Medicare Blog

how to get certified medicare advantage plans

by Jayne Green Published 2 years ago Updated 1 year ago
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To register, you will need to make a profile through a carrier access portal or directly through the AHIP login portal. You will need your National Producer Number during the registration process. To receive your certification you'll have to pass a test. The test is open book, but you only get two hours to complete it.Mar 4, 2019

How do I qualify for a Medicare Advantage plan (Medicare Part C)?

There are 2 general eligibility requirements to qualify for a Medicare Advantage plan (Medicare Part C): 1. You must be enrolled in Original Medicare (Medicare Part A and Part B). 2.

How do I join a Medicare Advantage plan?

How to join a Medicare Advantage Plan. Use Medicare's Plan Finder. Visit the plan's website to see if you can join online. Fill out a paper enrollment form. Contact the plan to get an enrollment form, fill it out, and return it to the plan. All plans must offer this option. Call the plan you want to ...

What is a Medicare Advantage plan?

Medicare Advantage Plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide all your Part A and Part B benefits. Most Medicare Advantage Plans also offer prescription drug coverage. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan.

How can I save money on my Medicare Advantage plan?

Go to a doctor, other health care provider, facility, or supplier that belongs to the plan's network, so your services are covered and your costs are less. In most cases, this applies to Medicare Advantage HMOs and PPOs. Providers can join or leave a plan’s provider network anytime during the year.

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How hard is AHIP test?

Many returning Medicare agents say AHIP is easy — once you get the hang of it. Nobody's perfect, especially when learning something new! If you get more questions incorrect than you thought you would, or if you fail your first time taking the final AHIP exam, don't fret. Just study up on those areas a little more.

How much does AHIP cost?

We didn't mention it yet, but AHIP isn't free. Typically, the AHIP certification test costs $175, but many carriers offer a discounted rate of $125 if you take the exam through their agent portals.

How do I verify my AHIP certification?

Once you have logged in, scroll down to where it shows “My Certifications” on the “Medicare Course Home” tab. Under AHIP, Fraud, Waste & Abuse Training, click on the “2016 – CMS General Compliance Training” link.

What is the biggest disadvantage of Medicare Advantage?

The takeaway There are some disadvantages as well, including provider limitations, additional costs, and lack of coverage while traveling. Whether you choose original Medicare or Medicare Advantage, it's important to review healthcare needs and Medicare options before choosing your coverage.

What does AHIP certified mean?

AHIP certification is an industry recognized method of proving that you have completed the required Medicare training courses, and you understand how to sell medicare in a way that is compliant with the Centers for Medicare & Medicaid Services (CMS).

How long is AHIP certification good for?

How long does my AHIP certification last? 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.

What is Loma certification?

LOMA offers an employee training and development program used by the majority of American life insurance companies, and by life insurance companies in over 70 countries worldwide. The president and CEO of LL Global is David Levenson. LOMA administers a series of designation programs.

Who are AHIP members?

S - USamaritan Health Plans.Sanford Health Plans.SCAN Health Plan.Security Health Plan of Wisconsin.Senior Health Insurance Company of Pennsylvania.Sentara Healthcare.Sharp Health Plan.SilverScript Insurance Company.More items...

What are the top 3 Medicare Advantage plans?

List of Medicare Advantage plansCategoryCompanyRatingBest overallKaiser Permanente5.0Most popularAARP/UnitedHealthcare4.2Largest networkBlue Cross Blue Shield4.1Hassle-free prescriptionsHumana4.01 more row•Feb 16, 2022

Who is the largest Medicare Advantage provider?

UnitedHealthcareUnitedHealthcare is the largest provider of Medicare Advantage plans and offers plans in nearly three-quarters of U.S. counties.

Can you switch back to Medicare from Medicare Advantage?

Yes, you can elect to switch to traditional Medicare from your Medicare Advantage plan during the Medicare Open Enrollment period, which runs from October 15 to December 7 each year. Your coverage under traditional Medicare will begin January 1 of the following year.

What are the benefits of Medicare?

Here’s a short list on what will be covered: 1 The basics of Medicare fee-for-service eligibility and benefits 2 The different types of Medicare Advantage and Part D prescription drug plans 3 Eligibility and coverage 4 Nondiscrimination training 5 Marketing and enrollment under the Medicare Advantage and Part D program requirements

What is AHIP certification?

AHIP (stands for America’s Health Insurance Plans) certification is accepted by all and required by most carriers if you want to legally sell Medicare Advantage (MA) or Prescription Drug Plans (PDPs) for the current certification year. Be aware that while most carriers will require AHIP certification, it will only serve as a pre-requisite ...

Why do you keep your Medicare card?

Keep your red, white, and blue Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare. Below are the most common types of Medicare Advantage Plans. An HMO Plan that may allow you to get some services out-of-network for a higher cost.

What is MSA plan?

Medicare Medical Savings Account (Msa) Plan. MSA Plans combine a high deductible Medicare Advantage Plan and a bank account. The plan deposits money from Medicare into the account. You can use the money in this account to pay for your health care costs, but only Medicare-covered expenses count toward your deductible.

What is a special needs plan?

Special Needs Plans (SNPs) Other less common types of Medicare Advantage Plans that may be available include. Hmo Point Of Service (Hmopos) Plans. An HMO Plan that may allow you to get some services out-of-network for a higher cost. and a. Medicare Medical Savings Account (Msa) Plan.

