WELLCARE ACT MASTERY UPDATED EXAM SCRIPT
QUESTIONS AND ANSWERS GUARANTEE A+
✔✔Low-Income Subsidy (LIS), which is often referred to as Extra Help, does not apply
to Part C but eliminates all Part D plan premiums.
TRUE
FALSE - ✔✔False
✔✔Confirm you have the member's current ___ in our systems to ensure they receive
resources timely throughout and beyond their onboarding journey.
A. Mobile phone number
B. Social media ID
C. Email address
D. Both A and C - ✔✔D. Both A and C.
✔✔Grievance requests, or any evidence concerning a grievance, must be filed orally or
in writing no later than ___ calendar days from the date of the event or the date the
member is made aware of the issue.
A. 60
B. 90
C. 120
D. 180 - ✔✔A. 60
✔✔All Medicare grievances will be resolved within ___ days from the date the plan is
made aware of the issue.
A. 30
B. 60
C. 90
D. 120 - ✔✔A. 30
✔✔For 2026, Wellcare has 41 new plans going to market.
TRUE
FALSE - ✔✔True
✔✔Members who have Low-Income Subsidy (LIS) and enroll in a Prescription Drug
Plan (PDP) other than Wellcare's ___ plan may pay a premium regardless of LIS
subsidy status.
A. Classic
B. Value Script - ✔✔A. Classic
✔✔For 2026, preferred networks include:
A. Walgreens
B. CVS
C. Some Grocery Chains
, D. All of these - ✔✔D. All of these
✔✔Wellcare's ___ Prescription Drug Plan (PDP) is designed for Low-Income Subsidy
(LIS) members.
A. Classic
B. Value Script - ✔✔A. Classic
✔✔Exclusively aligned enrollment includes the use of several strategies to integrate
coverage of Medicare and Medicaid benefits, such as fully integrated enrollee materials,
single ID cards, and unified appeal and grievance processes.
TRUE
FALSE - ✔✔TRUE
✔✔The Medicare Prescription Payment Plan, while not a cost savings program, is a
payment option that could help manage out-of-pocket Part D costs by allowing
members who opt-in to spread prescription expenses across monthly payments.
TRUE
FALSE - ✔✔TRUE
✔✔In 2026, Medicare Advantage Part D (MAPD) plans will adopt one of five distinct
formularies, each tailored to specific product types, with each following a standardized
five-tier structure.
TRUE
FALSE - ✔✔FALSE
✔✔Once a member has reached the $2,100 out-of-pocket maximum for covered
medications, they will pay $0 for their covered prescriptions for the rest of the calendar
year. This is the ___ stage.
A. Annual Deductible
B. Initial Coverage
C. Catastrophic Coverage
D. None of these - ✔✔C. Catastrophic Coverage
✔✔Beginning in 2025, all Fully Integrated Dual Eligible (FIDE) Special Needs Plans
(SNPs) also qualify as Applicable Integrated Plans (AIPs), but not all AIPs qualify as
FIDE SNPs.
TRUE
FALSE - ✔✔TRUE
✔✔Exclusively aligned enrollment occurs when state policy limits enrollment in a D-SNP
to only ___ individuals who receive coverage of Medicaid benefits through the D-SNP
and a Medicaid managed care plan owned and operated by the same parent company
as the D-SNP.
A. Full-Benefit Dually Eligible
QUESTIONS AND ANSWERS GUARANTEE A+
✔✔Low-Income Subsidy (LIS), which is often referred to as Extra Help, does not apply
to Part C but eliminates all Part D plan premiums.
TRUE
FALSE - ✔✔False
✔✔Confirm you have the member's current ___ in our systems to ensure they receive
resources timely throughout and beyond their onboarding journey.
A. Mobile phone number
B. Social media ID
C. Email address
D. Both A and C - ✔✔D. Both A and C.
✔✔Grievance requests, or any evidence concerning a grievance, must be filed orally or
in writing no later than ___ calendar days from the date of the event or the date the
member is made aware of the issue.
A. 60
B. 90
C. 120
D. 180 - ✔✔A. 60
✔✔All Medicare grievances will be resolved within ___ days from the date the plan is
made aware of the issue.
A. 30
B. 60
C. 90
D. 120 - ✔✔A. 30
✔✔For 2026, Wellcare has 41 new plans going to market.
TRUE
FALSE - ✔✔True
✔✔Members who have Low-Income Subsidy (LIS) and enroll in a Prescription Drug
Plan (PDP) other than Wellcare's ___ plan may pay a premium regardless of LIS
subsidy status.
A. Classic
B. Value Script - ✔✔A. Classic
✔✔For 2026, preferred networks include:
A. Walgreens
B. CVS
C. Some Grocery Chains
, D. All of these - ✔✔D. All of these
✔✔Wellcare's ___ Prescription Drug Plan (PDP) is designed for Low-Income Subsidy
(LIS) members.
A. Classic
B. Value Script - ✔✔A. Classic
✔✔Exclusively aligned enrollment includes the use of several strategies to integrate
coverage of Medicare and Medicaid benefits, such as fully integrated enrollee materials,
single ID cards, and unified appeal and grievance processes.
TRUE
FALSE - ✔✔TRUE
✔✔The Medicare Prescription Payment Plan, while not a cost savings program, is a
payment option that could help manage out-of-pocket Part D costs by allowing
members who opt-in to spread prescription expenses across monthly payments.
TRUE
FALSE - ✔✔TRUE
✔✔In 2026, Medicare Advantage Part D (MAPD) plans will adopt one of five distinct
formularies, each tailored to specific product types, with each following a standardized
five-tier structure.
TRUE
FALSE - ✔✔FALSE
✔✔Once a member has reached the $2,100 out-of-pocket maximum for covered
medications, they will pay $0 for their covered prescriptions for the rest of the calendar
year. This is the ___ stage.
A. Annual Deductible
B. Initial Coverage
C. Catastrophic Coverage
D. None of these - ✔✔C. Catastrophic Coverage
✔✔Beginning in 2025, all Fully Integrated Dual Eligible (FIDE) Special Needs Plans
(SNPs) also qualify as Applicable Integrated Plans (AIPs), but not all AIPs qualify as
FIDE SNPs.
TRUE
FALSE - ✔✔TRUE
✔✔Exclusively aligned enrollment occurs when state policy limits enrollment in a D-SNP
to only ___ individuals who receive coverage of Medicaid benefits through the D-SNP
and a Medicaid managed care plan owned and operated by the same parent company
as the D-SNP.
A. Full-Benefit Dually Eligible
