2025 Wellcare ACT Mastery Exam with
Questions and Correct Answers\ Verified
Solutions
The Wellcare preferred pharmacy network includes Walgreens, CVS, and some grocery
chains in 2024. - Answer True
Wellcare continues to expand its reach by offering more products in a wider geography.
____ new Wellcare plans are going to market. - Answer Twenty-three
All Prescription Drug Plans (PDPs) will off er a $___ copay for most Part D preventive
vaccines, regardless of which network pharmacy is used by members. - Answer Zero
Which of the Prescription Drug Plan (PDP) products is new to the 6-tier formulary
structure for 2024? - Answer Classic
In the Catastrophic Coverage stage, the member will pay $___ for brand and generic
drugs for the remainder of the year once their total out of pocket costs reach $8,000. -
Answer Zero
Members are no longer required to pay a partial deductible due to the Inflation
Reduction Act. - Answer True
Wellcare has new All-Dual D-SNP products in AL, AR, FL, GA, KY, LA, MI, MS, NC, NM,
OH, OK, TX, and WI. - Answer True
All Prescription Drug Plans (PDPs) will feature a $0 Tier 1 benefit when filled at preferred
pharmacies. - Answer True
,____ Prescription Drug Plans (PDPs) will be offered across all 50 U.S. states and
Washington, D.C. - Answer Three
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
Questions and Correct Answers\ Verified
Solutions
The Wellcare preferred pharmacy network includes Walgreens, CVS, and some grocery
chains in 2024. - Answer True
Wellcare continues to expand its reach by offering more products in a wider geography.
____ new Wellcare plans are going to market. - Answer Twenty-three
All Prescription Drug Plans (PDPs) will off er a $___ copay for most Part D preventive
vaccines, regardless of which network pharmacy is used by members. - Answer Zero
Which of the Prescription Drug Plan (PDP) products is new to the 6-tier formulary
structure for 2024? - Answer Classic
In the Catastrophic Coverage stage, the member will pay $___ for brand and generic
drugs for the remainder of the year once their total out of pocket costs reach $8,000. -
Answer Zero
Members are no longer required to pay a partial deductible due to the Inflation
Reduction Act. - Answer True
Wellcare has new All-Dual D-SNP products in AL, AR, FL, GA, KY, LA, MI, MS, NC, NM,
OH, OK, TX, and WI. - Answer True
All Prescription Drug Plans (PDPs) will feature a $0 Tier 1 benefit when filled at preferred
pharmacies. - Answer True
,____ Prescription Drug Plans (PDPs) will be offered across all 50 U.S. states and
Washington, D.C. - Answer Three
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
