- ICA does not publish a public pass-rate percentage for the ALHC's C1 exam, so treat any specific number you see elsewhere with suspicion.
- C1 requires 70% on 75 multiple-choice questions within a 150-minute window, closed book.
- Enrollment includes the exam plus one retake, both due within 180 days of purchase.
- You cannot access the exam until you finish the required study materials first.
What "ALHC Pass Rate" Actually Means
Search around for "ALHC pass rate" and you'll find a mix of vague percentages, recycled blog claims, and numbers borrowed from entirely different credentials that happen to share the same acronym. That confusion is worth clearing up before we go further: the ALHC designation covered here is Associate, Life and Health Claims, administered by the International Claim Association (ICA), and delivered online through McCann Associates via the Adaptera platform. If you've read a "pass rate" statistic that cites a different certifying body, exam fee, or salary figure, it almost certainly wasn't describing this credential.
This article focuses specifically on ICA's C1 Medical Aspects of Claims exam, the course most candidates ask about first and the one most directly tied to the "pass rate" question. It is one piece of the six-course ALHC designation, which also includes courses C2 through C4 plus two approved introductory courses. If you haven't mapped out the full sequence yet, the ALHC requirements guide walks through exactly which courses count and in what order.
How the C1 Exam Is Scored
Rather than guessing at a pass-rate percentage, it's more useful to understand exactly how the exam is scored, because the scoring mechanics tell you more about your realistic odds than a headline number ever could.
- 75 multiple-choice questions make up the entire exam.
- 70% is the passing requirement - you need roughly 53 of 75 questions correct.
- 150 minutes is the total time limit, which works out to two minutes per question if you use the entire window.
- The exam is closed book, with no outside references or computer assistance permitted during the test itself.
- Exiting the exam submits it for scoring - there's no pause-and-resume, so plan your sitting accordingly.
For the exact numeric threshold and how it's calculated, see the dedicated ALHC passing score breakdown, which goes deeper into what 70% means in practice for a 75-question exam.
Key Takeaway
Because the exam is closed book and time-boxed at 150 minutes, pass/fail outcomes are driven far more by preparation depth than by exam-day tricks or time management alone.
Exam Format and Conditions That Shape Outcomes
Several structural details in the C1 course-and-exam package directly affect how candidates perform, and none of them are optional extras - they're built into how McCann Associates and Adaptera deliver the course.
Study Materials Gate the Exam
You must complete the assigned study materials before the exam even unlocks. This isn't a suggestion - it's a system requirement, so candidates who try to skip ahead simply can't.
- No shortcut to "just take the test cold"
- Course content and exam are sequenced together on purpose
Closed-Book, Single-Sitting Format
No outside reference materials or computer assistance are allowed during the 150-minute window. Once you exit, the exam is submitted for scoring - there's no partial-completion option.
- Memorization and applied understanding matter more than lookup speed
- Employers may add their own proctoring even though ICA itself does not require it
These conditions matter because they determine what "being ready" actually looks like. A candidate who has skimmed the material but not internalized it will feel the 150-minute closed-book format acutely. For a full breakdown of what makes this exam demanding - or not - the ALHC difficulty guide covers the format in more detail.
| Exam Element | C1 Specification |
|---|---|
| Question count | 75 multiple-choice |
| Time limit | 150 minutes |
| Passing score | 70% |
| Reference materials | Closed book, none allowed |
| Retake included | Yes, one retake within 180 days |
| Proctoring | Not required by ICA; may be required by employer |
| Cost | US$325 member / US$550 nonmember (course + exam) |
Why There's No Single Published Pass Rate
Unlike some large multiple-choice certification programs that publish annual pass-rate reports, ICA's public materials on claim.org and the Adaptera enrollment pages focus on course structure, pricing, and exam mechanics - not aggregate scoring statistics. That's a meaningful distinction for anyone researching "ALHC pass rate 2026" content, because it means:
- Any specific percentage circulating online is not sourced from ICA's own published materials for this credential.
- The most reliable signal you have is the 70% passing threshold itself, not a claimed historical average.
- Because the course gates the exam behind completed study materials, the population that actually sits the exam has already demonstrated some baseline engagement - which likely shapes outcomes in ways a raw "pass rate" number wouldn't capture anyway.
Factors That Influence Your Odds
Since ICA doesn't publish a pass-rate figure, it's worth thinking in terms of the concrete factors that shift your odds up or down within the format described above.
Time Management Inside 150 Minutes
Two minutes per question sounds generous until you hit a run of scenario-based items on medical terminology or claim evaluation concepts. Candidates who practice under timed conditions before exam day tend to avoid the panic of realizing, with 20 questions left, that time is running short.
