Medicare Blog

what certification is needed to sell medicare advantage plans?

by Della Wintheiser Published 2 years ago Updated 1 year ago

In order to sell Medicare Advantage plans during the Annual Enrollment Period (AEP), most insurers require completion of AHIP's Medicare training courses. Insurers generally require AHIP to assure that agents selling their plans are compliant with the latest CMS guidelines and regulations.

How do I get AHIP certified to sell Medicare plans?

First, you need to be licensed to sell Medicare plans in your state. Then you’ll need to contract with carriers. Most insurance carriers will require you to complete specific training along with AHIP certification.

Do you need Medicare insurance sales agent certification?

But no matter how much experience you have, you need proper Medicare insurance sales agent training to complete the certification process. Medicare products and regulations change every year. As a result, new plans come on the market, and existing plans shift their offerings. Sweeping Advantage-wide changes happen, too.

How do I start selling Medicare Advantage plans?

Before you can start selling Medicare Advantage plans, you must receive the proper training, licensing, and certifications. Check with your state’s department of insurance to learn about state-specific requirements. After you’re licensed, the next step is marketing your services. First, you need to be licensed to sell Medicare plans in your state.

What licenses do I need to sell Medicare plans?

What kind of Medicare-related licenses do I need? Just as with selling other types of insurance, you'll generally need a health insurance license to sell Medicare plans. Specific requirements for licensure vary by state, but you'll need a resident license for your own state and non-resident licenses for any other states in which you plan to sell.

What is an AHIP certification?

AHIP certification is proof that you've completed a series of AHIP Medicare training courses and that you now know how to sell plans in a way that is compliant with up-to-date Centers for Medicare & Medicaid Services (CMS) regulations.

Is selling Medicare Advantage lucrative?

Is Selling Medicare Lucrative? In short, yes. The average Medicare Advantage policy pays around $287 a year in commission if the purchase replaces an existing plan. However, you can get approximately double that — $573— if you write up a new Medicare Advantage plan for someone who hasn't had one before.

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 do I become Medicare expert?

How to Become a Medicare Specialist. Entry-level Medicare specialist jobs require a high school diploma and provide on the job training. Higher level roles as require a bachelor's degree in a field such as healthcare administration and experience in the field.

How much do Medicare leads cost?

As mentioned previously, new Medicare Advantage pay $25 for each direct mail lead.

How do I get Medicare clients?

⍟ 14 Ways to Generate Medicare Supplement LeadsBuild & Maintain a Website. ... Social Media Presence. ... Video Marketing. ... Blogging, Writing Articles. ... Email. ... Online Events: Live webinars, podcasts. ... Direct Requests / Client Referrals. ... Lead Swapping Partnerships (Asking other professionals for referrals)More items...

How much is the AHIP exam?

$175Typically, 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 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.

How do you prepare for AHIP test?

The best way to prepare for your AHIP test is by going through the AHIP modules and taking careful, accurate notes. We will discuss the importance of note-taking and your notes on the exam later in this article but first, let's take a closer look at the AHIP Modules.

What is CMS training?

The Centers for Medicare & Medicaid Services (CMS) has developed two web-based training (WBT) courses. The courses are: Part C Organization Determinations, Appeals, and Grievances, and. Part D Coverage Determinations, Appeals, and Grievances.

What license do I need to sell Medicare insurance in Florida?

The 2-15 agents license allows an agent to sell all forms of Life Insurance, Health Insurance, Medicare Supplement, HMO, Home Health Care, Managed Care and Long Term Care policies in Florida.

What Is Medicare Advantage?

DD: I’d like to start with the basics, Luis. I’m sure there are a lot of people who have heard about Medicare, maybe they’re brand new agents or so...

Is Medicare Advantage A Tough Sell?

DD: When I started in final expense sales, I saw many Medicare Advantage prospects, but I never sold any Medicare Advantage plans.Why? Because agen...

How To Get Certified To Sell Medicare Advantage Plans?

DD: What’s the process for somebody who wants to learn how to become a Medicare Advantage insurance agent?You have to do more than getting your ins...

What Happens After AHIP?

Once you get that AHIP done then you’ve done about 70% of your required certifications.Each carrier that you’re appointed with wants to make sure t...

What Are The Long-Term Benefits Of Selling Medicare Insurance?

DD: What would you describe as the long-term advantages selling Medicare Advantage plans as your primary line of business?LM: When you’re doing cro...

Commission For Selling Medicare Advantage Plans?

DD: A lot of agents are looking at this like we’ve talked about it from a final expense standpoint.They’re used to getting pretty high first year c...

How Long Would It Take To Write 500 Sales?

DD: How long do you think it would take to write 500 pieces of business? Somebody who’s serious about this business, they’re full-time, they really...

Can You Cross Sell?

DD: When we look at new Medicare Advantage clients, ones that we found or wrote from maybe one of these referral partners, what’s the guidelines on...

When Can You Sell Medicare Advantage?

DD: A lot of agents look at the Medicare Advantage business and think they can only sell these products when the person turns 65 and then if not, o...

