AHIP Certification 2027:
What Medicare Agents Need to Know
What AHIP certification actually is
The requirement comes from CMS, not from AHIP. Under 42 CFR § 422.2274, every Medicare Advantage organization has to train and test the agents and brokers who sell its plans each year, on Medicare rules, on the plan products, and on state and federal requirements. The same section says the agent has to score 85% or higher on all forms of that testing.
AHIP’s course is the industry’s shared version of the Medicare-rules part. Instead of every carrier writing its own, most accept AHIP’s. AHIP’s own FAQ goes further and says the majority of its member organizations and partners accept only AHIP’s training, and it tells agents to confirm with each plan administrator. Two things it is not: it is not a license, and it is not a CMS certificate.
What the 2027 course covers
AHIP describes the plan year 2027 course in two parts.
- Medicare: fee-for-service eligibility and benefits, the types of Medicare Advantage and Part D plans, eligibility and coverage, nondiscrimination, and the marketing and enrollment rules for Medicare Advantage and Part D.
- Fraud, waste and abuse: how to identify it, industry detection efforts, the legal tools against it, its human and financial cost, the Parts C and D fraud, waste and abuse and general compliance requirements, who commits it, and how to report it.
The training is in English and Spanish, and you can switch language as you go. AHIP’s FAQ describes five Medicare modules plus the nondiscrimination, fraud, waste and abuse, and general compliance sections.
What it costs
| Item | What AHIP publishes |
|---|---|
| Plan year 2027 MFWA course | $175, members and non-members alike |
| Carrier rate | Some carriers arrange a lower carrier-specific rate; ask that carrier how to apply it |
| CE credits | Extra fee; the number of credits and the cost vary by state |
| Refunds | None once any course material is opened, or after 90 days from purchase |
The refund rule is the one to know before you click buy. AHIP’s FAQ has an entry for agents who bought the previous year’s course by mistake, and the answer is the same refund policy. Make sure the course says plan year 2027, and get your carrier’s link first if it has one.
The final exam, by AHIP’s own rules
- 50 questions, drawn at random from all five Medicare modules.
- 90% to pass, which is 45 of 50. That is stricter than the 85% floor in the CMS rule.
- Not open book, in AHIP’s words.
- Two hours. The exam submits itself at the two-hour mark.
- One window, one tab. Closing the exam window or moving to another tab or window throws the attempt away, and you start over.
- No answer review. AHIP does not show which questions you missed.
The module review questions are the study tool. They come with feedback and sources, you can submit them as many times as you like, and they do not count toward the final. AHIP’s public pages do not say how many final exam attempts a purchase includes, so check the course home in your account before you start rather than relying on what someone remembers from last year.
Step by step for plan year 2027
- Ask each carrier, or your FMO, for its AHIP instructions first. The price you pay and where your score goes both depend on it.
- Create your account at ahipmedicaretraining.com with your National Producer Number. AHIP notes your NPN is not the same as a carrier writing number or agent ID.
- Buy the plan year 2027 course, not last year’s.
- Decide on CE before the final. AHIP requires you to apply for CE credits before you open the exam.
- Finish the modules and the review questions. A module only marks complete once every slide is viewed and its review questions are answered.
- Take the final in one sitting, in one tab, with two clear hours.
- Send your score to each carrier from the AHIP portal, then confirm with each carrier that it arrived.
- Complete each carrier’s own 2027 certification and check your appointment is active before you take an appointment with a client.
- Download your certificate. AHIP does not mail certificates, and there is no separate certificate for the fraud, waste and abuse section.
Where the deadlines come from
CMS lets plans begin marketing the coming plan year on October 1 (42 CFR § 422.2263), and the Open Enrollment Period runs from October 15 to December 7, according to Medicare.gov. An agent who is not ready-to-sell with a carrier on those dates cannot write that carrier’s 2027 business. AHIP is usually the slowest piece to start and the quickest to finish, so the carrier certifications and appointments are what to chase once it is done.
After you pass
AHIP proves you know the rules. It does not book a single appointment. The agents who do well in a season are the ones whose follow-up runs whether or not they are on a call: every inquiry answered in minutes, every Scope of Appointment and reminder sent on time, every renewal conversation on a calendar.
That is the part AIOS Coach builds for independent agents, on a CRM account the agent owns. If you are setting up for 2027, how to automate insurance lead follow-up and AI content compliance for Medicare agents are the two posts to read next. If you are still choosing an upline, start with IMO vs FMO.
Common questions
What is AHIP certification?
It is the annual Medicare + Fraud, Waste, and Abuse (MFWA) training and exam sold by AHIP, the health insurance industry association. CMS requires Medicare Advantage and Part D plans to train and test the agents who sell their plans every year, and most of those plans accept AHIP’s course as the Medicare-rules part of that requirement. It is not a license and it is not issued by CMS.
How much does AHIP certification cost for 2027?
AHIP lists the plan year 2027 course at $175, the same for members and non-members. Some carriers arrange a lower carrier-specific rate, which you get through that carrier’s instructions, so ask before you buy. Continuing education credits are an extra fee that varies by state.
How many questions are on the AHIP exam, and what score do you need?
AHIP’s published FAQ says the final exam is 50 questions drawn at random from all five Medicare modules, and you need 90% to pass. The exam submits itself at the two-hour mark.
Is the AHIP exam open book?
No. AHIP’s FAQ states plainly that the AHIP Medicare final exam is not an open-book exam. The module review questions, which you can submit as many times as you like, are the study tool AHIP provides.
How many attempts do you get on the AHIP final exam?
AHIP’s public course page and FAQ do not state how many final exam attempts one purchase includes, so we are not going to guess. Check the course home in your account before you start, and treat every submission as if it counts.
Do I still need carrier certifications after AHIP?
Yes. AHIP covers Medicare rules and fraud, waste and abuse. Each carrier still has its own plan year 2027 product training, and you need it, plus an active appointment, before you can sell that carrier’s plans.
Can I get CE credit for AHIP?
AHIP says CE credits are available in every state, the District of Columbia and Puerto Rico, for an additional fee. Its FAQ says you must apply for CE before you take the final exam, and some states require you to take the exam again in front of a monitor.
Sources
- AHIP, Medicare + Fraud, Waste, and Abuse Training: plan year 2027 training available, $175 for members and non-members, course topics, English and Spanish, CE in every state, D.C. and Puerto Rico.
- AHIP, Medicare FAQs (PDF, linked from the AHIP Medicare training site): final exam length and passing score, the two-hour submission, not open book, carrier-specific rates, refunds, CE timing, score transmission and certificates.
- 42 CFR § 422.2274: (b)(2) and (c)(4), annual training and testing of agents and brokers at 85% or higher.
- 42 CFR § 422.2263(a): marketing for the coming plan year may begin October 1.
- Medicare.gov, Joining a plan: the Open Enrollment Period, October 15 to December 7.
General information only. This is not legal, compliance or contracting advice, and AIOS Coach is not affiliated with AHIP. The sources above were read on November 1, 2026. AHIP updates its course and each carrier sets its own certification requirements every plan year; confirm with AHIP and with each carrier before you act.