HealthSherpa Medicare is a Medicare quoting and enrollment platform that allows agents and brokers to shop, quote, and enroll Medicare beneficiaries across Medicare Advantage (MA), Medicare Advantage with Prescription Drug (MAPD), Prescription Drug Plans (PDP), and Medigap plans. ACA plans are not supported through this integration; ACA support via HealthSherpa is planned as a separate integration.
With this integration, users can securely transfer Individual Records from AMS+ to HealthSherpa Medicare for quoting and enrollment.
If your agency has Rx Collect enabled, prescription, pharmacy, and provider information is included in the data sent to HealthSherpa Medicare and returned to AMS+ after enrollment.
Requirements
Activating the integration
- You must be the Account Owner in AMS+ to activate this integration. Administrators can modify settings and deactivate the integration after it has been activated.
Starting quotes
- You must be logged into AMS+ as an Agency User or Agent CRM User.
- To start quotes for Individual Records, you must be assigned to a Security Group with the Individual Visible and Edit permissions.
- If you are an Agent CRM User, you need access to Individual Records assigned to your Accessible Agent, and optionally unassigned records.
Credentials
- In addition to your AMS+ login, agents using this integration need separate credentials for HealthSherpa Medicare — a separate third-party subscription independent of AMS+, which may involve additional costs.
In this article
- Activating the integration
- Setting up the integration
- Starting quotes in AMS+
- Technical documentation
- Troubleshooting
Activating the integration
Go to My Agency Settings > Third Party Integrations > HealthSherpa Medicare and select the Add to AgencyBloc… button.
Once activated, AMS+ generates a webhook URL and API key for your agency. Both are displayed on the integration settings page and can be copied from there. You will need to provide these to HealthSherpa Medicare to complete the connection on their end.
Deactivating the integration
Go to the My Agency Settings > Third Party Integrations > HealthSherpa Medicare page and select the Deactivate button in the top-right corner.
If you deactivate and later reactivate the integration, your agency's webhook URL and API key remain the same. You do not need to provide new credentials to HealthSherpa Medicare after reactivating.
Setting up the integration
Before completing setup, keep the following in mind:
- You need an active HealthSherpa Medicare account. This is a third-party subscription independent of AMS+ and may involve additional costs.
- Carrier and Carrier Product names must match between AMS+ and HealthSherpa Medicare. If names do not match, the enrollment sync may create duplicate Carrier Records and Carrier Products in AMS+. We recommend updating names in AMS+ to match HealthSherpa Medicare before the integration goes live.
- All active agents should have a valid NPN on their Agent Record in AMS+. Enrollments are attributed to agents by NPN. If an agent's NPN in HealthSherpa Medicare does not match an Agent Record in AMS+, the returned Policy will be created without a servicing agent assigned.
- All active agents' HealthSherpa Medicare logins should be linked to your agency. Each agent authenticates with their own HealthSherpa Medicare login, separate from linking that login to your agency in HealthSherpa. If an agent's login isn't linked to the agency, enrollments they submit return only limited data — see Data sent to AMS+ for details.
- Account Owners can hide HealthSherpa Medicare from the Start Quote menu. If your agency does not use this integration, you can remove it from the Start Quote menu so agents do not see it.
In HealthSherpa Medicare, an enrollment includes a contact and a Medicare plan. In AMS+, a contact is the equivalent of an Individual Record and a plan is the same as a Policy.
| HealthSherpa Medicare | AMS+ |
|---|---|
| Contact | Individual Record |
| Plan | Policy (and optionally Carrier Product) |
When HealthSherpa Medicare sends enrollment data to AMS+, we will take steps to put that data in the right places based on your integration settings. See below for more details.
Individual Records
By default, we will try to match HealthSherpa Medicare contacts to existing Individual Records. If the contact was sent from AMS+, we will match on the AMS+ record it originated from. If the contact was created directly in HealthSherpa Medicare, we will try to match on MBI. If no MBI is available, we will try to match on First Name, Last Name, and Date of Birth. If we cannot find a match, we will create a new Individual Record.
Once matched or created, you can configure how the Individual Record is updated:
- Update all fields — AMS+ overwrites the Individual Record with all data returned from HealthSherpa Medicare. Use this if HealthSherpa Medicare is your system of record for client data.
- Update address fields only — AMS+ updates only the address on the Individual Record. Use this if you want to preserve other AMS+ data while keeping addresses current.
- Do not update the Individual Record — AMS+ creates or matches the Individual but does not overwrite any existing data. Use this if AMS+ is your system of record.
You must also configure the Individual Type and Individual Status applied to Individual Records created or updated by this integration before saving.
Note: Policy data is always written from the enrollment return regardless of your Individual Record update setting.
What Individual fields are updated?
Carrier Products
If you choose to bring over Carrier Product data, we will try to match HealthSherpa Medicare plans to existing Carrier Products by plan name. If we cannot find a match, we can create a new Carrier Product depending on your Carrier Product sync settings.
