Wellcare ACT Mastery Exam Questions and Answers
(Latest 2025) Verified Solutions
Once the enrollment is completed, you can save a copy of the application for your reference. -
ANSWER-False
When an enrollment application is completed in Ascend, brokers/agents can complete a Health Risk
Assessment (HRA) directly in Ascend after the enrollment application, through the Value-Based
Enrollment (VBE) portal. - ANSWER-True
Which of the following statements about Scope of Appointment (SOA) is FALSE? - ANSWER-c.
An electronic SOA submitted in Ascend must be in a Pending status prior to beginning the
appointment.
When a paper SOA form is used, it must be completed __________ hosting the sales presentation. -
ANSWER-a.
48 Hours prior to
Communication of PHI can be:
(Select all that apply.) - ANSWER-a.
Written
b.
Electronic
c.
Verbal
Brokers/Agents can access the following resources under the Shared Resources section in Centene
Workbench. - ANSWER-d.
All of these
Marketing materials that have been developed by a third-party marketing organization (TPMO) for
multiple MA organizations or plans must be pre-reviewed by each MA organization, submitted to CMS
in the Health Plan Management System (HPMS), and opted-in by the Plan prior to distribution. -
ANSWER-True
If a requested effective date is available for the special election period being selected, ensure you are
requesting a date within the correct timeframe for the member based on their eligibility date or
change date needed. - ANSWER-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: - ANSWER-a.
Appeal
Wellcare does not need to be informed of all marketing/sales events at which plans or materials will
be presented or distributed (formal and informal). - ANSWER-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? - ANSWER-
c.
Member Payments
Providers may create co-branded marketing pieces using the Wellcare name and logo, as long as they
are using the current, approved logo. - ANSWER-False
, Which is an example of a top beneficiary complaint that affects Star Ratings? - ANSWER-c.
The beneficiary did not understand that enrolling in a Wellcare plan would change their current
Medicare Advantage plan.
At the end of this course, there will be a Mastery Exam. Agents must achieve a passing score of 85%
or higher to successfully complete this course. - ANSWER-True
You can help prevent grievances by:
(Select all that apply.) - ANSWER-a.
Always confirming availability of the beneficiary's primary and specialist providers by using the
provider search tool available on the plan's website.
b.
Always using plan materials to clearly explain plan benefits and cost (including medications) and check
for understanding.
The Single Sign-On Portal provides access to several applications, including CustomPoint. - ANSWER-
True
Which elements are available as part of Wellcare's Sales Support model? - ANSWER-d.
All of these
Noting the correct enrollment period on enrollment applications helps in preventing delayed
enrollment processing. - ANSWER-True
Wellcare continues to expand its reach by offering more products in a wider geography. ____ new
Wellcare plans are going to market. - ANSWER-a.
Twenty-three
In the Catastrophic Coverage stage, the member will pay $___ for brand and generic drugs for the
remainder of the year once their total out of pocket costs reach $8,000. - ANSWER-d.
Zero
All Prescription Drug Plans (PDPs) will feature a $0 Tier 1 benefit when filled at preferred pharmacies.
- ANSWER-True
Which Prescription Drug Plan (PDP) product features no deductible on any tier? - ANSWER-c.
Value Plus
With the Pharmacy Benefit Manager (PBM) migration to Express Scripts effective 1/1/2024, existing
members can continue to use their current ID card 1/1/2024 and beyond. - ANSWER-False
All Prescription Drug Plans (PDPs) will offer a $___ copay for most Part D preventive vaccines,
regardless of which network pharmacy is used by members. - ANSWER-a.
Zero
Which Prescription Drug Plan (PDP) product has the richest formulary with the most adherence
generics on Tier 1? - ANSWER-c.
