As you may know, AHIP is a required certification for any insurance agent who wants to sell Medicare Advantage plans. The test costs $175, but you can get $50 off by using this link! It’s really a small price to pay for the amount of money you can bring in from selling Medicare Advantage, especially during AEP. Ready to get started?
*The 2019 test is still available. It will be replaced by the 2020 test in the early summer months.
AHIP stands for “America’s Health Insurance Plans” and was formed by merging of the HIAA and AAHP (Health Insurance Association of America and the Association of Health Plans). The test ensures that all who pass truly understand the healthcare industry and all its rules and helps eliminate fraud, waste, and abuse.
AHIP has roughly 1,300 member companies who sell health insurance to about 200 million Americans. Their goal is to create a more affordable and reliable health care system. AHIP is responsible for gathering research and data on policies, disability income, long-term care insurance, and other medical expenses to uncover what both consumers and health plans need. AHIP also belongs to the Council for Affordable Quality Healthcare Inc., a non-profit based out of D.C. with the mission of improving healthcare plans, associations, and providers.
AHIP works with companies that provide most types of health insurance, including medical, long-term care, disability income, dental, supplemental, and more. The organization releases newsletters, publications, a magazine, and various online materials throughout the year advocating for a better healthcare industry. They also conduct educational and quality assurance programs to keep the public informed.
From AHIP, “Our vision is to advance a vibrant, private-public system with consumer choice, product flexibility, and innovation. We support initiatives empowering consumers with information they need to make health care decisions, promoting health care quality in partnership with health care providers and expanding affordable health care coverage to all Americans.”
From AHIP, “Our mission is to be an effective advocate for a workable legislative and regulatory environment at the federal and state levels in which our members can advance their vision of a health care system that meets the needs of consumers, employers and public purchasers.”
Most insurers require that you complete the AHIP Medicare training courses before you can sell their Medicare Advantage plans. It confirms that you are compliant with CMS regulations and that you understand the rules regarding the plans you are selling. If you get into compliance issues while selling Medicare Advantage plans, it reflects on the plan you are selling – therefore, you cannot sell without your AHIP certification.
To be AHIP certified, you must pass the Medicare and Fraud, Waste, and Abuse (FWA) test. It includes 50 questions, which you have two hours to complete. You MUST pass with at least a 90% score – but you have three attempts to do so. That said, please do not try to take the test until you feel like you fully understand the material and are ready to dedicate the two-hour time block for it. Technically, if you fail three times, you can pay for another three attempts – but most carriers will not accept a passing score after you’ve already failed three times.
You are required to pass both sections: Medicare and FWA. Once you pass those, some carriers will require you to pass a test about their specific plans as well. If you want, you can also spend some time with other AHIP training courses just to learn more about your industry. For example, you can take a course specifically about Disability Insurance or Long-Term Care Insurance.
The Medicare course you need to pass includes information about Medicare eligibility, basic Medicare benefits, and different kinds of Medicare Advantage and prescription drug plans. You’ll also need to know the rules about nondiscrimination and compliance.
The FWA test that you need to pass includes information about FWA rules, the cost of not adhering to FWA rules, and how to report FWA violations.
The AHIP website is simple to follow. You’ll start by either creating a new account or logging into your existing account. Select the plan year that you are certifying for, and then choose whether or not you want your AHIP training to give you continuing education credits (you should). Complete the modules and test quizzes so you can prepare, and then pass your exam with a 90% or better. Then, you can print, save, or transmit your certificate. We recommend doing all three so you don’t lose track of it!
If you contract with Senior Market Advisors, you can receive weekly newsletters and regular emails that include information like notices about other AHIP certification discounts (no cost to you). Click here to start contracting, or call to have your questions answered (1-844-452-5020).
*This post was originally published on March 20, 2017, and updated on January 17, 2019.