AHIP Certification: Everything You Need to Know About AHIP Medicare Training
UPDATE – June 1, 2021: Medicare + Fraud, Waste and Abuse Training for Plan Year 2022 will open on Monday, June 22, 2021. Click here to receive a $50 discount on your test.
This may be your first time pursuing AHIP certification, or you may be a seasoned Medicare agent. Either way, preparation is vital. In addition to the associated cost, some carriers limit the number of attempts to pass, and most have strict requirements about minimum scoring.
If you’re planning to take the AHIP test, we’ve compiled the essential information to help you prepare.
The AHIP Medicare + Fraud, Waste, and Abuse Certification is administered by America’s Health Insurance Plans, a trade association of insurance providers whose stated mission is to “improve and protect the health and financial security of consumers, families, businesses, communities and the nation.” They facilitate and administer annual testing for Medicare agents.
Most insurance carriers require completion of AHIP’s yearly certification before they will allow agents to sell their products, and some also require additional carrier-specific training.
The standard cost of AHIP certification is $175. Click here for a $50 discount.
Many carriers allow a maximum of 3 attempts, meaning that if you fail 3 times, you will not be allowed to sell those carriers’ plans for the next year.
Some carriers, however, will allow you to pay another $175 and take the test 3 more times.
Failing a carrier’s certification will prohibit you from selling their plans for the next plan year. It may also result in the loss of earned renewals.
Be sure to visit AHIP Certification Central and click on the carrier’s logo to see full AHIP certification and re-certification details.
You must re-certify with AHIP each year. You can recertify via a carrier link for the discounted $125 rate as long as you are an agent in good standing.
To pass the AHIP test, you must score at least 90%.
Since the test is updated each year, it’s unlikely that any answers you find online will be up-to-date or accurate. The AHIP certification exam is open book, however.
In addition to the Medicare Training Course, AHIP also offers modules in Medicare Fraud, Waste, and Abuse (FWA) and CMS General Compliance. You’ll need to complete all sections successfully before receiving certification.
It’s a good idea to download all of the slides for each module for review.
For the Medicare Training portion of AHIP, make sure you spend extra time on subjects like:
- Compliance, specifically in client communications and enrollment
- Medicare eligibility and coverage
- Differences in plan types
- Plan and coverage details for Medicare Advantage and PDP
For the Fraud, Waste, and Abuse (FWA) portion of your AHIP certification, review materials related to:
- Preventing FWA
- Spotting FWA and proper reporting procedures
- The consequences of FWA
Check out NCC’s library of CMS Medicare documents for related materials.
The AHIP test itself is timed (you have 2 hours to complete the final exam), but the training modules you’ll be given prior to your test are not timed. They can take up to several hours to complete depending on how familiar you are with the material.
The test includes 50 questions, and you have two hours to complete your exam.
Each state is different, but generally yes, you can get CE credits for taking AHIP for an additional fee. Some states will require an exam proctor for CE Credits.
If you’re new to AHIP, use our link to their website and register.
For existing users who registered with AHIP after June 2012, your registration should still be valid. Make sure to log into AHIP’s website to confirm that you still remember your correct username and password. Your National Producer Number (NPN) can be used as your username. If you have trouble, AHIP’s website supports both password resets and username requests.
Even if you have registered in years past, you will have to pay to retake the certification each year.
You will need to complete your AHIP certification before you sell most carriers’ plans, but other than that, there is no set deadline.
The current year’s AHIP certification will be taken down and updated for the next year around mid-June each year.
Generally, the next year’s AHIP certification will also allow you to sell current year plans with most carriers (i.e., passing the 2021 AHIP certification will allow you to sell both 2020 and 2021 products ).
Most carriers require AHIP before you can take their specific certification to sell their Medicare Advantage or PDP plans. While there are a few exceptions, it is highly recommended that you complete the AHIP Certification if you plan to sell Medicare Advantage or PDP plans.
If you’ve already passed this year’s exam by logging in through a carrier portal, you don’t need to retake the test for additional carriers. Instead, you can transmit your scores directly from your AHIP account.
You can also log into the carrier site where you would like your score transmitted, use their internal links to connect to AHIP’s website, then transmit your score.
Once you’ve completed your test on the AHIP website, you will receive a link to a printable copy of your certificate. If you’ve used a carrier discount link, you’ll be shown a link to transmit your results to the carrier.
Carriers often have specific methods they prefer you to use when navigating the AHIP courses, so be sure to read the information provided by the carrier carefully.
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