Before saving, you must configure how AMS+ matches plans to Carrier Products, along with the Coverage Type mapping for all four plan types: MA, MAPD, PDP, and Medigap. This mapping is also used when syncing Policy Records.
What Carrier Product fields are updated?
Policy Records
By default, we will automatically create a new Policy Record in AMS+ for every HealthSherpa Medicare enrollment. We will also try to match the carrier in the enrollment to an existing Carrier Record by carrier name. If we cannot find a match, we will create a new Carrier Record using the HealthSherpa Medicare carrier name and associate it with the new Policy Record.
You must also configure the default Policy Status applied to Policy Records created by this integration before saving.
What Policy fields are populated?
Starting quotes in AMS+
If you have access to this integration, you can send Individual Records to HealthSherpa Medicare for quoting and enrollment.
- Select the Start Quote button on an Individual Record and select Send to HealthSherpa Medicare from the menu.
You will be directed to the HealthSherpa Medicare login page. After logging in, the client's data will be pre-populated and you can begin quoting.
- When you are ready to enroll, initiate the enrollment from within HealthSherpa Medicare.
Note: HealthSherpa Medicare sessions may expire after a period of inactivity. If your session has expired, you will be prompted to log in again before continuing. This is similar to the behavior of other quoting integrations in AMS+.
- Complete the enrollment in HealthSherpa Medicare.
-
Once the enrollment is submitted, the client's Individual, Carrier Product, and Policy data is returned through HealthSherpa Medicare to AMS+ automatically based on your integration settings. See enrollment sync settings | See data sent to AMS+
Note: Only completed, submitted enrollments trigger a data return. Partial quotes or abandoned sessions do not send data back to AMS+. PDF copies of enrollment applications are not included — these must be uploaded to the Individual or Policy Record manually. If HealthSherpa Medicare sends an enrollment with a confirmation number that has already been processed, AMS+ will not create a duplicate Policy.
Note: Only one record can be sent to HealthSherpa Medicare at a time. Bulk send is not supported in this release.
What happens if I send the same record more than once?
When you send an Individual Record, AMS+ checks whether the client has a Medicare Beneficiary ID (MBI) on file:
- If the client has an MBI, AMS+ searches HealthSherpa Medicare for a matching contact. If a match is found, the existing contact is updated. If no match is found, a new contact is created. If more than one match is found, AMS+ updates the first contact returned by HealthSherpa Medicare rather than creating a new one.
- If the client has no MBI on file, AMS+ skips the search and creates a new HealthSherpa Medicare contact.
Once a record has been linked to a HealthSherpa Medicare contact, that link is remembered. If the client's name, date of birth, or MBI changes in AMS+ afterward, subsequent sends update the same linked contact directly — AMS+ does not run another search.
Each send updates the linked HealthSherpa Medicare contact with the client's current AMS+ data, including any changes to demographics, Medicare information, or Rx data. HealthSherpa Medicare replaces the contact's data on each send — there are no duplicates created across quoting sessions.
Note: Data does not sync automatically in either direction. To push updated client data from AMS+ to HealthSherpa Medicare, resend the Individual Record using the Start Quote button. Data is only pushed from HealthSherpa Medicare to AMS+ when an enrollment is completed in HealthSherpa Medicare.
Technical documentation
Note: Rx Collect prescription, pharmacy, and provider data is included in the integration only for AMS+ accounts with Rx Collect enabled. Agencies without Rx Collect will still receive full quoting and enrollment sync functionality.
Data sent to HealthSherpa Medicare
When you send an Individual Record to HealthSherpa Medicare for quoting, here is the data we send:
| AMS+ Field | HealthSherpa Field |
|---|---|
| First Name | First Name |
| Last Name | Last Name |
| DOB | Date of Birth |
| Gender | Sex |
| Email* | |
| Home Phone** | Phone |
| Address Line 1*** | Address 1 |
| Address Line 2*** | Address 2 |
| City*** | City |
| State*** | State |
| Zip Code*** | ZIP Code |
| Medicare Beneficiary ID (MBI)**** | Medicare Number |
| Medicare Effective Date (Part A) | Part A Effective Date |
| Medicare Effective Date (Part B) | Part B Effective Date |
| Prescriptions: Medication Name***** | Drug Name |
| Prescriptions: Dosage Name***** | Dosage Name |
| Prescriptions: Quantity***** | Dosage Quantity |
| Prescriptions: Days of Supply***** | Dosage Frequency |
| Prescriptions: Pharmacy Name***** | Pharmacy Name |
| Prescriptions: Pharmacy Address***** | Pharmacy Address |
| Providers: Provider Name***** | Provider Name |
| Providers: Provider Address***** | Provider Address |
*Falls back to secondary email if primary is invalid or missing.
**If no home phone is found, we will try the cell phone. If no cell phone is found, we will try the business phone.
***If more than one address is found, we will use the primary address.
****Used to match against existing HealthSherpa Medicare contacts to prevent duplicates.
*****Rx Collect required. Sent as part of a full wipe-and-replace on each send — HealthSherpa Medicare reflects the current AMS+ Rx list.
