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Wellcare ACT Mastery Exam 2025/2026 – 150 Verified TeleAgent Questions & Answers on Medicare Advantage, PDP, LIS, D-SNP, Compliance Rules, and PHI/PII Security

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This in-depth preparation guide contains 150 fully verified questions and answers for the Wellcare ACT Mastery Exam 2025/2026, ensuring agents achieve top scores with confidence. The content is tailored for TeleAgents and professionals working with Medicare Advantage (MA) plans, Medicare Advantage Prescription Drug (MAPD) plans, Prescription Drug Plans (PDP), Dual Eligible Special Needs Plans (D-SNP), and Chronic Condition Special Needs Plans (C-SNP). It covers Low-Income Subsidy (LIS) categories and rules, Preferred Provider and Pharmacy networks, formulary structures, supplemental benefits, and cost-sharing guidelines. Included are critical updates from the Inflation Reduction Act for 2025 and 2026, such as changes in annual prescription drug out-of-pocket thresholds, Medicare’s authority to negotiate drug prices, and Part D cost caps. The document also details compliance requirements under Centene’s Ethics and Compliance Program, agent certification obligations, Third-Party Marketing Organization (TPMO) disclaimer rules, and standards for marketing and sales events. Special attention is given to operational and regulatory knowledge, including enrollment period rules, Scope of Appointment (SOA) procedures, grievance and appeal processes, Health Risk Assessments (HRA), and safeguarding of Protected Health Information (PHI) and Personally Identifiable Information (PII). Real-world scenarios and best practices help agents avoid compliance violations, prevent grievances, and improve Star Ratings performance. This resource is ideal for: Courses: Medicare Sales Training, Insurance Licensing & Certification Prep, Health Plan Compliance, Healthcare Marketing Law, Medicare Advantage Operations Students: Licensed insurance agents, Medicare brokers, call center representatives, healthcare compliance officers, training coordinators, health plan administrators, and professionals preparing for recertification in Medicare product sales By mastering this material, learners will be fully prepared for the Wellcare ACT Mastery Exam, confident in both technical plan details and compliance essentials. Keywords: TeleAgent, Medicare Advantage, Prescription Drug Plan, Dual Eligible Special Needs Plan, Chronic Condition Special Needs Plan, Low-Income Subsidy, Inflation Reduction Act, Value Script, Value Plus, Express Scripts Pharmacy, Preferred pharmacy network, Grievance procedures, Compliance training, PHI protection, Health Risk Assessment, Scope of Appointment, Third-Party Marketing Organization rules

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Wellcare ACT Mastery
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Wellcare ACT Mastery

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2025 Wellcare ACT Mastery Exam
2025/2026 Exam Questions and Answers
| A+ Score Assured



20. 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. - 🧠ANSWER

✔✔FALSE


Enrollment applications must be received by Wellcare no later than ___ calendar

day(s) following receipt from the beneficiary. - 🧠ANSWER ✔✔1


Which elements are available as part of Wellcare's Sales Support model? -

🧠ANSWER ✔✔All of these

,Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all

Part D plan premiums - 🧠ANSWER ✔✔False


Prior to completing the enrollment form, broker/agents should always confirm the

beneficiary's primary care provider (PCP) and/or specialists - 🧠ANSWER ✔✔True


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


Brokers/Agents may be investigated after being suspected of noncompliant activity

reported through a - 🧠ANSWER ✔✔Complaint Tracking Module (CTM)


Grievance

Secret Shop Finding

A broker/agent who has never had any verbal warnings cannot be issued a

Corrective Action Plan. - 🧠ANSWER ✔✔False


Wellcare does not need to be informed of all marketing/sales events at which plans

or materials will be presented or distributed (formaland informal). - 🧠ANSWER

✔✔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/regional or media use. - 🧠ANSWER ✔✔True


CustomPoint sales material order dates will be posted on Wellcare.com -

🧠ANSWER ✔✔False


The online Centene Workbench self-service portal enables you to - 🧠ANSWER

✔✔All of these


The TPMO disclaimer must be used by any TPMO that sells plans on behalf of

more than one MA plan provider. The disclaimer must be: - 🧠ANSWER

✔✔Included in any marketing materials, including print materials and television

advertisements developed, used, or distributed by the TPMO.




Verbally conveyed within the first minute of a sales call.




Prominently displayed on TPMO websites (regardless of content).




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Wellcare ACT Mastery

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