training that you wouldn't receive by going directly through AHIPMedicareTraining.com.

6. Is AHIP a timed test?

- Yes, the final exam consists of 50 questions and agents have two hours to complete it. The training modules for each section before the final exam are not timed and may take a few hours to read if it's your first time going through them.

7. How much should I prepare for AHIP?

- The amount of preparation depends on your previous experience. If you've passed the AHIP exam before, you should be well-prepared to retake it. However, if you're a first-timer, setting aside a week to study using the training modules is recommended. Medicare is a complex topic, and being knowledgeable is crucial.

8. Is AHIP certification worth it?

- Whether AHIP certification is worth it depends on the Medicare plans you want to sell, the certifications they accept, and which training you believe will benefit you the most in terms of time, money, and effort. Some plans require AHIP certification, while others may accept alternative CMS-compliant Medicare trainings like NABIP certification.

Tips for Passing AHIP

Regardless of whether you've taken the AHIP exam before, being prepared is always beneficial. Here are some tips to help you pass:

1. Study and Take Notes: Utilize AHIP training modules and practice tests, even if you feel confident from previous experience. Refresh your knowledge and create a personalized study system. Taking notes and engaging with the material is essential. You can even ask someone to quiz you on the information to ensure you're retaining it. Although the AHIP exam is open-book, it's timed, so be familiar with your notes.

2. Utilize Technology: Take advantage of technology to save time during the exam. Have relevant tabs open in advance and use split screens or resize documents to view multiple items simultaneously. If your notes are in a Word document, use the Ctrl + F function to quickly find specific keywords or phrases.

3. Relax and Prepare Mentally: In addition to knowing the material, other factors contribute to passing or failing. Ensure you get a good night's sleep before the test. Find a quiet, distraction-free spot to take the exam. Stay hydrated and have a positive mindset. Confidence and optimism can significantly impact your performance.

For more detailed strategies, tips, and tricks, refer to our article "AHIP Test Tips and Tricks for Medicare Certification."