Value Plus
Members are no longer required to pay a partial deductible due to the Inflation Reduction Act. -
ANSWER-True
Wellcare has new All-Dual D-SNP products in AL, AR, FL, GA, KY, LA, MI, MS, NC, NM, OH, OK, TX, and
WI. - ANSWER-True
(Latest 2025) Verified Solutions
Once the enrollment is completed, you can save a copy of the application for your reference. -
ANSWER-False
When an enrollment application is completed in Ascend, brokers/agents can complete a Health Risk
Assessment (HRA) directly in Ascend after the enrollment application, through the Value-Based
Enrollment (VBE) portal. - ANSWER-True
Which of the following statements about Scope of Appointment (SOA) is FALSE? - ANSWER-c.
An electronic SOA submitted in Ascend must be in a Pending status prior to beginning the
appointment.
When a paper SOA form is used, it must be completed __________ hosting the sales presentation. -
ANSWER-a.
48 Hours prior to
Communication of PHI can be:
(Select all that apply.) - ANSWER-a.
Written
b.
Electronic
c.
Verbal
Brokers/Agents can access the following resources under the Shared Resources section in Centene
Workbench. - ANSWER-d.
All of these
Marketing materials that have been developed by a third-party marketing organization (TPMO) for
multiple MA organizations or plans must be pre-reviewed by each MA organization, submitted to CMS
in the Health Plan Management System (HPMS), and opted-in by the Plan prior to distribution. -
ANSWER-True
If a requested effective date is available for the special election period being selected, ensure you are
requesting a date within the correct timeframe for the member based on their eligibility date or
change date needed. - ANSWER-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: - ANSWER-a.
Appeal
Wellcare does not need to be informed of all marketing/sales events at which plans or materials will
be presented or distributed (formal and informal). - ANSWER-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? - ANSWER-
c.
Member Payments
Providers may create co-branded marketing pieces using the Wellcare name and logo, as long as they
are using the current, approved logo. - ANSWER-False
, Which is an example of a top beneficiary complaint that affects Star Ratings? - ANSWER-c.
The beneficiary did not understand that enrolling in a Wellcare plan would change their current
Medicare Advantage plan.
At the end of this course, there will be a Mastery Exam. Agents must achieve a passing score of 85%
or higher to successfully complete this course. - ANSWER-True
You can help prevent grievances by:
(Select all that apply.) - ANSWER-a.
Always confirming availability of the beneficiary's primary and specialist providers by using the
provider search tool available on the plan's website.
b.
Always using plan materials to clearly explain plan benefits and cost (including medications) and check
for understanding.
The Single Sign-On Portal provides access to several applications, including CustomPoint. - ANSWER-
True
Which elements are available as part of Wellcare's Sales Support model? - ANSWER-d.
All of these
Noting the correct enrollment period on enrollment applications helps in preventing delayed
enrollment processing. - ANSWER-True
Wellcare continues to expand its reach by offering more products in a wider geography. ____ new
Wellcare plans are going to market. - ANSWER-a.
Twenty-three
In the Catastrophic Coverage stage, the member will pay $___ for brand and generic drugs for the
remainder of the year once their total out of pocket costs reach $8,000. - ANSWER-d.
Zero
All Prescription Drug Plans (PDPs) will feature a $0 Tier 1 benefit when filled at preferred pharmacies.
- ANSWER-True
Which Prescription Drug Plan (PDP) product features no deductible on any tier? - ANSWER-c.
Value Plus
With the Pharmacy Benefit Manager (PBM) migration to Express Scripts effective 1/1/2024, existing
members can continue to use their current ID card 1/1/2024 and beyond. - ANSWER-False
All Prescription Drug Plans (PDPs) will offer a $___ copay for most Part D preventive vaccines,
regardless of which network pharmacy is used by members. - ANSWER-a.
Zero
Which Prescription Drug Plan (PDP) product has the richest formulary with the most adherence
generics on Tier 1? - ANSWER-c.
Value Plus
Members are no longer required to pay a partial deductible due to the Inflation Reduction Act. -
ANSWER-True
Wellcare has new All-Dual D-SNP products in AL, AR, FL, GA, KY, LA, MI, MS, NC, NM, OH, OK, TX, and
WI. - ANSWER-True
