WellCare ACT Mastery Exam REVIEW 2026/2027
WITH EXPERT-VERIFIED SOLUTIONS
• Wellcare launched new tiered provider plans in ______ and _____. (Select two
options.) -✓✓ Arizona and Oregon
• For 2025, Wellcare has 43 new plans going to market. -✓✓ 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 the following:
(Select all that apply.) -✓✓ If a member is not connected to a primary care provider
(PCP), always encourage and assist with connecting them to an in-network doctor
Avoid Submitting applications with no PCP to assist these higher-risk members
None of these
• Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part D
plan premiums. -✓✓ False
• When completing enrollments, be sure to collect the member's ____ and ____ to help
ensure they receive important resources throughout and beyond their onboarding
journey. -✓✓ Email address, Mobile phone number, fax number
• Low-Income Subsidy (LIS) Level 4 is ending and moving to Level 1 as new
certifications and recertifications take place. -✓✓ True
• Which Prescription Drug Plan (PDP) has the richest formulary with the most
adherence generics on Tier 1? -✓✓ Value Plus
• In 2025, Medicare Advantage Prescription Drug (MAPD) plans will have six
formularies with six individual tier structures. -✓✓ False
• For 2025, Wellcare will be offering plans to more than 51 million beneficiaries, which
accounts for 77% of all eligible Medicare beneficiaries in our ___ states. -✓✓ 32
• All Prescription Drug Plans (PDPs) offer preferred cost-sharing including $0 copay on
Tier 1 preferred generic medications through Express Scripts Pharmacy home delivery.
-✓✓ True
• Members who have LIS and enroll in a plan other than Wellcare's Classic plan will pay
a premium regardless of LIS subsidy status. -✓✓ True
, • New for PY2025, the Wellcare Spendables™ Card will include Home Improvement
and Safety Items on select Dual Eligible Special Needs Plans (D-SNPs) (amount varies
by plan). -✓✓ True
• As part of Centene's Ethics and Compliance program, Centene requires all agents to
review and agree to its Business Ethics and Code of Conduct Policy. -✓✓ True
• Self-reporting of a compliance issue must be made to Corporate Compliance or to a
Health Plan Sales Leader and must indicate: -✓✓ All of these
• Agents must meet all required contracting, training, and certification requirements
annually to be eligible to sell Wellcare's Medicare products. -✓✓ True
• When completing an application, you should ensure that you enter the provider ID of a
specialist and not a primary care provider (PCP). -✓✓ False
• Prior to the beginning of the enrollment process, an agent is required to cover certain
beneficiary specific information, including but not limited to: -✓✓ All of these
• Upon completion of the application, you must provide the beneficiary with the
enrollment application confirmation ID. -✓✓ True
• The Third-Party Marketing Organization (TPMO) disclaimer must be used by any
TPMO that sells plans on behalf of more than one Medicare Advantage (MA) plan
provider. The disclaimer must be: (Select all that apply.) -✓✓ 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)
Electronically conveyed when communicating with a beneficiary through email, online
chat, or other electronic means of communication (regardless of content)
• Which of the following statements about completing telephonic enrollments is FALSE?
-✓✓ Must include some of the required elements necessary to complete the enrollment
• When enrolling a Dual Eligible Special Needs Plan (D-SNP) beneficiary, be sure to
verify plan enrollment eligibility and that the Medicare Savings Program (MSP) level is
eligible for the requested plan. -✓✓ True
• Verbal permission granted to discuss plan details qualifies an authorized
representative to complete an application on behalf of the beneficiary. -✓✓ False
WITH EXPERT-VERIFIED SOLUTIONS
• Wellcare launched new tiered provider plans in ______ and _____. (Select two
options.) -✓✓ Arizona and Oregon
• For 2025, Wellcare has 43 new plans going to market. -✓✓ 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 the following:
(Select all that apply.) -✓✓ If a member is not connected to a primary care provider
(PCP), always encourage and assist with connecting them to an in-network doctor
Avoid Submitting applications with no PCP to assist these higher-risk members
None of these
• Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part D
plan premiums. -✓✓ False
• When completing enrollments, be sure to collect the member's ____ and ____ to help
ensure they receive important resources throughout and beyond their onboarding
journey. -✓✓ Email address, Mobile phone number, fax number
• Low-Income Subsidy (LIS) Level 4 is ending and moving to Level 1 as new
certifications and recertifications take place. -✓✓ True
• Which Prescription Drug Plan (PDP) has the richest formulary with the most
adherence generics on Tier 1? -✓✓ Value Plus
• In 2025, Medicare Advantage Prescription Drug (MAPD) plans will have six
formularies with six individual tier structures. -✓✓ False
• For 2025, Wellcare will be offering plans to more than 51 million beneficiaries, which
accounts for 77% of all eligible Medicare beneficiaries in our ___ states. -✓✓ 32
• All Prescription Drug Plans (PDPs) offer preferred cost-sharing including $0 copay on
Tier 1 preferred generic medications through Express Scripts Pharmacy home delivery.
-✓✓ True
• Members who have LIS and enroll in a plan other than Wellcare's Classic plan will pay
a premium regardless of LIS subsidy status. -✓✓ True
, • New for PY2025, the Wellcare Spendables™ Card will include Home Improvement
and Safety Items on select Dual Eligible Special Needs Plans (D-SNPs) (amount varies
by plan). -✓✓ True
• As part of Centene's Ethics and Compliance program, Centene requires all agents to
review and agree to its Business Ethics and Code of Conduct Policy. -✓✓ True
• Self-reporting of a compliance issue must be made to Corporate Compliance or to a
Health Plan Sales Leader and must indicate: -✓✓ All of these
• Agents must meet all required contracting, training, and certification requirements
annually to be eligible to sell Wellcare's Medicare products. -✓✓ True
• When completing an application, you should ensure that you enter the provider ID of a
specialist and not a primary care provider (PCP). -✓✓ False
• Prior to the beginning of the enrollment process, an agent is required to cover certain
beneficiary specific information, including but not limited to: -✓✓ All of these
• Upon completion of the application, you must provide the beneficiary with the
enrollment application confirmation ID. -✓✓ True
• The Third-Party Marketing Organization (TPMO) disclaimer must be used by any
TPMO that sells plans on behalf of more than one Medicare Advantage (MA) plan
provider. The disclaimer must be: (Select all that apply.) -✓✓ 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)
Electronically conveyed when communicating with a beneficiary through email, online
chat, or other electronic means of communication (regardless of content)
• Which of the following statements about completing telephonic enrollments is FALSE?
-✓✓ Must include some of the required elements necessary to complete the enrollment
• When enrolling a Dual Eligible Special Needs Plan (D-SNP) beneficiary, be sure to
verify plan enrollment eligibility and that the Medicare Savings Program (MSP) level is
eligible for the requested plan. -✓✓ True
• Verbal permission granted to discuss plan details qualifies an authorized
representative to complete an application on behalf of the beneficiary. -✓✓ False
