WELLCARE ACT MASTERY FINAL EXAM ACTUAL
QUESTIONS AND ANSWERS GUARANTEE A+
✔✔The Minimum Necessary Rule within the privacy rule requires that any request or
distribution of Protected Health Information (PHI) occurs with only the minimum amount
of PHI required to complete the intended task and includes email and physical
distribution.
TRUE
FALSE - ✔✔TRUE
✔✔As part of Centene's Ethics and Compliance program, Centene requires all
contracted brokers/agents to review, agree, and adhere to Centene's Business Ethics
and Code of Conduct Policy.
TRUE
FALSE - ✔✔TRUE
✔✔The broker/agent's role in the investigation process of reported non-compliant
behavior is to:
A. Respond as quickly as possible
B. Answer questions honestly and completely
C. Offer or provide information or documents related to the investigation
D. All of these - ✔✔D. All of these
✔✔At ____, brokers/agents present plan-specific information to an audience.
A. Formal Sales Events
B. Informal Sales Events
C. Educational Events - ✔✔A. Formal Sales Events
✔✔Marketing/sales events are prohibited from taking place within ___ of an educational
event in the same location.
A. 12 hours
B. 48 hours
C. 18 hours
D. 72 hours - ✔✔A. 12 hours
✔✔Failing to select a Special Election Period (SEP) or selecting the incorrect SEP will
create a Request for Information (RFI) or result in a denied application.
TRUE
FALSE - ✔✔TRUE
✔✔Members who fail to pay the required premiums before the end of the grace period
(Wellcare has a three-month grace period) will be terminated.
TRUE
FALSE - ✔✔TRUE
, ✔✔Best practices to keep in mind for Dual Eligible Special Needs Plan (D-SNP) and
Chronic Condition Special Needs Plan (C-SNP) enrollments include:
A. Ensuring the beneficiary has designated a primary care provider (PCP)
B. If no PCP, assist the beneficiary in searching for an in-network PCP that is accepting
new patients
C. Make the beneficiary aware if their PCP or other providers are out-of-network for the
plan they are selecting
D. All of these - ✔✔D. All of these
✔✔An oral or written request to the plan, provider, or facility requesting information on
benefit changes or preferred drugs is ___.
A. A Grievance
B. An Appeal
C. An Inquiry - ✔✔C. An Inquiry
✔✔Traditional Medicare Advantage (TMA) Non-Dual Eligible Special Needs Plans (D-
SNPs) that offer the Wellcare Spendables® Card include covered over-the-counter
(OTC) items and increased buying power for Dental, Vision, and Hearing (DVH)
services.
TRUE X
FALSE - ✔✔TRUE
✔✔A ___ Special Needs Plan (SNP) is for beneficiaries eligible for both Medicare and
Medicaid, are enrolled in Medicare Part A and Part B, and are receiving full Medicaid
benefits and/or assistance with Medicare premiums or cost-sharing through one of the
Medicare Savings Program (MSP) categories.
A. Chronic
B. Dual Eligible - ✔✔B. Dual Eligible
✔✔Final 2026 plan and benefit information may be discussed with beneficiaries on or
after October 1, 2025.
TRUE
FALSE - ✔✔TRUE
✔✔Special Supplemental Benefits for the Chronically Ill (SSBCI) may be available for
members on select Dual Eligible Special Needs Plans (D-SNPs) who have:
A. Certain chronic conditions
B. Need intensive care management
C. Are at high risk for hospitalization
D. All of these are required - ✔✔D. All of these are required
QUESTIONS AND ANSWERS GUARANTEE A+
✔✔The Minimum Necessary Rule within the privacy rule requires that any request or
distribution of Protected Health Information (PHI) occurs with only the minimum amount
of PHI required to complete the intended task and includes email and physical
distribution.
TRUE
FALSE - ✔✔TRUE
✔✔As part of Centene's Ethics and Compliance program, Centene requires all
contracted brokers/agents to review, agree, and adhere to Centene's Business Ethics
and Code of Conduct Policy.
TRUE
FALSE - ✔✔TRUE
✔✔The broker/agent's role in the investigation process of reported non-compliant
behavior is to:
A. Respond as quickly as possible
B. Answer questions honestly and completely
C. Offer or provide information or documents related to the investigation
D. All of these - ✔✔D. All of these
✔✔At ____, brokers/agents present plan-specific information to an audience.
A. Formal Sales Events
B. Informal Sales Events
C. Educational Events - ✔✔A. Formal Sales Events
✔✔Marketing/sales events are prohibited from taking place within ___ of an educational
event in the same location.
A. 12 hours
B. 48 hours
C. 18 hours
D. 72 hours - ✔✔A. 12 hours
✔✔Failing to select a Special Election Period (SEP) or selecting the incorrect SEP will
create a Request for Information (RFI) or result in a denied application.
TRUE
FALSE - ✔✔TRUE
✔✔Members who fail to pay the required premiums before the end of the grace period
(Wellcare has a three-month grace period) will be terminated.
TRUE
FALSE - ✔✔TRUE
, ✔✔Best practices to keep in mind for Dual Eligible Special Needs Plan (D-SNP) and
Chronic Condition Special Needs Plan (C-SNP) enrollments include:
A. Ensuring the beneficiary has designated a primary care provider (PCP)
B. If no PCP, assist the beneficiary in searching for an in-network PCP that is accepting
new patients
C. Make the beneficiary aware if their PCP or other providers are out-of-network for the
plan they are selecting
D. All of these - ✔✔D. All of these
✔✔An oral or written request to the plan, provider, or facility requesting information on
benefit changes or preferred drugs is ___.
A. A Grievance
B. An Appeal
C. An Inquiry - ✔✔C. An Inquiry
✔✔Traditional Medicare Advantage (TMA) Non-Dual Eligible Special Needs Plans (D-
SNPs) that offer the Wellcare Spendables® Card include covered over-the-counter
(OTC) items and increased buying power for Dental, Vision, and Hearing (DVH)
services.
TRUE X
FALSE - ✔✔TRUE
✔✔A ___ Special Needs Plan (SNP) is for beneficiaries eligible for both Medicare and
Medicaid, are enrolled in Medicare Part A and Part B, and are receiving full Medicaid
benefits and/or assistance with Medicare premiums or cost-sharing through one of the
Medicare Savings Program (MSP) categories.
A. Chronic
B. Dual Eligible - ✔✔B. Dual Eligible
✔✔Final 2026 plan and benefit information may be discussed with beneficiaries on or
after October 1, 2025.
TRUE
FALSE - ✔✔TRUE
✔✔Special Supplemental Benefits for the Chronically Ill (SSBCI) may be available for
members on select Dual Eligible Special Needs Plans (D-SNPs) who have:
A. Certain chronic conditions
B. Need intensive care management
C. Are at high risk for hospitalization
D. All of these are required - ✔✔D. All of these are required
