- How the ALHC Credential Is Actually Structured
- The Two Introductory Prerequisite Courses
- ICA C1: Medical Aspects of Claims (This Site's Focus)
- What C1 Actually Tests
- C2 Through C4: The Rest of the ALHC Coursework
- C1 Exam Format, Fees, and Registration
- Who Pursues ALHC and Why
- Scheduling Your Prep Around C1's Content
- Frequently Asked Questions
- ALHC is earned through six total courses: two introductory courses plus ICA's C1-C4 series.
- This guide's exam facts apply specifically to ICA C1, Medical Aspects of Claims - not a single unified ALHC exam.
- C1 is 75 multiple-choice questions, 150 minutes, closed book, with a 70% passing requirement.
- The C1 course-and-exam package costs $325 for ICA members and $550 for nonmembers, delivered through McCann Associates via Adaptera.
How the ALHC Credential Is Actually Structured
Before diving into any single exam, it helps to understand what "ALHC" is actually built from. Associate, Life and Health Claims is a designation awarded by the International Claim Association (ICA), and it is not a single comprehensive test. Instead, candidates complete a sequence of six courses: two introductory courses that establish foundational insurance knowledge, followed by four ICA-specific courses labeled C1 through C4. Each course has its own study materials and its own exam.
If you've landed on this page looking for a breakdown of "exam domains," it's worth being precise about terminology. Rather than one exam with multiple weighted content domains, ALHC candidates work through separate course exams, each covering a distinct body of claims knowledge. This article focuses on the course where we have verified exam facts: ICA C1, Medical Aspects of Claims. For a broader look at eligibility across the full designation, see our ALHC requirements guide.
The Two Introductory Prerequisite Courses
Before tackling the ICA-specific coursework, ALHC candidates must complete two introductory courses. ICA recognizes two approved routes:
- LOMA route: LOMA 280 or 281, together with LOMA 290 or 291.
- AHIP route: AHIP Parts A and B.
These introductory courses are completed outside of ICA's own platform, so candidates need to submit external completion records to ICA once finished. This is a step people frequently overlook - completing LOMA or AHIP coursework doesn't automatically register with ICA; you have to actively provide proof. Build this into your planning early, since delays in documentation can hold up your progress through the rest of the designation. Our requirements breakdown covers this documentation step in more detail.
Key Takeaway
Choose one introductory pathway (LOMA or AHIP) and complete both required parts before assuming you're ready to start ICA's C1 through C4 sequence - ICA needs proof of completion on file.
ICA C1: Medical Aspects of Claims (This Site's Focus)
Once the introductory requirement is satisfied, candidates move into ICA's own course series, starting with C1: Medical Aspects of Claims. This is the course this site is built around, and it's the one with verifiable, publicly documented exam mechanics.
C1 is delivered as an online course-and-exam package through McCann Associates, using the Adaptera platform. A key structural detail: the exam does not unlock until you've completed the assigned study materials. This isn't a "read whenever, test whenever" arrangement - ICA and McCann Associates gate access to make sure candidates work through the content sequentially.
C1: Medical Aspects of Claims
This course exists to build the medical literacy that life and health claims examiners rely on daily. Claims professionals routinely review physician notes, diagnostic codes, and treatment histories - C1 is designed to make sure they can interpret that information accurately rather than take it at face value.
- Understanding how medical documentation supports or contradicts a claim
- Recognizing terminology and concepts examiners encounter in medical records
- Applying medical context to claims decisions without formal clinical training
What C1 Actually Tests
The C1 exam consists of 75 multiple-choice questions with a 150-minute time limit. To pass, candidates need a 70% score. It's a closed-book exam - no outside reference materials and no computer assistance are permitted during the test itself, and exiting the exam submits it for scoring, so there's no pausing and returning later.
One detail that trips up first-time candidates: ICA itself does not require proctoring for the C1 exam. However, individual employers may impose their own proctoring requirements, so it's worth checking with your organization's claims department or training coordinator before you assume you can sit for the exam unsupervised. For a full walkthrough of what "closed book, no outside materials" means in practice on test day, see how hard the ALHC exam actually is.
Because the exam is closed book and time-boxed, familiarity with medical terminology and claims-relevant medical concepts needs to be near-automatic by exam day - you won't have time to look things up mid-test. This is one of the clearest ways C1 differs from open-note or reference-permitted professional exams in other fields.
