What is the AHIP Certification and How Do I Get It?

Posted: August 21, 2022 - By: The Quotit Team - Selling Insurance


What is the AHIP Certification

As of 2021, almost 64 million Americans received their health insurance coverage through Medicare, according to the Kaiser Family Foundation. Approximately 42% of that group was enrolled in Medicare Advantage plans, which are supplemental plans offered by private insurers that Medicare-eligible folks can purchase for their Part A and Part B coverage, along with additional benefits.

If you’re looking to grow your health insurance agency or brokerage, selling Medicare Advantage plans may be something you want to strongly consider. But you can’t simply decide to sell these products, snap your fingers, and all of a sudden start selling them. Most insurers let agencies and brokers sell Medicare Advantage plans only if they have completed their AHIP certification.

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What Is AHIP Certification?

America’s Health Insurance Plans (AHIP) is a lobbying group that represents upwards of 1,300 health insurers across the United States. To ensure that brokers understand what they need to do in order to comply with Medicare regulations, AHIP has put together training courses that agencies need to complete in order to compliantly sell Medicare Advantage plans to their clients.

In 2020, AHIP certification consists of two different courses:

  1. The Medicare course explores the ins and outs of Medicare, including what it is, who’s eligible, and what the various Medicare benefits look like. Enrollees will also learn about the various types of Medicare Advantage plans, including Part D prescription drug coverage. Additionally, this course also covers non-discrimination training and marketing and enrollment guidelines.
  2. The Fraud, Waste & Abuse (FWA) course outlines how to identify fraud, what the health insurance industry is doing to improve fraud detection, how you can combat FWA, and the impact FWA has on our lives. Enrollees will also learn to identify folks who are most likely to commit FWA and what they need to do to report an incident.

Simply put, if your agency is interested in selling Medicare Advantage plans, you must pass the AHIP test and receive certification. Otherwise, even if you’re able to convince one or two insurers to let you sell Medicare Advantage plans, the vast majority will not work with you—causing you to leave serious money on the table.

What Are the Benefits of AHIP Certification?

There are a number of reasons why your agency needs to pursue AHIP certification, which we’ll examine next.

1. You’re able to sell Medicare Advantage plans

Most obviously, because AHIP certification enables you to compliantly sell Medicare Advantage plans, it allows you to unlock additional revenue streams. 

More than 27 million people are currently enrolled in Medicare Advantage plans, so this gives you access to a large customer base. The more clients you convert, the more revenue and commissions you generate.

2. You learn even more about your industry

From the outsider’s perspective, Medicare is a complicated business—particularly for first-timers who just aged into the program. By achieving your AHIP certification, you’ll learn everything there is to know about Medicare and Medicare Advantage plans—giving you a wealth of knowledge that you can transmit to clients and leads whenever they come to you with questions.

Using this information, you can position yourself as a trusted adviser—someone who is immensely knowledgeable in the world of health insurance and can be counted on to help select the best coverage given the circumstances.

3. You avoid potentially costly missteps

The last thing you want is to start selling Medicare Advantage plans only to find out the hard way that you’re not in compliance with various regulations. Failure to identify and report FWA or running afoul of Medicare Advantage marketing regulations could have an adverse impact on your business—up to and including losing the ability to sell these insurance products to seniors.

If the name of the game is growing your business, you obviously can’t afford to wind up in this situation. With AHIP certification under your belt, you can avoid this outcome.

How Can You Get AHIP Certification?

The good news is that earning AHIP certification isn’t anywhere near as hard as it might sound. All you need to do is complete the two courses outlined above. In most cases, this will set you back $175, though some insurers offer a $50 discount if you take the exam through their portal. Why not take advantage of that?

Once you complete the courses, you’ll then have to take a timed exam to make sure you’ve mastered the content. The test should be, more or less, straightforward, and as long as you pay attention and do your best, it will likely be relatively easy to pass.

If you have your sights set on growing your insurance business by selling Medicare Advantage products, there’s no better time than now to begin the AHIP certification process. That way, you’ll be able to add more value for your clients and do your part to make sure that more and more people have the health insurance coverage they need year in and year out.

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