What is AHIP Certification and How do I Get It?
What is AHIP certification?
The AHIP (America’s Health Insurance Plans) certification is an accreditation that qualifies you to sell Medicare in a manner complaint with the Centers for Medicare & Medicaid Services. Becoming AHIP Certified means completing the required Medicare training courses and passing a certification exam.
AHIP certification is accepted by all carriers and required by most, as it is an industry-recognized method of proving you are qualified. If you are an insurance agent looking to legally sell Medicare Advantage or Prescription Drug Plans for the current certification year.
The best time to get your AHIP certification is before the Medicare Annual Enrollment Period (AEP). AEP is the best time to sell insurance, so being certified and ready to go is your best bet for a successful year.
Additionally, while most carriers require AHIP certification, it is only one step to selling insurance. Carriers will have carrier-specific requirements to selling their policies, and the AHIP certification is often the pre-requisite. Check out carrier-specific requirements for the carriers you want to sell for more details.
This certification should be an integrated part of your insurance continuing education program.
What are the benefits of getting AHIP certified?
The AHIP certification is not just a requirement to your ability to sell Medicare Advantage & PDP. It is the beginning of your expertise and training as an insurance agent in FWA and other guidelines set by CMS. Once obtained, it acknowledges your qualification and preparedness to sell. Additionally, you will learn to become an expert about Medicare and Medicare Advantage plans, which will allow you to be a knowledgeable and trusted advisor for the people you serve.
What to expect from the AHIP Medicare Training?
The Medicare training material is meant to test your understanding of a variety of relevant Medicare topics.
Some of the topics and trainings that will be covered in the AHIP Course Modules include:
- 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
What to expect from the AHIP Medicare Fraud Waste and Abuse Training (FWA)?
The FWA online course will cover many relevant and important topics, including:
- 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 certification requires that you take and pass an AHIP Exam. The exam is taken online, and in order to take the exam, you must register through the AHIP website.
The AHIP 2025 certification season started on June 24, 2024. Log in through the AHIP website using your National Producer Number (NPN) as your user name and the password you set when you registered, or when you last signed in.
The test is 50 questions, and is an open book test. The test has a 2 hour time limit. You must pass both parts of the test to be AHIP certified for the current year.
The test normally costs $175 to take. You will have three attempts to pass, and a passing score is 90% or higher. If you fail all three attempts, you will need to apply and pay again for another three attempts.
It is important to note that even if you pass on the second three attempts, many carriers will not accept three failures in a given plan year. If you don’t pass on the first three attempts, most carriers would not allow you to sell their products for that plan year, even if you did go on to pass the AHIP test.
Upon completion of the AHIP certification, you would then upload it to the website of each carrier you wish to work with. Once your certification is uploaded, each carrier will have their own training and certifications that you must complete in order to sell.
How do I prepare for the AHIP Certification?
There are a number of ways to prepare for the AHIP exam.
One way to study is through the considerable amount of self-study insurance education courses available online. There are many resources you can find online to prepare for these tests. These training courses cover the same material for example, and are great at preparing you for the test.
Additionally, if you are an independent agent, you may consider signing with an FMO. FMO’s typically offer trainings, agent support, and tools, and can assist you through your career. Some FMO’s even cover a cost of the exam, making it a cheaper investment for you.