What is the certification test for Medicare Advantage?

Selling Medicare Advantage plans, you get a contract with a carrier, but once you’re contracted with that carrier every year that you are in Medicare Advantage sales, you’re going to have to take a certification test called AHIP. A lot of people freak out, “Oh, it’s so hard.”. Well, it’s Medicare 101. You need to know the product that you’re ...

What is the difference between Medicare Supplement and Advantage?

As long as you’ve done that you’ve done your CYA. The other difference between a Supplement and an Advantage plan is you have a prescription portion. So you’ve got to sell a prescription drug plan with a Medicare Supplement.

How often do you need to take AHIP certification?

Now, certifications in AHIP have to be done every year. It’s a yearly requirement for all Medicare Advantage agents. DD: When you take these certifications, you’re learning all the intricacies of the product, which helps you sell more Medicare Advantage plans. So, these tests are important.

What is the age limit for Medicare?

LM: When somebody has Medicare they’re normally 65 and over. You do have a segment of the population under 65 that get Medicare who are usually disabled. Once someone is on Medicare they have two options – Medicare Advantage or Medicare Supplement. There’s not a good or a bad option, there is simply two options.

Can you door knock Medicare Advantage?

Now in the Medicare Advantage world if you don’t have permission to contact you’re not supposed to contact. You can’t door knock for Medicare Advantage, so you’ve got to wait for it to come to you, but you can put a lot of honey out there to attract the bees.

Does Medicare Advantage include prescriptions?

For Medicare Advantage a prescription plan is included. The copays per carrier are probably different, but they function the same way. All you’ve got to do is pull up the formulary, which is usually in a PDF and just do the search for the medications and make sure they’re in there.

Can you make a ton upfront selling Medicare Advantage?

Selling Medicare Advantage insurance, you don’t make a ton upfront.

How to become a Medicare agent?

The first step to becoming a licensed Medicare agent is to complete a pre-licensing course. You can usually choose to take this course in a traditional classroom setting or online in a self-study format if you prefer. Choose your state of residence , select the “Life and Health” option , and then choose the exam prep package that best suits your needs. Once you’ve completed the course, you’ll receive a Certificate of Completion that is valid for one year from the date it was issued. You will need to pass your state licensing exam within this time.

Is selling Medicare a good job?

Selling Medicare is a great line of work for individuals who are professional, outgoing, and self-motivated. It can also be a very lucrative line of work if you’re willing to work as hard as you can and set ambitious goals for yourself.

How much does it cost to get a AHIP certification?

To get certified by AHIP, you need to complete the two courses above. Once that’s done, you need to complete a certification exam, which typically costs $175. Many insurers, however, offer a $50 discount if you sign up to take the exam through their company-branded portal. The certification exam is a timed test.

How many Medicare beneficiaries are there in 2018?

According to the Kaiser Family Foundation (KFF), in 2018, some 20.4 million Medicare beneficiaries (34 percent) were members of Medicare Advantage plans—which are plans offered by private insurers that receive compensation from the Medicare program. KFF data also suggests that program enrollment figures have nearly doubled over the last decade.

What is the Ahip certification?

AHIP recently published the guidelines for its 2020 certification program, which includes two courses: Medicare. This class covers the basics of Medicare eligibility and benefits; the different types of Medicare Advantage and Part D prescription drug plans; eligibility and coverage; nondiscrimination training; and marketing ...

What is the job of a health insurance broker?

As a health insurance broker or agent, your job is to sell health insurance to as many people as possible. To do that, you target all kinds of people—young millennials, small-business owners, HR administrators at larger organizations, self-employed individuals, and even seniors. According to the Kaiser Family Foundation (KFF), in 2018, ...

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 ...

Standard Medicare Supplement Coverage

To make it easier for you to compare one Medicare Supplement policy to another, Indiana allows 8 standard plans to be sold. The plans are labeled with a letter, A through N. Plans H, I, and J are no longer offered, and Plans C and F are only available to people who were eligible for Medicare before January, 2020.

How To Get Certified To Sell Medicare Advantage Plans

DD: Whats the process for somebody who wants to learn how to become a Medicare Advantage insurance agent?

Easier Than You Think

So is it that complex? Is it hard? No. You just got to do a little bit of homework.

Passive Income Is King

DD: Ill add in my perspective. Ive been in the business since 2011 and most of my business has been focused on final expense.

Why Sell Medicare Advantage

DD: Explain to agents what the opportunity is in selling Medicare Advantage plans to clients?

Learn Cms Compliance Rules And Regulations

The Medicare Communications and Marketing Guidelines is where all the compliance rules live. These are updated semi-regularly, but you can always check the latest version on this CMS page.

What Are The Long

DD: What would you describe as the long-term advantages selling Medicare Advantage plans as your primary line of business?

Is Selling Medicare Lucrative?

In short, yes. The average Medicare Advantage policy pays around $262 a year in commission if the purchase replaces an existing plan. However, you can get approximately double that — $525 — if you write up a new Medicare Advantage plan for someone who hasn't had one before.

