WELLCARE MASTERY FINAL EXAM 2026/2027
QUESTIONS AND SOLUTIONS RATED A+
✔✔Wellcare offers Medicare Advantage (MA) products to meet the needs of a variety of
beneficiaries. We offer: - ✔✔All of These
$0 or low premium on many plans
$0 fitness benefits on all plans
Preventive care including $0 screenings (in-network)
✔✔In 2025, Medicare Advantage Prescription Drug (MAPD) plans will have six
formularies with six individual tier structures. - ✔✔False
✔✔Effective 2025, key provisions of the Inflation Reduction Act include a lower annual
threshold of $_____ for out-of-pocket (OOP) prescription drug costs in Medicare. -
✔✔2,000
✔✔All Traditional Medicare Advantage Prescription Drug (MAPD) plans with drug
coverage include a $0 copay Tier 6 at all in-network pharmacy locations. - ✔✔True
✔✔Low-Income Subsidy (LIS) Level 4 is ending and moving to Level 1 as new
certifications and recertifications take place. - ✔✔True
✔✔The Single Sign-On Portal provides access to multiple applications, including
CustomPoint® - ✔✔True
✔✔Brokers/Agents can submit a support ticket online through their Centene Workbench
portal. - ✔✔True
✔✔Brokers/Agents may be investigated after being suspected of noncompliant activity
reported through a: (Select all that apply.) - ✔✔Complaint Tracking Module (CTM)
Grievance
Secret Shop Finding
✔✔Which elements are available as part of Wellcare's sales support model? - ✔✔All of
These
Online Self-Service
Local Field Sales
Corporate Office
✔✔CustomPoint® sales material order dates will be posted on Wellcare.com. -
✔✔False
, ✔✔. Wellcare does not need to be informed of informal marketing/sales events at which
plans or materials will be presented or distributed. - ✔✔False
✔✔Materials that include plan comparisons or cost sharing do not require Centers for
Medicare & Medicaid Services (CMS) submission. - ✔✔False
✔✔Beneficiary-facing marketing materials developed by a Third-Party Marketing
Organization (TPMO) for multiple Medicare Advantage (MA) organizations or plans can
be reviewed by just one MA organization, submitted to the Centers for Medicare &
Medicaid Services (CMS) in the Health Plan Management System (HPMS), and opted
in by the health plan after distribution. - ✔✔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 option is the preferred method to submit enrollment? - ✔✔Ascend Application
✔✔Best practices to keep in mind for Dual Eligible Special Needs Plan (D-SNP) and
Chronic Condition Special Needs Plan (C-SNP) enrollments include the following:
(Select all that apply.) - ✔✔If a member is not connected to a primary care provider
(PCP), always encourage and assist with connecting them to an in-network doctor.
Avoid submitting applications with no PCP to assist these higher-risk members.
✔✔When completing an enrollment, be sure to use the correct enrollment application
for the desired plan year. - ✔✔True
✔✔A grievance request, 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.
30 - ✔✔60
✔✔The Pre-Enrollment Checklist (PECL) should be provided and reviewed with your
client after enrollment to ensure the enrollee understands important plan benefits and
rules. - ✔✔False
✔✔The online Member Portal is available Monday - Friday, 8:00am - 8:00pm. -
✔✔False
✔✔Medicare Star Ratings and performance are at the forefront of Wellcare's quality
strategy. Wellcare's quality focus consists of six drivers. Which of the following is not a
Wellcare quality driver? - ✔✔Member payments
QUESTIONS AND SOLUTIONS RATED A+
✔✔Wellcare offers Medicare Advantage (MA) products to meet the needs of a variety of
beneficiaries. We offer: - ✔✔All of These
$0 or low premium on many plans
$0 fitness benefits on all plans
Preventive care including $0 screenings (in-network)
✔✔In 2025, Medicare Advantage Prescription Drug (MAPD) plans will have six
formularies with six individual tier structures. - ✔✔False
✔✔Effective 2025, key provisions of the Inflation Reduction Act include a lower annual
threshold of $_____ for out-of-pocket (OOP) prescription drug costs in Medicare. -
✔✔2,000
✔✔All Traditional Medicare Advantage Prescription Drug (MAPD) plans with drug
coverage include a $0 copay Tier 6 at all in-network pharmacy locations. - ✔✔True
✔✔Low-Income Subsidy (LIS) Level 4 is ending and moving to Level 1 as new
certifications and recertifications take place. - ✔✔True
✔✔The Single Sign-On Portal provides access to multiple applications, including
CustomPoint® - ✔✔True
✔✔Brokers/Agents can submit a support ticket online through their Centene Workbench
portal. - ✔✔True
✔✔Brokers/Agents may be investigated after being suspected of noncompliant activity
reported through a: (Select all that apply.) - ✔✔Complaint Tracking Module (CTM)
Grievance
Secret Shop Finding
✔✔Which elements are available as part of Wellcare's sales support model? - ✔✔All of
These
Online Self-Service
Local Field Sales
Corporate Office
✔✔CustomPoint® sales material order dates will be posted on Wellcare.com. -
✔✔False
, ✔✔. Wellcare does not need to be informed of informal marketing/sales events at which
plans or materials will be presented or distributed. - ✔✔False
✔✔Materials that include plan comparisons or cost sharing do not require Centers for
Medicare & Medicaid Services (CMS) submission. - ✔✔False
✔✔Beneficiary-facing marketing materials developed by a Third-Party Marketing
Organization (TPMO) for multiple Medicare Advantage (MA) organizations or plans can
be reviewed by just one MA organization, submitted to the Centers for Medicare &
Medicaid Services (CMS) in the Health Plan Management System (HPMS), and opted
in by the health plan after distribution. - ✔✔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 option is the preferred method to submit enrollment? - ✔✔Ascend Application
✔✔Best practices to keep in mind for Dual Eligible Special Needs Plan (D-SNP) and
Chronic Condition Special Needs Plan (C-SNP) enrollments include the following:
(Select all that apply.) - ✔✔If a member is not connected to a primary care provider
(PCP), always encourage and assist with connecting them to an in-network doctor.
Avoid submitting applications with no PCP to assist these higher-risk members.
✔✔When completing an enrollment, be sure to use the correct enrollment application
for the desired plan year. - ✔✔True
✔✔A grievance request, 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.
30 - ✔✔60
✔✔The Pre-Enrollment Checklist (PECL) should be provided and reviewed with your
client after enrollment to ensure the enrollee understands important plan benefits and
rules. - ✔✔False
✔✔The online Member Portal is available Monday - Friday, 8:00am - 8:00pm. -
✔✔False
✔✔Medicare Star Ratings and performance are at the forefront of Wellcare's quality
strategy. Wellcare's quality focus consists of six drivers. Which of the following is not a
Wellcare quality driver? - ✔✔Member payments
