2025 Wellcare ACT Mastery Exam – TeleAgent
100% Correct Answers | Verified
Effective 2025, key provisions of the Inflation Reduction Act include a lower annual threshold of $_____
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
for out-of-pocket (OOP) prescription drug costs in Medicare. - Correct Answer - $2,000
ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Wellcare launched new tiered provider plans in ______ and _____. (Select two options.) - Correct
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Answer - Arizona and Oregon
ty ty ty ty ty
For 2025, Wellcare has 43 new plans going to market. - Correct Answer - True
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Best practices to keep in mind for Dual Eligible Special Needs Plan (D-SNP) and Chronic Condition
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Special Needs Plan (C-SNP) enrollments include the following: (Select all that apply.) - Correct Answer -
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
If a member is not connected to a primary care provider (PCP), always encourage and assist with
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
connecting them to an in-network doctor
ty ty ty ty ty ty
Avoid Submitting applications with no PCP to assist these higher-risk members
ty ty ty ty ty ty ty ty ty ty
None of these ty ty
Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part D plan premiums. -
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Correct Answer - False
ty ty ty ty ty
When completing enrollments, be sure to collect the member's ____ and ____ to help ensure they
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
receive important resources throughout and beyond their onboarding journey. - Correct Answer - Email
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
address, Mobile phone number, fax number
ty ty ty ty ty ty
Low-Income Subsidy (LIS) Level 4 is ending and moving to Level 1 as new certifications and
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
recertifications take place. - Correct Answer - True
ty ty ty ty ty ty ty ty ty
Which Prescription Drug Plan (PDP) has the richest formulary with the most adherence generics on Tier
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
1? - Correct Answer - Value Plus
ty ty ty ty ty ty ty ty
In 2025, Medicare Advantage Prescription Drug (MAPD) plans will have six formularies with six
ty ty ty ty ty ty ty ty ty ty ty ty ty
individual tier structures. - Correct Answer - False
ty ty ty ty ty ty ty ty ty
For 2025, Wellcare will be offering plans to more than 51 million beneficiaries, which accounts for 77% of
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
all eligible Medicare beneficiaries in our ___ states. - Correct Answer - 32
ty ty ty ty ty ty ty ty ty ty ty ty ty ty
All Prescription Drug Plans (PDPs) offer preferred cost-sharing including $0 copay on Tier 1 preferred
ty ty ty ty ty ty ty ty ty ty ty ty ty ty
generic medications through Express Scripts Pharmacy home delivery. - Correct Answer - True
ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Members who have LIS and enroll in a plan other than Wellcare's Classic plan will pay a premium
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
regardless of LIS subsidy status. - Correct Answer - True
ty ty ty ty ty ty ty ty ty ty ty
, New for PY2025, the Wellcare Spendables™ Card will include Home Improvement and Safety Items on
ty ty ty ty ty ty ty ty ty ty ty ty ty ty
select Dual Eligible Special Needs Plans (D-SNPs) (amount varies by plan). - Correct Answer - True
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
As part of Centene's Ethics and Compliance program, Centene requires all agents to review and agree to
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
its Business Ethics and Code of Conduct Policy. - Correct Answer - True
ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Self-reporting of a compliance issue must be made to Corporate Compliance or to a Health Plan Sales
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Leader and must indicate: - Correct Answer - All of these
ty ty ty ty ty ty ty ty ty ty ty ty
Agents must meet all required contracting, training, and certification requirements annually to be eligible
ty ty ty ty ty ty ty ty ty ty ty ty ty
to sell Wellcare's Medicare products. - Correct Answer - True
ty ty ty ty ty ty ty ty ty ty ty
When completing an application, you should ensure that you enter the provider ID of a specialist and not
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
a primary care provider (PCP). - Correct Answer - False
ty ty ty ty ty ty ty ty ty ty ty
Prior to the beginning of the enrollment process, an agent is required to cover certain beneficiary specific
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
information, including but not limited to: - Correct Answer - All of these
ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Upon completion of the application, you must provide the beneficiary with the enrollment application
ty ty ty ty ty ty ty ty ty ty ty ty ty
confirmation ID. - Correct Answer - True
ty ty ty ty ty ty ty ty
The Third-Party Marketing Organization (TPMO) disclaimer must be used by any TPMO that sells plans
ty ty ty ty ty ty ty ty ty ty ty ty ty ty
on behalf of more than one Medicare Advantage (MA) plan provider. The disclaimer must be: (Select all
