WELLCARE ACT MASTERY FINAL PAPER 2026
TESTED QUESTIONS WITH FULL SOLUTION
GRADED A+
◉ Noting the correct enrollment period on enrollment applications
helps in preventing delayed enrollment processing. Answer: True
◉ When verifying a D-SNP beneficiary's Medicaid eligibility through
the Ascend Medicaid search tool, you should confirm their current
Medicaid status qualifies for the selected D-SNP being enrolled in
and explain that changes in Medicaid eligibility may affect
enrollment and/or cost sharing. Answer: True
◉ Which of the following statements about Scope of Appointment
(SOA) is FALSE? Answer: An electronic SOA submitted in Ascend
must be in a Pending status prior to beginning the appointment.
◉ Key areas you as a broker/agent have control over and impact
upon regarding Star Ratings for quality are: Answer: All of these
◉ Beneficiary-facing marketing materials for multiple MA
organizations or plans must be submitted to the HPMS Marketing
Module by the third-party marketing organization (TPMO) no later
than 30 days of use. Answer: False
,◉ When completing an enrollment, be sure to use the correct
enrollment application for the desired plan year. Answer: True
◉ 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
◉ Although options for capturing and submitting SOAs vary by
health plan, Wellcare accepts SOAs in which of the following
methods? Answer: All of these
◉ 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. Answer: True
◉ Which of the following is not considered a grievance? Answer: A
dispute of the appeal of an organization determination, coverage
determination, or a Late Enrollment Penalty (LEP) determination.
◉ Brokers/Agents can access and download enrollment materials
through CustomPoint. Answer: True
◉ ______ 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. Answer:
Educational
◉ Materials that include plan comparisons or cost-sharing do not
require CMS submission. 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: Member Payments
◉ The Pharmacy Benefit Manager (PBM) migration to Express
Scripts effective 1/1/2024 will impact which plan(s)? Answer: Both
PDP & MAPD
◉ A Low-Income Subsidy (LIS) member will be assigned one of ____
copay categories depending on the level of need. Answer: Four
◉ The 2024 Inflation Reduction Act (IRA) Part D Benefits include
reduced insulin copays for all insulins and insulin-combination
products that are on the formulary, regardless of tier, and are
included in the $35 cap for one month's supply. Answer: True
◉ Wellcare's 2024 product expansion represents a __% increase
from 2023. Answer: One
TESTED QUESTIONS WITH FULL SOLUTION
GRADED A+
◉ Noting the correct enrollment period on enrollment applications
helps in preventing delayed enrollment processing. Answer: True
◉ When verifying a D-SNP beneficiary's Medicaid eligibility through
the Ascend Medicaid search tool, you should confirm their current
Medicaid status qualifies for the selected D-SNP being enrolled in
and explain that changes in Medicaid eligibility may affect
enrollment and/or cost sharing. Answer: True
◉ Which of the following statements about Scope of Appointment
(SOA) is FALSE? Answer: An electronic SOA submitted in Ascend
must be in a Pending status prior to beginning the appointment.
◉ Key areas you as a broker/agent have control over and impact
upon regarding Star Ratings for quality are: Answer: All of these
◉ Beneficiary-facing marketing materials for multiple MA
organizations or plans must be submitted to the HPMS Marketing
Module by the third-party marketing organization (TPMO) no later
than 30 days of use. Answer: False
,◉ When completing an enrollment, be sure to use the correct
enrollment application for the desired plan year. Answer: True
◉ 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
◉ Although options for capturing and submitting SOAs vary by
health plan, Wellcare accepts SOAs in which of the following
methods? Answer: All of these
◉ 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. Answer: True
◉ Which of the following is not considered a grievance? Answer: A
dispute of the appeal of an organization determination, coverage
determination, or a Late Enrollment Penalty (LEP) determination.
◉ Brokers/Agents can access and download enrollment materials
through CustomPoint. Answer: True
◉ ______ 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. Answer:
Educational
◉ Materials that include plan comparisons or cost-sharing do not
require CMS submission. 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: Member Payments
◉ The Pharmacy Benefit Manager (PBM) migration to Express
Scripts effective 1/1/2024 will impact which plan(s)? Answer: Both
PDP & MAPD
◉ A Low-Income Subsidy (LIS) member will be assigned one of ____
copay categories depending on the level of need. Answer: Four
◉ The 2024 Inflation Reduction Act (IRA) Part D Benefits include
reduced insulin copays for all insulins and insulin-combination
products that are on the formulary, regardless of tier, and are
included in the $35 cap for one month's supply. Answer: True
◉ Wellcare's 2024 product expansion represents a __% increase
from 2023. Answer: One
