WELLCARE EXAM 2024 UPDATED QUESTIONS AND
VERIFIED ANSWERS
A request to the plan to the plan from a member or provider for a formal review of an Action (Denial) or
Adverse Plan Determination (medicare) is a/an: - CORRECT ANSWER✅✅✅a.APPEAL
A grievance request, or any evidence concerning a grievance, must be filed orally or in writing no later
than __ calendar days from the date of the event or the date the member is made aware of the issue. -
CORRECT ANSWER✅✅✅60
An LEP is assessed by CMS when a member goes___days or longer without creditable prescription drug
coverage after they become Medicare-eligible. - CORRECT ANSWER✅✅✅B. 63 DAYS
Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-assisted electronic
enrollments. - CORRECT ANSWER✅✅✅TRUE
A Health Risk Assessment (HRA): - CORRECT ANSWER✅✅✅a. Provides physiscians with an overview
of a member's health status.
B. help us understand the
unique health situation og each of our members and allows us to make sure they receive the
services that meet their needs.
c. is an important part of our quality initiative, directly
impacting our star ratings.
D. ALL OF THESE (CORRECT)
A broker/agent may be terminated for cause if they fail to comply with compliance investigation,
encourage others to avoid the compliance interview process, or fail to provide truthful complete
information. - CORRECT ANSWER✅✅✅TRUE
A broker/ agent who has never had any verbal warnings cannot be issued a corrective action plan. -
CORRECT ANSWER✅✅✅FALSE
, A Low-income subsidy (LIS) member will be assigned of the __copay categories depending on the level
of need. - CORRECT ANSWER✅✅✅C. FOUR
All prescription drug plans (PDPs) will feature a $0 Tier 1 benefit when filled at preferred pharmacies. -
CORRECT ANSWER✅✅✅TRUE
All prescription drug plans (PDPs) will continue to offer $0 Tier 1 preferred cost-sharing through Express
Scripts pharmacy (mail order). - CORRECT ANSWER✅✅✅TRUE
All Prescription Drug Plans (PDPs) will offer a $__ copay for most Part D preventive Vaccines, regardless
of which network pharmacy is used by members. - CORRECT ANSWER✅✅✅ZERO
At the end of this course, there will be a Mastery Exam. Agents must achieve a passing score of 85% or
higher to successfully complete this course. - CORRECT ANSWER✅✅✅TRUE
Although options for capturing and submitting SOAs vary by health plan, wellcare accepts SOAs in which
of the following methods? - CORRECT ANSWER✅✅✅ALL OF THESE
Any request or distribution of PH should contain only the minimum amount of PH required to complete
the intended task - CORRECT ANSWER✅✅✅TRUE
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. - CORRECT ANSWER✅✅✅TRUE
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.
- CORRECT ANSWER✅✅✅FALSE
Broker/Agents can submit a support ticket online through their Centene Workbench portal - CORRECT
ANSWER✅✅✅TRUE
VERIFIED ANSWERS
A request to the plan to the plan from a member or provider for a formal review of an Action (Denial) or
Adverse Plan Determination (medicare) is a/an: - CORRECT ANSWER✅✅✅a.APPEAL
A grievance request, or any evidence concerning a grievance, must be filed orally or in writing no later
than __ calendar days from the date of the event or the date the member is made aware of the issue. -
CORRECT ANSWER✅✅✅60
An LEP is assessed by CMS when a member goes___days or longer without creditable prescription drug
coverage after they become Medicare-eligible. - CORRECT ANSWER✅✅✅B. 63 DAYS
Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-assisted electronic
enrollments. - CORRECT ANSWER✅✅✅TRUE
A Health Risk Assessment (HRA): - CORRECT ANSWER✅✅✅a. Provides physiscians with an overview
of a member's health status.
B. help us understand the
unique health situation og each of our members and allows us to make sure they receive the
services that meet their needs.
c. is an important part of our quality initiative, directly
impacting our star ratings.
D. ALL OF THESE (CORRECT)
A broker/agent may be terminated for cause if they fail to comply with compliance investigation,
encourage others to avoid the compliance interview process, or fail to provide truthful complete
information. - CORRECT ANSWER✅✅✅TRUE
A broker/ agent who has never had any verbal warnings cannot be issued a corrective action plan. -
CORRECT ANSWER✅✅✅FALSE
, A Low-income subsidy (LIS) member will be assigned of the __copay categories depending on the level
of need. - CORRECT ANSWER✅✅✅C. FOUR
All prescription drug plans (PDPs) will feature a $0 Tier 1 benefit when filled at preferred pharmacies. -
CORRECT ANSWER✅✅✅TRUE
All prescription drug plans (PDPs) will continue to offer $0 Tier 1 preferred cost-sharing through Express
Scripts pharmacy (mail order). - CORRECT ANSWER✅✅✅TRUE
All Prescription Drug Plans (PDPs) will offer a $__ copay for most Part D preventive Vaccines, regardless
of which network pharmacy is used by members. - CORRECT ANSWER✅✅✅ZERO
At the end of this course, there will be a Mastery Exam. Agents must achieve a passing score of 85% or
higher to successfully complete this course. - CORRECT ANSWER✅✅✅TRUE
Although options for capturing and submitting SOAs vary by health plan, wellcare accepts SOAs in which
of the following methods? - CORRECT ANSWER✅✅✅ALL OF THESE
Any request or distribution of PH should contain only the minimum amount of PH required to complete
the intended task - CORRECT ANSWER✅✅✅TRUE
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. - CORRECT ANSWER✅✅✅TRUE
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.
- CORRECT ANSWER✅✅✅FALSE
Broker/Agents can submit a support ticket online through their Centene Workbench portal - CORRECT
ANSWER✅✅✅TRUE