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
that apply.) - Correct Answer - Included in any marketing materials, including print materials and
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
television advertisements developed, used, or distributed by the TPMO
ty ty ty ty ty ty ty ty ty
Verbally conveyed within the first minute of a sales call
ty ty ty ty ty ty ty ty ty
Prominently displayed on TPMO websites (regardless of content) ty ty ty ty ty ty ty
Electronically conveyed when communicating with a beneficiary through email, online chat, or other
ty ty ty ty ty ty ty ty ty ty ty ty
electronic means of communication (regardless of content)
ty ty ty ty ty ty ty
Which of the following statements about completing telephonic enrollments is FALSE? - Correct Answer -
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Must include some of the required elements necessary to complete the enrollment
ty ty ty ty ty ty ty ty ty ty ty ty
When enrolling a Dual Eligible Special Needs Plan (D-SNP) beneficiary, be sure to verify plan enrollment
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
eligibility and that the Medicare Savings Program (MSP) level is eligible for the requested plan. - Correct
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Answer - True
ty ty ty
Verbal permission granted to discuss plan details qualifies an authorized representative to complete an
ty ty ty ty ty ty ty ty ty ty ty ty ty
application on behalf of the beneficiary. - Correct Answer - False
ty ty ty ty ty ty ty ty ty ty ty ty
Members who fail to pay the required premiums before the end of the grace period (Wellcare has a three-
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
month grace period) will be terminated. - Correct Answer - True
ty ty ty ty ty ty ty ty ty ty ty
The online Member Portal is available Monday - Friday, 8:00am - 8:00pm. - Correct Answer - False
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
The Pre-Enrollment Checklist (PECL) should be provided and reviewed with the prospective enrollee after
ty ty ty ty ty ty ty ty ty ty ty ty ty
enrollment to ensure the enrollee understands important plan benefits and rules. - Correct Answer -
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
False
ty
A grievance request, or any evidence concerning a grievance, must be filed orally or in writing no later
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
than _____ calendar days from the date of the event or the date the member is made aware of the issue.
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
- Correct Answer - 60
ty ty ty ty ty ty
Grievance procedures are separate and distinct from initial determination and appeal procedures. -
ty ty ty ty ty ty ty ty ty ty ty ty
100% Correct Answers | Verified
Effective 2025, key provisions of the Inflation Reduction Act include a lower annual threshold of $_____
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
for out-of-pocket (OOP) prescription drug costs in Medicare. - Correct Answer - $2,000
ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Wellcare launched new tiered provider plans in ______ and _____. (Select two options.) - Correct
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Answer - Arizona and Oregon
ty ty ty ty ty
For 2025, Wellcare has 43 new plans going to market. - Correct Answer - True
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Best practices to keep in mind for Dual Eligible Special Needs Plan (D-SNP) and Chronic Condition
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Special Needs Plan (C-SNP) enrollments include the following: (Select all that apply.) - Correct Answer -
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
If a member is not connected to a primary care provider (PCP), always encourage and assist with
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
connecting them to an in-network doctor
ty ty ty ty ty ty
Avoid Submitting applications with no PCP to assist these higher-risk members
ty ty ty ty ty ty ty ty ty ty
None of these ty ty
Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part D plan premiums. -
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Correct Answer - False
ty ty ty ty ty
When completing enrollments, be sure to collect the member's ____ and ____ to help ensure they
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
receive important resources throughout and beyond their onboarding journey. - Correct Answer - Email
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
address, Mobile phone number, fax number
ty ty ty ty ty ty
Low-Income Subsidy (LIS) Level 4 is ending and moving to Level 1 as new certifications and
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
recertifications take place. - Correct Answer - True
ty ty ty ty ty ty ty ty ty
Which Prescription Drug Plan (PDP) has the richest formulary with the most adherence generics on Tier
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
1? - Correct Answer - Value Plus
ty ty ty ty ty ty ty ty
In 2025, Medicare Advantage Prescription Drug (MAPD) plans will have six formularies with six
ty ty ty ty ty ty ty ty ty ty ty ty ty
individual tier structures. - Correct Answer - False
ty ty ty ty ty ty ty ty ty
For 2025, Wellcare will be offering plans to more than 51 million beneficiaries, which accounts for 77% of
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
all eligible Medicare beneficiaries in our ___ states. - Correct Answer - 32
