AHIP 2026 Certification Guide

2026 AHIP Certification Guide for Medicare Agents

Each year, Medicare agents must complete a series of certifications before they’re ready to sell to Medicare Advantage (MA/MAPD) or Prescription Drug Plans (PDPs) to their clients. One of the most important is the AHIP. Our AHIP 2026 certification guide should help you check this off your list.

The 2026 AHIP training is available on June 23, 2025, and it will cover any business written for the remainder of 2025 and all of 2026.

If you’re looking to stay compliant, contract with carriers, and be “Ready to Sell,” here’s everything you need to know to get started; including test tips, module breakdowns, discount info, and what happens if you do not pass.

What Is the AHIP and Why It’s Important

The AHIP (America’s Health Insurance Plans) certification is a CMS-compliant annual training course designed to ensure Medicare agents understand:

• The structure of Original Medicare
• How Medicare Advantage and Part D plans work
• Compliance and marketing rules
• Enrollment periods
• Fraud, waste, and abuse (FWA) prevention

Most MA/MAPD and PDP carriers, with a few exceptions (such as UnitedHealthcare, which has its own certification) require agents to pass AHIP. Completing it is often the first step toward certification with each carrier for the Annual Enrollment Period (AEP).

2026 AHIP Launch Date

• Course Available: June 23, 2025
• Covers: Remainder of 2025 and all of 2026
• Cost: $175 (discounts often available through major carriers)

Crowe/Pinnacle Financial Agents can receive a $50 discount by taking the course through PFSinsurance.com. Just log in, go to the Certifications tab, and scroll to the AEP Toolkit for the Pinnacle AHIP discount link.

2026 AHIP Test Tips

• The test includes 50 multiple choice questions
• Agents have 2 hours and 3 attempts
• Passing Score: 90%
• If you fail all three attempts, you must repurchase and retake the course
• Warning: Some carriers will not allow you to sell their plans for the year if you fail three times

Watch our YouTube video: AHIP Test Tips 2025

What’s in the AHIP Modules

The AHIP course is split into two key parts:

Part 1: Medicare Overview (5 Modules)

1. Module 1 – Overview of Medicare Program Basics: Choices, Eligibility and Benefits (this includes the FFS (fee-for-service) model
2. Module 2 – Medicare Health Plans
3. Module 3 – Medicare Part D; Prescription Drug Coverage
4. Module 4 – Marketing Medicare Advantage and Part D Plans
5. Module 5 – Enrollment Guidance Medicare Advantage and Part D Plan

TIP: Download the slides for all Modules. If you took the 2025 course, you do not have to complete all 5 modules, you can skip 1-3. You may only need to complete modules 4 & 5.

Because each module includes a 20-question practice test, it may not be a bad idea to go over all modules. The final exam questions are pulled directly from these quizzes. Pay close attention to any you got wrong to be sure you answer them correctly when it counts.

Part 2: Fraud, Waste & Abuse (FWA)

Part 2 of the AHIP certifications FWA consists of 3 Modules

1. Non-Discrimination Training; what qualifies as discrimination and what does not.
2. Medicare Fraud, Waste and Abuse; how to identify and report FWA, financial and ethical consequences and the impact of FWA.
3. General Compliance; legal tools and compliance requirements and who they apply to.

Each of these modules has a practice test and a final test when those are completed. You only need a score of 70 to pass this portion.

After You Pass: What’s Next

1. Download your AHIP certificate
2. Transmit your results to participating carriers through AHIP, or manually upload it to the carriers you are contracted with dashboards
3. Complete carrier-specific certifications for each MA or PDP product line

Helpful Reminders

• UnitedHealthcare (UHC) doesn’t require AHIP but does have its own certification
• AHIP 2026 is similar to 2025, but includes updates for new CMS rules, including changes related to Part D redesign and marketing compliance
• You must complete AHIP before you receive a RTS from most carriers even if you complete their certifications.

If you’re a new agent looking to join a supportive upline or an existing agent who wants to add a carrier to your existing contract:
Click here for online contracting

Getting AHIP-certified early is a smart move. It opens doors to carrier contracts, helps avoid delays, and gives you the confidence to serve your Medicare clients accurately and compliantly.

Click here to stay up-to-date on agent events and information.

Don’t wait until the last minute; take advantage of our AHIP 2026 tips, download the modules, and use the practice tests. Remember, three tries is all you get before you have to start over; so make your first try count!