Depth of Understanding vs. Surface Familiarity
Because the exam is closed book, recognizing a term isn't the same as being able to apply it to a claims scenario. The ALHC exam domains guide is a useful companion here for mapping which content areas deserve the deepest review versus a lighter pass.
Whether You Treat the Retake as a Safety Net or a Crutch
Knowing a retake is included can relax first-attempt anxiety, but it can also tempt candidates to under-prepare "just this once." Both patterns show up in real candidate behavior, and only one of them is a good use of your 180-day window.
The Retake Safety Net
One of the more candidate-friendly mechanics of the C1 package is that enrollment includes the exam and one retake, both to be completed within 180 days of purchase. If your access expires before you've used both attempts, repurchasing the course is required - so timeline discipline matters as much as content mastery.
- 180-day clock starts at enrollment, not at your first attempt, so don't delay starting the study materials.
- One retake is built in - treat your first attempt seriously rather than as a "practice run," since a second failure means repurchasing the full package.
- Expired access has no grace period described in the enrollment terms, so mark your calendar the day you register.
For a broader look at how this 180-day window interacts with course pacing and when to schedule your attempt, see the ALHC exam dates and scheduling guide.
Comparing C1 to the Rest of the ALHC Path
C1 Medical Aspects of Claims is one course within a larger designation. The full ALHC credential requires two approved introductory courses plus ICA's C1 through C4:
Introductory Course Options
Candidates choose one approved pairing to satisfy the introductory requirement before or alongside the C-series courses.
- LOMA 280 or 281, together with LOMA 290 or 291
- AHIP Parts A and B
- External completion records must be submitted directly to ICA
ICA Core Courses (C1-C4)
C1 focuses on medical aspects of claims; C2 through C4 round out the remaining core content required for the designation. Each is delivered as its own course-and-exam package through McCann Associates and Adaptera.
- Same general exam mechanics apply across the series (closed book, timed, scored pass/fail)
- Budget and schedule each course separately - they are not bundled into one sitting
Because each course is purchased and completed on its own timeline, total cost and total prep time add up across the full designation rather than in one lump sum. The ALHC certification cost breakdown walks through how the C1 member/nonmember pricing fits into the bigger picture.
How to Stack the Odds in Your Favor
Given that there's no published percentage to benchmark against, your best strategy is to control the variables the exam format actually rewards.
Work Through the Required Study Materials in Full
- Don't skip sections hoping the exam won't unlock questions on them - you can't access the exam until materials are complete anyway
- Take notes on medical terminology and claim-evaluation concepts as you go
Simulate Closed-Book, Timed Conditions
- Practice answering scenario-style questions without reference materials open
- Track how long you spend per question to build a realistic pace for the 150-minute limit
Review Weak Spots, Then Schedule
- Revisit any topic areas where practice answers were inconsistent
- Schedule your attempt with enough runway left in your 180-day window to use the included retake if needed
If you want a condensed reference to run through in the final days before your exam, the ALHC cheat sheet compiles must-know facts in one page, and the ALHC study guide lays out a more detailed first-attempt strategy. You can also build timed, exam-style practice into your routine using the question sets on ALHC Exam Prep's practice tests, which mirror the multiple-choice format and closed-book pacing you'll face on exam day.
Beyond passing the exam itself, it's worth asking what the designation does for your career once you hold it. Insurers, TPAs, and claims departments hiring for medical claims roles often look for the ALHC as a signal of applied claims knowledge - a topic covered in more depth in the ALHC jobs guide and the ALHC salary guide. If you're still weighing whether the time and course fees are worth it before you commit to the full designation, the ALHC ROI analysis breaks down that decision in detail, and practicing with ALHC Exam Prep beforehand can help you gauge your own readiness before spending on the official course package.
FAQ
No. ICA's published materials on claim.org and its Adaptera enrollment pages describe course structure, pricing, and exam mechanics, but no aggregate pass-rate percentage is published for the C1 exam.
You need 70% correct on 75 multiple-choice questions, which works out to roughly 53 correct answers, within a 150-minute time limit.
Enrollment includes one retake in addition to your first attempt, and both must be completed within 180 days of purchasing the course-and-exam package. If that window expires, you'll need to repurchase access.
No. The C1 exam is closed book with no outside reference materials or computer assistance allowed, and exiting the exam automatically submits it for scoring.
ICA itself does not require proctoring for the exam, but individual employers sponsoring candidates may impose their own proctoring requirements.