Medicare Licenses and Training

Medicare Advantage is a great line to sell, whether you're a newcomer to selling insurance or an experienced insurance professional looking to diversify your portfolio. But no matter how much experience you have, you need proper Medicare insurance sales agent training to complete the certification process.

How to Choose Medicare Carriers and Plans to Sell

Most new agents want to rush in and offer every Medicare Advantage plan from day one. It's an understandable ambition, but it can quickly become overwhelming.

Ordering Medicare Enrollment Kits from Carriers

Each carrier has its own Medicare enrollment kit, which includes handouts that policyholders need when they're considering signing up. Different carriers include various materials in their kits, but most contain:

Help Protect Yourself with E&O Insurance

As a Medicare insurance sales agent, your role is to help your clients prepare for the unexpected and help protect themselves from financial risks. You might have the best intentions, but sometimes things don't work out as planned.

Start Working Toward a Rewarding Career Selling Medicare

All of these certifications, training requirements, and legal protections can make selling Medicare insurance feel overwhelming at first. But don't let them deter you from reaching your end goal — a rewarding and lucrative career.

What is Medicare Advantage?

One of the benefits is the sale of Medicare Advantage or a Medicare supplement that provides you with a residual income for years. This is a passive income you enjoy the benefit of from every sale. Working as an independent agent means the commissions pay directly to you.

What to do when selling Medicare supplements?

When you sell Medicare supplements from home, you need to offer a variety of products to meet each beneficiary’s needs. This includes supplement products, prescription drug coverage, Medicare Advantage products, and ancillary products. Ensure the products you are offering benefit the client, not a push for your pocketbook.

How to remain independent with Medicare?

To remain independent, you will likely need to obtain your insurance company contracts through a Medicare Insurance FMO. An FMO will work to obtain the best contracts for you to sell clients. Their support in finding you the best product to offer frees your time to meet clients and close sales.

How many clients does Medicare have?

Your income is only limited by the time you put into working. On average, a Medicare insurance agent in business for five (5) years has around 400-500 clients.

How many people will be on Medicare in 2060?

Projections are that by 2060 there will be 98 million people in that age range. The estimation is 21.1 million over age 85 in 2030. What this means when it comes to Medicare insurance sales is that one in every seven people, the equivalent of 15.2% of the population, meets Medicare age qualifications.

How many Americans have Medicare Advantage?

Ambition to put forth the effort to make sales. About 1/3 of Americans obtain their Medicare through Medicare Advantage Plans. The other 2/3 of the eligible persons have original Medicare, and about 81% of those enroll in supplement coverage.

Do insurance agents have to be vested?

Normally agents are vested from the first day, so you have true ownership of your business and policy renewals. Many insurance carriers provide vacation packages and exotic trips to their top-selling agents. The perks are great, and the more “extras” you offer clients, the more profit you make.

What does AHIP stand for, and how does it work?

AHIP stands for “America’s Health Insurance Plans” and was formed by merging of the HIAA and AAHP (Health Insurance Association of America and the Association of Health Plans). The point is that everyone who is able to pass the AHIP exam fully understands how to compliantly sell Medicare Advantage.

How Long Does AHIP Take?

The AHIP Medicare exam only takes most agents about a half hour to complete. It takes about two hours to work through the modules effectively. Since the AHIP is completely online and you can work through it from home, we recommend giving yourself a full three hours to really take in all the information.

About AHIP

AHIP has roughly 1,300 member companies who sell health insurance to about 200 million Americans. Their goal is to create a more affordable and reliable health care system.

Who Needs AHIP Certification?

Most insurers require that you complete the AHIP Medicare training courses and pass the AHIP exam before you can sell their Medicare Advantage plans. It confirms that you are compliant with CMS regulations and that you understand the rules regarding the plans you are selling.

AHIP Courses

To be AHIP certified, you must pass the Medicare and Fraud, Waste, and Abuse (FWA) test. It includes 50 questions, which you have two hours to complete. You MUST pass with at least a 90% score – but you have three attempts to do so.

How to Get Your AHIP Certificate

The AHIP website is simple to follow. You’ll start by either creating a new account or logging into your existing account. Select the plan year that you are certifying for, and then choose whether or not you want your AHIP training to give you continuing education credits (you should).

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How to become a Medicare agent?

1. Becoming a licensed Medicare Agent – Complete a pre-licensing course. Courses tend to be similar in price and content. Depending on your own specific learning/studying style, you can choose to take the course in a traditional classroom, online or via self-study.

What to bring to Medicare exam?

What to Bring to the exam: Becoming a licensed Medicare Agent. An original copy of the Certificate of Completion from a completed pre-licensing course of study. A current, signed form of identification.

Does Crowe and Associates offer E&O insurance?

Most companies will require that you have an active Errors and Omissions (liability insurance) Policy. As a matter of fact, Crowe and Associates offers its contracted agents E&O insurance at a very competitive rate. Click here to learn more about E&O insurance through Crowe and Associates.

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