ty ty ty ty ty ty ty ty ty ty ty ty ty ty
All Prescription Drug Plans (PDPs) offer preferred cost-sharing including $0 copay on Tier 1 preferred
ty ty ty ty ty ty ty ty ty ty ty ty ty ty
generic medications through Express Scripts Pharmacy home delivery. - Correct Answer - True
ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Members who have LIS and enroll in a plan other than Wellcare's Classic plan will pay a premium
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
regardless of LIS subsidy status. - Correct Answer - True
ty ty ty ty ty ty ty ty ty ty ty
, New for PY2025, the Wellcare Spendables™ Card will include Home Improvement and Safety Items on
ty ty ty ty ty ty ty ty ty ty ty ty ty ty
select Dual Eligible Special Needs Plans (D-SNPs) (amount varies by plan). - Correct Answer - True
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
As part of Centene's Ethics and Compliance program, Centene requires all agents to review and agree to
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
its Business Ethics and Code of Conduct Policy. - Correct Answer - True
ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Self-reporting of a compliance issue must be made to Corporate Compliance or to a Health Plan Sales
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Leader and must indicate: - Correct Answer - All of these
ty ty ty ty ty ty ty ty ty ty ty ty
Agents must meet all required contracting, training, and certification requirements annually to be eligible
ty ty ty ty ty ty ty ty ty ty ty ty ty
to sell Wellcare's Medicare products. - Correct Answer - True
ty ty ty ty ty ty ty ty ty ty ty
When completing an application, you should ensure that you enter the provider ID of a specialist and not
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
a primary care provider (PCP). - Correct Answer - False
ty ty ty ty ty ty ty ty ty ty ty
Prior to the beginning of the enrollment process, an agent is required to cover certain beneficiary specific
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
information, including but not limited to: - Correct Answer - All of these
ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Upon completion of the application, you must provide the beneficiary with the enrollment application
ty ty ty ty ty ty ty ty ty ty ty ty ty
confirmation ID. - Correct Answer - True
ty ty ty ty ty ty ty ty
The Third-Party Marketing Organization (TPMO) disclaimer must be used by any TPMO that sells plans
ty ty ty ty ty ty ty ty ty ty ty ty ty ty
on behalf of more than one Medicare Advantage (MA) plan provider. The disclaimer must be: (Select all
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
that apply.) - Correct Answer - Included in any marketing materials, including print materials and
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
television advertisements developed, used, or distributed by the TPMO
ty ty ty ty ty ty ty ty ty
Verbally conveyed within the first minute of a sales call
ty ty ty ty ty ty ty ty ty
Prominently displayed on TPMO websites (regardless of content) ty ty ty ty ty ty ty
Electronically conveyed when communicating with a beneficiary through email, online chat, or other
ty ty ty ty ty ty ty ty ty ty ty ty
electronic means of communication (regardless of content)
ty ty ty ty ty ty ty
Which of the following statements about completing telephonic enrollments is FALSE? - Correct Answer -
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Must include some of the required elements necessary to complete the enrollment
ty ty ty ty ty ty ty ty ty ty ty ty
When enrolling a Dual Eligible Special Needs Plan (D-SNP) beneficiary, be sure to verify plan enrollment
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
eligibility and that the Medicare Savings Program (MSP) level is eligible for the requested plan. - Correct
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
Answer - True
ty ty ty
Verbal permission granted to discuss plan details qualifies an authorized representative to complete an
ty ty ty ty ty ty ty ty ty ty ty ty ty
application on behalf of the beneficiary. - Correct Answer - False
ty ty ty ty ty ty ty ty ty ty ty ty
Members who fail to pay the required premiums before the end of the grace period (Wellcare has a three-
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
month grace period) will be terminated. - Correct Answer - True
ty ty ty ty ty ty ty ty ty ty ty
The online Member Portal is available Monday - Friday, 8:00am - 8:00pm. - Correct Answer - False
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
The Pre-Enrollment Checklist (PECL) should be provided and reviewed with the prospective enrollee after
ty ty ty ty ty ty ty ty ty ty ty ty ty
enrollment to ensure the enrollee understands important plan benefits and rules. - Correct Answer -
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
False
ty
A grievance request, or any evidence concerning a grievance, must be filed orally or in writing no later
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
than _____ calendar days from the date of the event or the date the member is made aware of the issue.
ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty ty
- Correct Answer - 60
ty ty ty ty ty ty
Grievance procedures are separate and distinct from initial determination and appeal procedures. -
ty ty ty ty ty ty ty ty ty ty ty ty