Does Medicare Advantage include drug coverage?

Most Medicare Advantage Plans include drug coverage (Part D). In many cases , you’ll need to use health care providers who participate in the plan’s network and service area for the lowest costs.

What is Medicare Advantage Plan?

Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are an “all in one” alternative to Original Medicare. They are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have. Medicare.

Can't offer drug coverage?

Can’t offer drug coverage (like Medicare Medical Savings Account plans) Choose not to offer drug coverage (like some Private Fee-for-Service plans) You’ll be disenrolled from your Medicare Advantage Plan and returned to Original Medicare if both of these apply: You’re in a Medicare Advantage HMO or PPO.

Does Medicare cover dental?

Covered services in Medicare Advantage Plans. Most Medicare Advantage Plans offer coverage for things Original Medicare doesn’t cover, like some vision, hearing, dental, and fitness programs (like gym memberships or discounts). Plans can also choose to cover even more benefits. For example, some plans may offer coverage for services like ...

What are the requirements to qualify for Medicare Advantage?

There are 2 general eligibility requirements to qualify for a Medicare Advantage plan (Medicare Part C): 1. You must be enrolled in Original Medicare ( Medicare Part A and Part B). 2. You must live in the service area of a Medicare Advantage insurance provider that is accepting new users during your application period.

Who can sign up for Medicare Advantage?

Anyone who is enrolled in Original Medicare (Part A and Part B) may be eligible to sign up for a Medicare Advantage (Part C) plan. This includes people under the age of 65 who have qualified for Medicare because of a disability.

How much is Medicare Advantage 2021?

In 2021, the weighted average premium for a Medicare Advantage plan that includes prescription drug coverage is $33.57 per month. 1. 89 percent of Part C plans available throughout the country in 2021 cover prescription drugs, and 54 percent of those plans feature a $0 premium.

How long does Medicare enrollment last?

When you first become eligible for Medicare, you will be given an Initial Enrollment Period (IEP). Your IEP lasts for seven months. It begins three months before you turn 65 years old, includes the month of your birthday and continues on for three more months.

What is Medicare Part C?

Medicare Part C plans are sold by private insurance companies as an alternative to Original Medicare. Medicare Part C plans are required by law to offer at least the same benefits as Medicare Part A and Part B. There are several different types of Medicare Advantage plans, such as HMO plans and PPO plans. Each type of plan may feature its own ...

When is the Medicare open enrollment period?

The Medicare AEP lasts from October 15 to December 7 each year. During this time, you may be able to sign up for, change or disenroll from a Medicare Advantage plan.

Does Medicare Part A have an out-of-pocket limit?

Medicare Part A and Part B don't include an out-of-pocket spending limit. Medicare out-of-pocket costs​ can add up quickly if you're faced with a long-term inpatient hospital stay or undergo extensive medical care that requires high coinsurance or copay costs.

What is Medicare Advantage?

Medicare Advantage is private insurance's counterpart to Original Medicare. It's a great alternative for receiving your Medicare coverage. Rather than purchasing individual components through Original Medicare, Medicare Advantage bundles benefits from Part A and Part B and can even include drug coverage, vision, dental, hearing, ...

How long does Medicare Advantage last?

If you’re new to Medicare, you’ll want to enroll in an MA Plan during your Initial Enrollment Period (IEP). This period lasts for seven months— three months before the month when you turn 65, and three months after.

What is the lock in requirement for a health insurance plan?

Charges you’re responsible for. Lock-in requirement, which means you’re required to keep the plan for the rest of the year, unless you meet special circumstances or qualify for an enrollment period.

How to find a special needs plan?

If you're looking for a Special Needs Plan (SNP), use the drop down menu to answer questions about your needs. If you receive a lot of results, use the drop down menu to sort by lowest deductible or lowest premium. Select up to three plans you like best.

When is the open enrollment period for Medicare?

There’s also a Fall Open Enrollment Period (October 15 through December 7) during which you may sign up. Learn about enrollment periods and when they apply to you.

Is there more to Medicare Advantage than drug coverage?

But as you’ll soon see, there is much more to a Medicare Advantage plan than drug coverage. Don’t worry, though—we'll walk you through each step. By the time we’re through, you'll find the best Medicare Advantage plan for your needs.

What to know about Medicare Advantage?

Things to know about Medicare Advantage Plans. You're still in the Medicare Program. You still have Medicare rights and protections. You still get complete Part A and Part B coverage through the plan. Some plans offer extra benefits that Original Medicare doesn ’t cover – like vision, hearing, or dental. Your out-of-pocket costs may be lower in ...

Can you check with a health insurance plan before you get a service?

You can check with the plan before you get a service to find out if it's covered and what your costs may be. Following plan rules, like getting a Referral to see a specialist in the plan's Network can keep your costs lower. Check with the plan.

Can you pay more for a Medicare Advantage plan than Original Medicare?

Medicare Advantage Plans can't charge more than Original Medicare for certain services like chemotherapy, dialysis, and skilled nursing facility care. Medicare Advantage Plans have a yearly limit on your out-of-pocket costs for medical services. Once you reach this limit, you’ll pay nothing for covered services.

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