Every year, Medicare agents and brokers need to meet annual training and certification requirements. This needs to be done ahead of the annual election period that happens every fall, so summer is the natural time to focus on Medicare certification requirements.

What Do Medicare Agents Need to Do?

Medicare agents need to focus on requirements from two sources: CMS and the various carriers whose plans they want to sell.

  • CMS says that Medicare Advantage organizations and Part D sponsors must make sure their agents and brokers are trained and tested each year on Medicare rules and regulations. This information is based on the Medicare Managed Care Manual, the Medicare Prescription Drug Benefit Manual, the Medicare Communications and Marketing Guidelines, and other regulations. CMS also requires Medicare sales agents and brokers to complete annual Fraud, Waste and Abuse (FWA) training and certification.
  • Carriers require Medicare sales agents and brokers to meet these CMS requirements. They may also require additional training related to the Medicare products they offer.

AHIP Certification: Your All-In-One Training Solution

Going through testing and training requirements for multiple carriers might sound like a lot of work, but thankfully, many carriers require the same test. This test is the Medicare + Fraud, Waste and Abuse Training provided by AHIP.

If you want to sell Medicare Advantage or Medicare Part D plans, you will most likely need to complete the AHIP certification. To do this, you need to do the following:

  • Enroll in the AHIP course and pay the enrollment fee. Some carriers offer a discount, so check your options before you sign up and pay the fee.
  • Complete the online training materials. Some of the information may be new, so read over the materials even if you’re an experienced Medicare sales professional.
  • Make sure you’re ready for the test. The practice questions can help you determine whether you’re really ready.
  • Take the test. It’s a timed, two-hour test. You take it online, and you’re allowed to use your study materials for reference.
  • Get a passing score. You need to get a score of 90% or better in order to pass. If that sounds challenging, don’t worry – we have some tips to help you.

Contracting with Medicare Carriers

Passing the AHIP test is a key step in getting AEP-ready, but it’s not the only step. You’ll still have to contract with various carriers. Each one will have its own requirements. Although this often includes the AHIP certification, there may be additional things that you need to do.

At this point, you may be wondering just how many carriers you need to contract with. There’s not a definite answer, but the more, the merrier.

There can be a lot of variation among plans. The networks and formularies might be different. The copays might be different. Even the supplemental benefits might be different. The needs of your clients will also be different. The plan that’s perfect for one client might not be a good fit for another client. You need to be able to offer your clients the best plans for their situation, so the more plans you represent, the better.

There may be some new carriers and plan options in the areas you serve. Make sure you’re representing the major carriers in your region and that you’re familiar with a wide range of options so you can help your clients.

Give Yourself Time

Fall may seem like a long time away, but AEP will be here before you know it.

Remember, passing the AHIP test is just the first step. You also need to contract with the individual carriers and meet their requirements. Give yourself extra time in case there are any issues, like a technical glitch or a denied contract.

AHIP training for plan year 2023 begins on June 20, 2022. Mark your calendars!

Setting Yourself Up for a Rewarding Career

It may seem like you have to jump through a lot of hoops each year to sell Medicare. It’s true – there are a lot of rules. However, these training requirements help prepare you for a rewarding career in Medicare sales. Every day, 10,000 baby boomers age into Medicare. By completing these training requirements, you can help them get the coverage they need while building a fulfilling career for yourself.

Do you need support? See why smart Medicare agents join PTT Financial.