For Prescription Drug Plan (PDP) Medication home delivery, the plan will continue to offer a
discount (2.5x 30-day preferred retail copay) for a 90-day supply of Tier 2 medications. - CORRECT
ANSWER-Value Plus
Members who ha LIS and enroll in a plan other than Wellcare's Classic plan will pay a premium
regardless of LIS subsidy status. - CORRECT ANSWER-True
Wellcare's plan is designed for Low-|ncome Subsidy (LIS) members. - CORRECT ANSWER-
Classic
Custom Point sales material order dates will be posted on Wellcare.com - CORRECT ANSWER-False
Which of the following statements about Custom Point features is FALSE? - CORRECT ANSWER-Access
thru Wellcare.com
prescription drug plans (PDP)will be offered across all 50 U.S. states and washington D.C. -
CORRECT ANSWER-Three
Many of our Medicare Advantage (MA) plans offer supplemental benefits above and beyond what is
offered on Original Medicare. - CORRECT ANSWER-Meals, Transportation, OTC
A Low-Income Subsidy (LIS) member could be assigned one of copay categories depending on
the level of need. - CORRECT ANSWER-Four
The Medicare Prescription Payment Plan is a payment option that helps manage out-of-pocket (OOP)
Part B costs by allowing members who opt-in to spread costs throughout the benefit year. - CORRECT
ANSWER-False
,Which Prescription Drug Plan (PDP) is best for a dual-eligible chooser? - CORRECT ANSWER-Classic
Starting in 2025, a member may move through THREE benefit stages during the plan year. Which benefit
stage will no longer exist? - CORRECT ANSWER-Coverage Gap
The Prescription Drug Plan (PDP) network is expected to include over total pharmacies - CORRECT
ANSWER-60,000
Brokers/Agents can submit a support ticket online through their Centene Workbench portal - CORRECT
ANSWER-True
Which elements are available as part of Wellcare's sales support model? - CORRECT ANSWER-All of
these
Brokers/Agents may be investigated after being suspected of noncompliant activity reported through a:
(Select all that apply.) - CORRECT ANSWER-Complaint Tracking Module (CTM)
Grievance
Secret Shop Finding
Brokers/Agents can access the following resources under the Shared Resources section in Centene
Workbench: - CORRECT ANSWER-All of these
Self-reporting of a compliance issue must be made to Corporate Compliance or to a Health Plan Sales
Leader and must indicate: - CORRECT ANSWER-All of these
events are designed to inform the people who attend about Medicare Advantage, Prescription
Drug, or other Medicare programs without going into the specifics of a particular carrier. - CORRECT
ANSWER-Educational
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. - CORRECT ANSWER-True
, Materials nthat ninclude nplan ncomparisons nor ncost nsharing ndo nnot nrequire nCenters nfor nMedicare n&
nMedicaid nServices n(CMS) nsubmission. n- nCORRECT nANSWER-False
Although noptions nfor ncapturing nand nsubmitting nScopes nof nAppointment n(SOAs) nvary nby nhealth nplan,
nWellcare naccepts nSOAs nin nwhich nof nthe nfollowing nmethods? n- nCORRECT nANSWER-All nof nthese
Which noption nis nthe npreferred nmethod nto nsubmit nenrollment? n- nCORRECT nANSWER-Ascend nApplication
Which nof nthe nfollowing nstatements nabout nthe nScope nof nAppointment n(SOA) nis nFALSE? n-
nCORRECT nANSWER-An nelectronic nSOA nsubmitted nin nAscend nin na nPending nstatus nis nconsidered
ncomplete nand ncompliant
Enrollments nthrough nAscend noffer nthe nfollowing nunique nbenefits: n(Select nall nthat napply.) n-
nCORRECT nANSWER-All
When nverifying na nDual nEligible nSpecial nNeeds nPlan n(D-SNP) nbeneficiary's nMedicaid neligibility nthrough
nthe nAscend nMedicaid nsearch ntool, nyou nshould: n- nCORRECT nANSWER-Both
The nPre-Enrollment nChecklist n(PECL) nshould nbe nprovided nand nreviewed nwith nyour nclient nafter
nenrollment nto nensure nthe nenrollee nunderstands nimportant nplan nbenefits nand nrules. n- nCORRECT
nANSWER-False
Grievance nprocedures nare nseparate nand ndistinct nfrom ninitial ndetermination nand nappeal nprocedures. n-
nCORRECT nANSWER-True
A nrequest nto nthe nplan nfrom na nmember nor nprovider nfor na nformal nreview nof nan nAction n(Denial) nor
nAdverse nPlan nDetermination n(Medicare) nis na/an: n- nCORRECT nANSWER-Appeal
Any nrequest nor ndistribution nof nPHI nshould ncontain nonly nthe nminimum namount nof nPHI nrequired nto
ncomplete nthe nintended ntask. n- nCORRECT nANSWER-true
A nHealth nRisk nAssessment n(HRA) nprovides nan noverview nof na nmember's nhealth nstatus, ngives nus nthe
nopportunity nto nimprove nmember ncare, nand nprevent nfurther nhealth nchallenges. n- nCORRECT nANSWER-
True
During nan nappointment, nyou nmay nnot ndiscuss nany nproducts nnot nagreed nto nin nadvance nby nthe
nbeneficiary.