C2 Through C4: The Rest of the ALHC Coursework
After C1, candidates continue through ICA's remaining courses, C2, C3, and C4, to complete the six-course ALHC pathway (two introductory courses plus C1-C4). Each of these courses is delivered the same way as C1 - through McCann Associates via Adaptera - and each has its own dedicated study materials and exam.
Because this site's verified exam facts are specific to C1, we're intentionally not speculating about the exact format, fee, or content breakdown of C2, C3, or C4 here. If you're planning your full path through the designation, check ICA's own course listings for the current specifics on each remaining course, and register your intro-course completions with ICA before you start scheduling the C-series.
Key Takeaway
Treat the six ALHC courses as a sequence, not a single test. Confirm the current format and fee for each course directly with ICA before registering, since only C1's mechanics are detailed on this site.
C1 Exam Format, Fees, and Registration
Registration mechanics matter almost as much as content knowledge, because C1 has firm time limits on access. Here's what to plan around:
| Detail | Specification |
|---|---|
| Course-and-exam fee (member) | US$325 |
| Course-and-exam fee (nonmember) | US$550 |
| Question count | 75 multiple-choice questions |
| Time limit | 150 minutes |
| Passing score | 70% |
| Retake included | One retake within the enrollment window |
| Access window | 180 days from enrollment |
| Reference materials allowed | None - closed book, no computer assistance |
Enrollment includes the exam plus one retake, and both attempts must be completed within 180 days of enrollment. If that window lapses, access expires and you'll need to repurchase the course. This is one of the more consequential logistics details in the entire ALHC pathway - waiting too long to schedule your first attempt eats directly into your retake buffer. Our exam dates and scheduling guide and certification cost breakdown go deeper into planning around this window and budgeting for member versus nonmember pricing.
Who Pursues ALHC and Why
ALHC candidates are typically working professionals in life and health insurance claims roles - claims examiners, claims analysts, claims supervisors, and adjacent staff who need to interpret medical documentation as part of adjudicating claims. Because C1 specifically targets medical literacy, it's especially relevant for anyone whose day-to-day work involves reviewing physician statements, hospital records, or diagnostic information to support claims decisions.
Employers in the life and health insurance space often encourage or require ALHC coursework as part of internal claims training, which is also why some organizations layer their own proctoring requirements on top of ICA's exam, even though ICA itself doesn't mandate it. If you're evaluating whether pursuing the designation makes sense for your career trajectory, our ROI analysis and ALHC jobs overview break down how the credential connects to hiring and advancement conversations, and our salary guide looks at how it factors into compensation discussions.
Scheduling Your Prep Around C1's Content
Given the 180-day enrollment window and the fact that the exam doesn't unlock until study materials are completed, your prep schedule should be built backward from that deadline rather than treated casually. A simple way to structure it:
Work Through Assigned C1 Materials
- Complete the required study content in full - the exam won't unlock until you do
- Build a working vocabulary of medical terms relevant to claims review
Active Review and Self-Testing
- Practice interpreting sample medical documentation without notes, since the real exam is closed book
- Time yourself answering multiple-choice questions to build pace for the 150-minute limit
Final Consolidation
- Identify weak areas and revisit only those sections
- Confirm whether your employer requires proctoring before exam day
This kind of week-by-week structure is only useful when it's tied to C1's actual constraints - the gated access, the closed-book format, and the 70% threshold - rather than generic advice borrowed from unrelated certifications. For a more detailed walkthrough of preparation strategy, see our full ALHC study guide, and use our practice test platform to simulate the multiple-choice, timed format before your actual attempt. A quick-reference summary of the must-know facts covered here is also available in our ALHC cheat sheet.
Key Takeaway
Don't wait until late in your 180-day window to attempt the exam - front-load your study so you still have runway for the included retake if you need it.
If you're still getting oriented to the designation as a whole rather than just C1, our "What Is ALHC?" overview and meaning explainer are good starting points, and you can run through timed practice questions on our main practice test site once you've completed your assigned study materials.
Frequently Asked Questions
No. ALHC is earned through six separate courses - two introductory courses plus ICA's C1 through C4 - each with its own study materials and exam, rather than a single test with weighted domains.
C1, Medical Aspects of Claims, focuses on the medical knowledge claims professionals need to evaluate documentation such as physician notes and diagnostic information during claims review.
The C1 course-and-exam package costs US$325 for ICA members and US$550 for nonmembers, delivered through McCann Associates via the Adaptera platform.
No. C1 is closed book with no outside reference materials and no computer assistance permitted, and exiting the exam submits it for scoring.
Enrollment gives you 180 days to complete the exam and one included retake. If that window expires, your access lapses and you'll need to repurchase the course.