WELLCARE ACT MASTERY UPDATED COMPREHENSIVE
EXAM QUESTIONS AND ANSWERS SURE A+
✔✔In 2026, Wellcare will offer ___ Prescription Drug Plans (PDPs) across all 50 U.S.
states and Washington D.C.
A. Five
B. Two
C. Ten
D. Twenty - ✔✔B. Two
✔✔Brokers and agents may be investigated for non-compliant behavior based on any of
the following activities, EXCLUDING:
A. Complaint Tracking Module (CTM)
B. Grievance
C. Secret shopping finding
D. Yelp review - ✔✔D. Yelp review
✔✔Content and materials that include plan comparisons, cost-sharing, or rewards and
incentives do not require Centers for Medicare & Medicaid Services (CMS) submission.
TRUE
FALSE - ✔✔FALSE
✔✔Marketing benefits in a service area where those benefits are not available is
prohibited and considered misleading unless that is unavoidable because of local or
regional media use.
TRUE
FALSE - ✔✔TRUE
✔✔For telephonic enrollments, it is required that you obtain consent to record the call
with the beneficiary at the end of the call.
TRUE
FALSE - ✔✔FALSE
✔✔Members have access to the online self-service member portal___:
A: 24/7
B: 8am - 6pm MST only
C: 8am - 7pm CST only
D: 8am - 8pm MST only - ✔✔A: 24/7
✔✔If a member starts using a formulary protected class drug (PCD), the plan must
cover it for only 30 days.
TRUE
FALSE - ✔✔FALSE
, ✔✔Which is an example of a top beneficiary complaint that affects Star Ratings?
A. The beneficiary was enrolled in the correct plan
B. The provider was in-network and contracted with the selected plan
C. The beneficiary enrolled by the enrollment deadline
D. The beneficiary enrolling in a PPO plan did not understand how the plan worked with
in-network and out-of-network providers - ✔✔D. The beneficiary enrolling in a PPO plan
did not understand how the plan worked with in-network and out-of-network providers.
✔✔Which Prescription Drug Plan (PDP) is the best option for a non-dual-eligible
beneficiary and offers low to moderate premium with $0 Tier 1 copay at preferred cost-
share pharmacies?
A. Classic
B. Value Script - ✔✔B. Value Script
✔✔Brokers/agents can use their Personalized URL (PURL) to submit an application on
behalf of a beneficiary or assist them in the completion of their enrollment via the PURL.
TRUE
FALSE - ✔✔FALSE
✔✔When prospective Wellcare members check online for the status of their submitted
application, which element is optional?
A. Confirmation Number
B. Last Name
C. Date of Birth
D. Medicare ID Number - ✔✔A. Confirmation Number
✔✔A leading cause of sales allegations is the failure to inform a beneficiary that a
provider is out-of-network or is not available for a newly selected plan.
TRUE
FALSE - ✔✔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. A Grievance
B. An Appeal
C. An Inquiry - ✔✔B. An Appeal
✔✔Member payment for a 100-day supply mail order home delivery prescription on
Tiers 1 and 2 is a ___.
A. $0 copay
B. $3 copay
C. $5 copay
D. 10% coinsurance - ✔✔A. $0 copay
EXAM QUESTIONS AND ANSWERS SURE A+
✔✔In 2026, Wellcare will offer ___ Prescription Drug Plans (PDPs) across all 50 U.S.
states and Washington D.C.
A. Five
B. Two
C. Ten
D. Twenty - ✔✔B. Two
✔✔Brokers and agents may be investigated for non-compliant behavior based on any of
the following activities, EXCLUDING:
A. Complaint Tracking Module (CTM)
B. Grievance
C. Secret shopping finding
D. Yelp review - ✔✔D. Yelp review
✔✔Content and materials that include plan comparisons, cost-sharing, or rewards and
incentives do not require Centers for Medicare & Medicaid Services (CMS) submission.
TRUE
FALSE - ✔✔FALSE
✔✔Marketing benefits in a service area where those benefits are not available is
prohibited and considered misleading unless that is unavoidable because of local or
regional media use.
TRUE
FALSE - ✔✔TRUE
✔✔For telephonic enrollments, it is required that you obtain consent to record the call
with the beneficiary at the end of the call.
TRUE
FALSE - ✔✔FALSE
✔✔Members have access to the online self-service member portal___:
A: 24/7
B: 8am - 6pm MST only
C: 8am - 7pm CST only
D: 8am - 8pm MST only - ✔✔A: 24/7
✔✔If a member starts using a formulary protected class drug (PCD), the plan must
cover it for only 30 days.
TRUE
FALSE - ✔✔FALSE
, ✔✔Which is an example of a top beneficiary complaint that affects Star Ratings?
A. The beneficiary was enrolled in the correct plan
B. The provider was in-network and contracted with the selected plan
C. The beneficiary enrolled by the enrollment deadline
D. The beneficiary enrolling in a PPO plan did not understand how the plan worked with
in-network and out-of-network providers - ✔✔D. The beneficiary enrolling in a PPO plan
did not understand how the plan worked with in-network and out-of-network providers.
✔✔Which Prescription Drug Plan (PDP) is the best option for a non-dual-eligible
beneficiary and offers low to moderate premium with $0 Tier 1 copay at preferred cost-
share pharmacies?
A. Classic
B. Value Script - ✔✔B. Value Script
✔✔Brokers/agents can use their Personalized URL (PURL) to submit an application on
behalf of a beneficiary or assist them in the completion of their enrollment via the PURL.
TRUE
FALSE - ✔✔FALSE
✔✔When prospective Wellcare members check online for the status of their submitted
application, which element is optional?
A. Confirmation Number
B. Last Name
C. Date of Birth
D. Medicare ID Number - ✔✔A. Confirmation Number
✔✔A leading cause of sales allegations is the failure to inform a beneficiary that a
provider is out-of-network or is not available for a newly selected plan.
TRUE
FALSE - ✔✔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. A Grievance
B. An Appeal
C. An Inquiry - ✔✔B. An Appeal
✔✔Member payment for a 100-day supply mail order home delivery prescription on
Tiers 1 and 2 is a ___.
A. $0 copay
B. $3 copay
C. $5 copay
D. 10% coinsurance - ✔✔A. $0 copay
