AHIP Certification: A Comprehensive Guide

June 30, 2021

Are you thinking about the AHIP certification? In this week’s Broker Link Podcast, we take a closer look at what you need to know for AHIP Certification 2022.

AHIP Certification 2022

AHIP, (America’s Health Insurance Plans), is an industry-recognized certification test that is required by almost all Medicare carriers.  It’s required to sell Medicare Advantage (MA) or Prescription Drug Plans (PDPs) for each calendar year.

Most carriers require the AHIP certification as a prerequisite to their own additional specific certifications.  However, UnitedHealthcare does not require this certification for its products.

If you are doing this certification test for the first time or just want a reminder, here’s what you need to know:

The AHIP Certification Test

  • On average preparation for the AHIP certification test may take 10-15 hours
  • Available exclusively online
  • It’s completed in 5 modules with a quiz at the end of each section
  • The final test consists of 50 questions and requires a score of 90% or higher
  • You are allowed 3 attempts to take it per calendar year

If you have completed the exam the year prior, you may skip to sections 4 and 5, and complete the final exam.

The AHIP training INcludes:

  • The basics of Medicare fee-for-service eligibility and benefits
  • 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

Similarly, the Fraud Waste and Abuse Training will consist of:

  • How to identify FWA
  • An overview of the industry efforts in detecting fraud
  • Legal tools to combat FWA
  • Understand both the human and financial cost of FWA
  • Review Medicare Parts C and D Fraud, Waste, and Abuse and General Compliance requirements
  • Who commits FWA
  • Reporting FWA; loopholes and obligations

From the AHIP Medicare Training Website

In the Podcast we’ll also explore:

  • How to get carriers to pay for your certification
  • Where to find study guides
  • How many times you can take the AHIP
  • And so much more…

We have a complete library of podcasts to help you grow your business.  You can listen to all of our Broker Link episodes in our Podcast library here!

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