discount (2.5x 30-day preferred retail copay) for a 90-day supply of Tier 2 medications. - CORRECT
ANSWER-Value Plus
Members who ha LIS and enroll in a plan other than Wellcare's Classic plan will pay a premium
regardless of LIS subsidy status. - CORRECT ANSWER-True
Wellcare's plan is designed for Low-|ncome Subsidy (LIS) members. - CORRECT ANSWER-
Classic
Custom Point sales material order dates will be posted on Wellcare.com - CORRECT ANSWER-False
Which of the following statements about Custom Point features is FALSE? - CORRECT ANSWER-Access
thru Wellcare.com
prescription drug plans (PDP)will be offered across all 50 U.S. states and washington D.C. -
CORRECT ANSWER-Three
Many of our Medicare Advantage (MA) plans offer supplemental benefits above and beyond what is
offered on Original Medicare. - CORRECT ANSWER-Meals, Transportation, OTC
A Low-Income Subsidy (LIS) member could be assigned one of copay categories depending on
the level of need. - CORRECT ANSWER-Four
The Medicare Prescription Payment Plan is a payment option that helps manage out-of-pocket (OOP)
Part B costs by allowing members who opt-in to spread costs throughout the benefit year. - CORRECT
ANSWER-False
,Which Prescription Drug Plan (PDP) is best for a dual-eligible chooser? - CORRECT ANSWER-Classic
Starting in 2025, a member may move through THREE benefit stages during the plan year. Which benefit
stage will no longer exist? - CORRECT ANSWER-Coverage Gap
The Prescription Drug Plan (PDP) network is expected to include over total pharmacies - CORRECT
ANSWER-60,000
Brokers/Agents can submit a support ticket online through their Centene Workbench portal - CORRECT
ANSWER-True
Which elements are available as part of Wellcare's sales support model? - CORRECT ANSWER-All of
these
Brokers/Agents may be investigated after being suspected of noncompliant activity reported through a:
(Select all that apply.) - CORRECT ANSWER-Complaint Tracking Module (CTM)
Grievance
Secret Shop Finding
Brokers/Agents can access the following resources under the Shared Resources section in Centene
Workbench: - CORRECT ANSWER-All of these
Self-reporting of a compliance issue must be made to Corporate Compliance or to a Health Plan Sales
Leader and must indicate: - CORRECT ANSWER-All of these
events are designed to inform the people who attend about Medicare Advantage, Prescription
Drug, or other Medicare programs without going into the specifics of a particular carrier. - CORRECT
ANSWER-Educational
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. - CORRECT ANSWER-True
, Materials nthat ninclude nplan ncomparisons nor ncost nsharing ndo nnot nrequire nCenters nfor nMedicare n&
nMedicaid nServices n(CMS) nsubmission. n- nCORRECT nANSWER-False
Although noptions nfor ncapturing nand nsubmitting nScopes nof nAppointment n(SOAs) nvary nby nhealth nplan,
nWellcare naccepts nSOAs nin nwhich nof nthe nfollowing nmethods? n- nCORRECT nANSWER-All nof nthese
Which noption nis nthe npreferred nmethod nto nsubmit nenrollment? n- nCORRECT nANSWER-Ascend nApplication
Which nof nthe nfollowing nstatements nabout nthe nScope nof nAppointment n(SOA) nis nFALSE? n-
nCORRECT nANSWER-An nelectronic nSOA nsubmitted nin nAscend nin na nPending nstatus nis nconsidered
ncomplete nand ncompliant
Enrollments nthrough nAscend noffer nthe nfollowing nunique nbenefits: n(Select nall nthat napply.) n-
nCORRECT nANSWER-All
When nverifying na nDual nEligible nSpecial nNeeds nPlan n(D-SNP) nbeneficiary's nMedicaid neligibility nthrough
nthe nAscend nMedicaid nsearch ntool, nyou nshould: n- nCORRECT nANSWER-Both
The nPre-Enrollment nChecklist n(PECL) nshould nbe nprovided nand nreviewed nwith nyour nclient nafter
nenrollment nto nensure nthe nenrollee nunderstands nimportant nplan nbenefits nand nrules. n- nCORRECT
nANSWER-False
Grievance nprocedures nare nseparate nand ndistinct nfrom ninitial ndetermination nand nappeal nprocedures. n-
nCORRECT nANSWER-True
A nrequest nto nthe nplan nfrom na nmember nor nprovider nfor na nformal nreview nof nan nAction n(Denial) nor
nAdverse nPlan nDetermination n(Medicare) nis na/an: n- nCORRECT nANSWER-Appeal
Any nrequest nor ndistribution nof nPHI nshould ncontain nonly nthe nminimum namount nof nPHI nrequired nto
ncomplete nthe nintended ntask. n- nCORRECT nANSWER-true
A nHealth nRisk nAssessment n(HRA) nprovides nan noverview nof na nmember's nhealth nstatus, ngives nus nthe
nopportunity nto nimprove nmember ncare, nand nprevent nfurther nhealth nchallenges. n- nCORRECT nANSWER-
True
During nan nappointment, nyou nmay nnot ndiscuss nany nproducts nnot nagreed nto nin nadvance nby nthe
nbeneficiary.
