What Is AHIP Certification and How Do I Get It?

You have your leads in hand and your contracts signed, so you’re ready-to-sell, right? Well… almost. Did you complete your AHIP certification yet?

Remember, the government administers Medicare Advantage plans — and that means there are rules for selling them. But there’s no need to worry! The required certifications, such as AHIP training, are in place to help protect seniors and reward agents who do things the right way.

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What AHIP Stands for in Medicare

A national trade organization for those who provide health care coverage, services, and solutions in America, AHIP once stood for America’s Health Insurance Plans. For quick background, AHIP formed in 2013 when the Health Insurance Association of America (HIAA) and American Association of Health Plans (AAHP) merged. As of June 1, 2021, the organization goes solely by the name AHIP.

Today, AHIP represents nearly 127 member organizations offering health insurance to more than 200 million Americans and reaches more than 90,000 health care professionals.

AHIP advocates for a more affordable, equitable, and sustainable health care system through lobbying, research, and developing and analyzing policies. They are also well-known for their professional development courses, including their widely accepted Medicare and Fraud, Waste, and Abuse training for insurance agents selling Medicare Advantage and prescription drug plans.

AHIP advocates for a more affordable, equitable, and sustainable health care system through lobbying, research, and developing and analyzing policies.

What Does AHIP Certified Mean?

In order to sell Medicare Advantage plans during the Annual Enrollment Period (AEP), agents must complete annual Medicare and Fraud, Waste, and Abuse (FWA) training that is compliant with the Centers for Medicare & Medicaid Services (CMS). Insurers require this training to ensure their agents are aware of and understand the latest CMS guidelines and regulations.

In the Medicare industry, being AHIP certified means that someone has completed AHIP’s Medicare and FWA training, knows of and understands all CMS rules for selling Medicare Advantage and Part D plans, and is qualified to sell these plans for the current and/or upcoming plan year.

How Do You Get AHIP Certified?

AHIP’s 2025 certification season starts on June 24, 2024.

Agents can directly purchase and take the certification course through AHIP.org; however, some carriers have specific AHIP links. You can find their specific links via Ritter’s Certification Center. (You must log in or create a free account with our site to view these details.)

Agents can directly purchase and take the certification course through AHIP.org.

Generally speaking, the certification consists of two courses: Medicare and FWA. The AHIP Medicare training covers the basics of eligibility and benefits, along with the different types of Medicare Advantage and Part D prescription drug plans. Teaching compliance with the marketing guidelines and proper enrollment procedure is an important part of this course.

FWA training covers industry efforts and tools to detect fraud in the Medicare program. The federal government takes fraud very seriously. This training educates you on the human and financial cost of FWA, as well as the proper reporting techniques.

After completing the training modules, you’ll have to pass a timed, 50-question test with a score of 90 percent or higher to become AHIP certified.

FAQs About AHIP

Whether it’s your first time or your fifth, completing the annual AHIP certification is important for licensed insurance agents selling Medicare plans. Here are the answers to some frequently asked questions about AHIP certification.

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

Yes. Since plans and CMS regulations change year to year, you must pass the test annually in order to sell.

The good news is you’re already at an advantage if you passed last year, because you’ve proven to have a good foundational knowledge of Medicare sales.

Note: Many carriers require agents to continue certifying with them to receive renewal commissions. AHIP is oftentimes part of carriers’ certification requirements.

Do I need to complete the AHIP training review questions?

Yes. New and returning agents must complete all review questions, at the end of the training modules, before taking the AHIP final exam. How you do with answering the review questions will not affect your score on the final exam.

How many attempts at the AHIP test do I get?

Three. If you fail three times, you can re-enroll and purchase another set of three attempts; however, many carriers will not accept three failures in a given year and prohibit you from selling their product during that plan year.

How long must I take between failed attempts?

It depends. There’s no set time you need to wait before trying the AHIP test again.

If you fall just below the passing threshold and feel confident in your knowledge, you can give it another go immediately. If you miss the mark by more than a few points, we’d recommend taking more time to study before your second or third attempt.

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.

Do I have to take the training on a computer?

Nope! Agents are able to train on the go with AHIP’s mobile-friendly technology.

How much does AHIP cost?

It costs $175 to take the 2025 AHIP certification test.

AHIP’s digital and online educational courses are also subject to sales tax in several states. Starting June 1, 2024, if these tax laws apply to your state, you’ll be charged sales tax at checkout. If you have any questions or concerns, you can reach out to [email protected].

Is there a deadline to pass AHIP to sell in 2025?

Technically, yes. Passing AHIP is the initial step to completing most carrier certifications, so you won’t be ready-to-sell any MA plans until you do so.

Is AHIP an open-book test?

Yes. You can print the training modules and use your notes while taking the test.

Is AHIP a timed test?

Yes. The final exam is 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 get through if it’s your first time reading them.

What score do I need to pass?

90 percent. If you get a higher AHIP score, that’s great!

How much should I prepare?

It depends. If you’ve passed the AHIP exam before, you should be well-prepared to take it again. That’s the point of certifying in the first place — to become a knowledgeable professional!

If you’re a first-timer, don’t hesitate to set aside a week to prepare using the training modules. Medicare is a complex topic for all of us, and you want to be the most knowledgeable agent, right?

Is AHIP certification hard?

It depends. If this is your first time completing AHIP training, you’ll likely find it more difficult than a more experienced agent. While the course content and final exam questions are subject to change each year, if you’re up to date on the latest CMS regulations and truly understand them, we generally think you should be able to pass.

Remember AHIP is an open-book test, but it covers a lot of material. You’ll still want to study and prepare beforehand, so you know where to look in your materials for help with any questions that are more difficult for you.

If you struggle with test anxiety or test-taking, the Mayo Clinic has some great strategies that may help you increase your score.

Is AHIP certification worth it?

That’s a decision you’ll have to make. Sometimes, AHIP certification is required to sell certain Medicare plans. Sometimes, insurers will accept other CMS-compliant Medicare trainings, like NABIP certification. It depends on the plans you want to sell, what certifications they accept, and which training you believe is more beneficial for your money, time, and effort.

Advice for Passing AHIP

Even if you’ve taken the AHIP exam in the past, it never hurts to be prepared. Try using some of these tips to help you pass the test!

Make Sure You Study and Take Notes

We recommend using AHIP training modules and taking practice tests. Even if you think you know everything from passing it before, think again. A refresher can never hurt, but failing the test just might! When you study and prepare for the exam, engage yourself. Take notes and create your own studying system. You could even have a friend or family member quiz you to make sure you’re retaining the information. While the AHIP exam is an open-book test, it is timed. Therefore, it’s a good idea to have thorough notes, but make sure you’re very familiar with them.

Utilize Technology

A great way to cut down on time when searching for answers is to take advantage of technology. Have tabs open ahead of time that you’ll want to look at during the exam. You can also use split screens, or open a document and then size it to take up only part of your screen so you can look at multiple items at once. If your notes are in a Word document, try using Ctrl + F to find specific keywords or phrases to quickly jump to the section you’re looking for.

Ease Your Mind

While knowing the material is imperative to passing the test, there are other factors that can contribute to you either passing or failing. Be sure to get a good night’s sleep the day before the test. Find a spot to take the test with little to no distractions. Grab some water and a snack and don’t forget to have a positive mindset. A confident, optimistic attitude can go a long way!

For more strategies, tips, and tricks, check out our post, AHIP Test Tips and Tricks for Medicare Certification.

Editor’s Note: This was originally published in July 2016. It has been updated to include information more relevant to the 2025 Annual Enrollment Period.