Wellcare ACT Mastery Exam Questions and Answers (Latest 2023 – 2024) Verified Solutions

Which is an example of a top beneficiary complaint that affects Star Ratings? - The beneficiary did not understand that enrolling in a Wellcare plan would change their current Medicare Advantage plan An SEP is a period outside of the ICEP, AEP, or MA OEP when beneficiaries can enroll based solely on life events that qualify for an SEP period. - True Prior to the beginning of the enrollment process, a broker/agent is required to cover certain beneficiary specific information, including but not limited to: - All 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? - NOT - Serving Government Customers Once the enrollment is completed, you can save a copy of the application for your reference. - False The Mastery Exam will lock for a period of 48 hours after each failed attempt. - False 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: (Select all that apply.) - All 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: - Appeal Which of the following statements about Scope of Appointment (SOA) is FALSE - An electronic SOA submitted in Ascend must be in a Pending status prior to beginning the appointment Wellcare added which state to its footprint for 2024? - Delaware The Prescription Drug Plan (PDP) network is expected to include over ____ total pharmacies - 60,000 Members are no longer required to pay a partial deductible due to the Inflation Reduction Act - False 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 - True The Pharmacy Benefit Manager (PBM) migration to Express Scripts effective 1/1/2024 will impact which plan(s)? - Both Wellcare has new All-Dual D-SNP products in AL, AR, FL, GA, KY, LA, MI, MS, NC, NM, OH, OK, TX, and WI. - True Members who have LIS and enroll in other plans will have a premium to pay regardless of the level of LIS the member is granted - False Which of the Prescription Drug Plan (PDP) products is new to the 6-tier formulary structure for 2024? - NOT - Value Script All Prescription Drug Plans (PDPs) will offer a $___ copay for most Part D preventive vaccines, regardless of which network pharmacy is used by members - $0 Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part D plan premiums - False CVS Caremark Mail Order will be in-network for 2024 - False Which LIS category is assigned to members whose costs are fully subsidized and who receive the most assistance? - Three