WELLCARE ACT MASTERY TEST 2026 QUESTIONS AND
ANSWERS SURE A+
✔✔Although options for capturing and submitting Scopes of Appointment (SOAs) vary
by health plan, Wellcare accepts SOAs in which of the following methods? - ✔✔All of
these
✔✔Prior to completing the enrollment form, brokers/agents should always confirm the
beneficiary's primary care provider (PCP) and/or specialists. - ✔✔True
✔✔Failure to inform a beneficiary that a trusted provider is out-of-network or is not
available in the newly selected plan can cause a sales allegation. - ✔✔True
✔✔Which of the following statements about the Scope of Appointment (SOA) is
FALSE? - ✔✔An electronic SOA submitted in Ascend in a Pending status is considered
complete and compliant.
✔✔Grievance procedures are separate and distinct from initial determination and
appeal procedures. - ✔✔True
✔✔The online Member Portal is available Monday - Friday, 8:00am - 8:00pm. -
✔✔False
✔✔You can help prevent grievances by: (Select all that apply.) - ✔✔- Always confirming
availability of the beneficiary's primary and specialist providers by using the provider
search tool available on the plan's website.
-Always using plan materials to clearly explain plan benefits and cost (including
medications) and check for understanding.
-Always confirming a beneficiary's intent to enroll before accepting their enrollment
application.
✔✔Once the enrollment is completed, you can save a copy of the application for your
reference. - ✔✔False
✔✔All Traditional Medicare Advantage Prescription Drug (MAPD) plans with drug
coverage include a $0
copay Tier 6 at all in-network pharmacy locations. - ✔✔True
✔✔Marketing benefits in a service area where those benefits are not available is
prohibited and
, considered misleading unless that is unavoidable because of local/regional or media
use. - ✔✔True
✔✔An Election Period Request for Information (RFI) must be resolved within 7 calendar
days, or the
application will be denied. - ✔✔True
✔✔A request to the plan from a member or provider for a formal review of an Action
(Denial) or
Adverse Plan Determination (Medicare) is a/an: - ✔✔Appeal
✔✔All Traditional Medicare Advantage Prescription Drug (MAPD) plans will offer $0
copay for most Part
D preventive vaccines regardless of network pharmacy used by members. - ✔✔True
✔✔Wellcare Mutual of Omaha co-branded plans are offered in _____ states. - ✔✔Five
✔✔The Prescription Drug Plan (PDP) network is expected to include over ____ total
pharmacies. - ✔✔60,000
✔✔All three Prescription Drug Plans (PDPs) will offer a five-tier formulary design. -
✔✔true
✔✔Brokers/Agents may be investigated after being suspected of noncompliant activity
reported
through a: (Select all that apply.) - ✔✔- Complaint Tracking Module (CTM)
-Yelp Review
-Grievance
-Secret Shop Finding
✔✔Which elements are available as part of Wellcare's sales support model? - ✔✔All of
these
✔✔As part of Centene's Ethics and Compliance program, Centene requires all
contracted
brokers/agents to review and agree to its Business Ethics and Code of Conduct Policy. -
✔✔True
✔✔Which of the following actions are you required to do when contacted regarding an
allegation of
ANSWERS SURE A+
✔✔Although options for capturing and submitting Scopes of Appointment (SOAs) vary
by health plan, Wellcare accepts SOAs in which of the following methods? - ✔✔All of
these
✔✔Prior to completing the enrollment form, brokers/agents should always confirm the
beneficiary's primary care provider (PCP) and/or specialists. - ✔✔True
✔✔Failure to inform a beneficiary that a trusted provider is out-of-network or is not
available in the newly selected plan can cause a sales allegation. - ✔✔True
✔✔Which of the following statements about the Scope of Appointment (SOA) is
FALSE? - ✔✔An electronic SOA submitted in Ascend in a Pending status is considered
complete and compliant.
✔✔Grievance procedures are separate and distinct from initial determination and
appeal procedures. - ✔✔True
✔✔The online Member Portal is available Monday - Friday, 8:00am - 8:00pm. -
✔✔False
✔✔You can help prevent grievances by: (Select all that apply.) - ✔✔- Always confirming
availability of the beneficiary's primary and specialist providers by using the provider
search tool available on the plan's website.
-Always using plan materials to clearly explain plan benefits and cost (including
medications) and check for understanding.
-Always confirming a beneficiary's intent to enroll before accepting their enrollment
application.
✔✔Once the enrollment is completed, you can save a copy of the application for your
reference. - ✔✔False
✔✔All Traditional Medicare Advantage Prescription Drug (MAPD) plans with drug
coverage include a $0
copay Tier 6 at all in-network pharmacy locations. - ✔✔True
✔✔Marketing benefits in a service area where those benefits are not available is
prohibited and
, considered misleading unless that is unavoidable because of local/regional or media
use. - ✔✔True
✔✔An Election Period Request for Information (RFI) must be resolved within 7 calendar
days, or the
application will be denied. - ✔✔True
✔✔A request to the plan from a member or provider for a formal review of an Action
(Denial) or
Adverse Plan Determination (Medicare) is a/an: - ✔✔Appeal
✔✔All Traditional Medicare Advantage Prescription Drug (MAPD) plans will offer $0
copay for most Part
D preventive vaccines regardless of network pharmacy used by members. - ✔✔True
✔✔Wellcare Mutual of Omaha co-branded plans are offered in _____ states. - ✔✔Five
✔✔The Prescription Drug Plan (PDP) network is expected to include over ____ total
pharmacies. - ✔✔60,000
✔✔All three Prescription Drug Plans (PDPs) will offer a five-tier formulary design. -
✔✔true
✔✔Brokers/Agents may be investigated after being suspected of noncompliant activity
reported
through a: (Select all that apply.) - ✔✔- Complaint Tracking Module (CTM)
-Yelp Review
-Grievance
-Secret Shop Finding
✔✔Which elements are available as part of Wellcare's sales support model? - ✔✔All of
these
✔✔As part of Centene's Ethics and Compliance program, Centene requires all
contracted
brokers/agents to review and agree to its Business Ethics and Code of Conduct Policy. -
✔✔True
✔✔Which of the following actions are you required to do when contacted regarding an
allegation of