Data sent to AMS+
When HealthSherpa Medicare sends enrollment data to AMS+, here is the data that comes back:
Individual Records
If the contact resolves to an existing AMS+ Individual Record, that record is updated according to your Individual Record update setting. If the contact's link no longer resolves to an existing record (for example, if the record was deleted in AMS+), a new Individual Record is created from the enrollment data instead.
Note: How much data comes back depends on whether the submitting agent's HealthSherpa Medicare login is linked to your agency in HealthSherpa. If it's linked, the full set of fields below is returned. If it isn't linked, HealthSherpa Medicare only returns the client's name, state, and ZIP — everything else is left blank. If you notice an enrollment come back with almost no data, check whether that agent's HealthSherpa Medicare login is linked to your agency.
| HealthSherpa Field | AMS+ Field |
|---|---|
| First Name | First Name |
| Last Name | Last Name |
| Middle Name | Middle Initial* |
| Date of Birth | DOB |
| Phone Number | Phone |
| Address Street | Address Line 1 |
| Address Unit Number | Address Line 2 |
| City | City |
| State | State |
| Zip Code | Zip Code |
| Medicare Number | Medicare Beneficiary ID (MBI) |
| Part A Effective Date | Medicare Effective Date (Part A) |
| Part B Effective Date | Medicare Effective Date (Part B) |
| — | Gender** |
*Stored in full, not truncated to a single initial, despite the field name.
**Not included in the HealthSherpa Medicare enrollment payload. Left unset on creation; not updated on existing records.
Note: When your Individual update setting is "address fields only," only the address fields above are updated on existing records. All other fields are populated only when creating a new Individual Record.
Note: Individuals created or updated by this integration are attributed to HealthSherpa Medicare in the activity feed. If you have a workflow configured to trigger on Individual create or update, set the change-method filter to "When information comes from a partner tool (integration)" for it to fire on HealthSherpa Medicare enrollments.
Prescriptions, pharmacies, and providers
If your agency has Rx Collect enabled, the following Rx data is also synced. As with the outbound data sent to HealthSherpa Medicare, this is a full wipe-and-replace on each enrollment — items added, edited, or removed in HealthSherpa Medicare are reflected exactly on the next enrollment sync.
| HealthSherpa Field | AMS+ Field |
|---|---|
| Drug Name | Prescriptions: Medication Name |
| Dosage Name | Prescriptions: Dosage Name |
| Quantity | Prescriptions: Quantity |
| Frequency | Prescriptions: Days of Supply |
| Pharmacy Name | Prescriptions: Pharmacy Name |
| Pharmacy Address* | Prescriptions: Pharmacy Address |
| Provider Name | Providers: Provider Name |
| Provider Address* | Providers: Provider Address |
*HealthSherpa Medicare sends the pharmacy and provider address as separate street, city, state, and zip code fields; AMS+ combines these into a single address field.
Carrier Products
| HealthSherpa Field | AMS+ Field |
|---|---|
| Plan Name | Product Name |
| Plan Type | Coverage Type* |
*Mapped using your plan type configuration in integration settings.
Policy Records
| HealthSherpa Field | AMS+ Field |
|---|---|
| Carrier Name* | Carrier Name |
| Plan Name | Carrier Product** |
| Plan Type | Coverage Type*** |
| CMS Plan ID | Policy Custom Field**** |
| Confirmation Number | Policy Number and/or Policy Custom Field***** |
| Total Premium | Premium |
| Submission Date | App Submit Date |
| Effective Date | Effective Date |
| Submitting Agent NPN | Servicing Agent****** |
| — | Status******* |
*If the carrier name does not match an existing Carrier Record, a new Carrier Record is created using the HealthSherpa Medicare carrier name.
**Carrier Product matching is optional. Configure in integration settings to match HealthSherpa Medicare plans to existing Carrier Products by plan name. If no match is found, a new Carrier Product can be created automatically depending on your settings.
***Mapped using your plan type configuration in integration settings. If the mapped Coverage Type has been deleted or inactivated in AMS+, it will be automatically restored.
****Optional. Configure in integration settings to store the CMS Plan ID in a custom field. If no custom field is selected, the CMS Plan ID is not stored.
*****Optional. Configure in integration settings. Typically a temporary tracking number until the real policy number is issued.
******Matched to an Agent Record in AMS+ by NPN. If no match is found, the Policy is created without a servicing agent assigned. If the matched agent has more than one Agent/Agency assignment, the Policy is attributed to the agent, but the specific Agent/Agency assignment is left unset.
*******Set to the default Policy Status configured in your integration settings.
Troubleshooting
An agent is not being assigned to returned Policy Records.
Enrollments are attributed to agents by NPN. If the submitting agent's NPN in HealthSherpa Medicare does not match an Agent Record in AMS+, the Policy will be created without a servicing agent assigned.
Verify that the agent has a valid NPN on file in their AMS+ Agent Record and that it matches exactly what HealthSherpa Medicare has on record for that agent.