WELLCARE ACT MASTERY ACTUAL EXAM SCRIPT 2025
QUESTIONS WITH SOLUTIONS GUARANTEE A+
✔✔Verbal permission granted to discuss plan details qualifies an authorized
representative to complete an application on behalf of the beneficiary. - ✔✔FALSE
✔✔When completing an application, you should ensure that you enter the provider ID of
a specialist and not a primary care provider (PCP). - ✔✔FALSE
✔✔To ensure accurate data entry, agents should repeat the Medicare ID back to the
beneficiary. - ✔✔TRUE
✔✔Upon completion of the application, you must provide the beneficiary with the
enrollment application confirmation ID. - ✔✔TRUE
✔✔Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part
D plan premiums. - ✔✔FALSE
✔✔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
✔✔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
✔✔The Pre-Enrollment Checklist (PECL) should be provided and reviewed with the
prospective enrollee after enrollment to ensure the enrollee understands important plan
benefits and rules. - ✔✔FALSE
✔✔The online Member Portal is available Monday - Friday, 8:00am - 8:00pm. -
✔✔FALSE
✔✔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
✔✔Grievance procedures are separate and distinct from initial determination and
appeal procedures. - ✔✔TRUE
✔✔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. - ✔✔60
, ✔✔Once the enrollment is completed, you can save a copy of the application for your
reference. - ✔✔FALSE
✔✔Member PHI can be stored on an external hard drive or a cloud storage service like
Google Drive or Apple Cloud. - ✔✔FALSE
✔✔Which will be Wellcare's Preferred Mail Order pharmacy? - ✔✔Express Scripts®
Pharmacy
✔✔The Medicare Prescription Payment Plan is a payment option that helps manage
out-of-pocket (OOP) Part B costs by allowing members who opt-in to spread costs
throughout the benefit year. - ✔✔FALSE
✔✔All three Prescription Drug Plans (PDPs) will offer a five-tier formulary design. -
✔✔TRUE
✔✔The _________ plan is expected to continue to offer members a cost-effective
option, with one of the lowest premiums in the nation! - ✔✔Value Script
✔✔Wellcare Mutual of Omaha co-branded plans are offered in _____ states. - ✔✔Five
✔✔Wellcare offers Medicare Advantage (MA) products to meet the needs of a variety of
beneficiaries. We offer: - ✔✔All of these
✔✔All Traditional Medicare Advantage Prescription Drug (MAPD) plans with drug
coverage include a $0 copay Tier 6 at all in-network pharmacy locations. - ✔✔TRUE
✔✔Only members with a standalone Prescription Drug Plan (PDP) are eligible to use
the Medicare Prescription Payment Plan option. - ✔✔FALSE
✔✔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
✔✔Disciplinary actions stemming from the result of a compliance allegation are always
progressive. - ✔✔FALSE
✔✔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
✔✔A Scope of Appointment (SOA) is valid _____ following the beneficiary's signature
date. - ✔✔12 months
QUESTIONS WITH SOLUTIONS GUARANTEE A+
✔✔Verbal permission granted to discuss plan details qualifies an authorized
representative to complete an application on behalf of the beneficiary. - ✔✔FALSE
✔✔When completing an application, you should ensure that you enter the provider ID of
a specialist and not a primary care provider (PCP). - ✔✔FALSE
✔✔To ensure accurate data entry, agents should repeat the Medicare ID back to the
beneficiary. - ✔✔TRUE
✔✔Upon completion of the application, you must provide the beneficiary with the
enrollment application confirmation ID. - ✔✔TRUE
✔✔Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part
D plan premiums. - ✔✔FALSE
✔✔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
✔✔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
✔✔The Pre-Enrollment Checklist (PECL) should be provided and reviewed with the
prospective enrollee after enrollment to ensure the enrollee understands important plan
benefits and rules. - ✔✔FALSE
✔✔The online Member Portal is available Monday - Friday, 8:00am - 8:00pm. -
✔✔FALSE
✔✔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
✔✔Grievance procedures are separate and distinct from initial determination and
appeal procedures. - ✔✔TRUE
✔✔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. - ✔✔60
, ✔✔Once the enrollment is completed, you can save a copy of the application for your
reference. - ✔✔FALSE
✔✔Member PHI can be stored on an external hard drive or a cloud storage service like
Google Drive or Apple Cloud. - ✔✔FALSE
✔✔Which will be Wellcare's Preferred Mail Order pharmacy? - ✔✔Express Scripts®
Pharmacy
✔✔The Medicare Prescription Payment Plan is a payment option that helps manage
out-of-pocket (OOP) Part B costs by allowing members who opt-in to spread costs
throughout the benefit year. - ✔✔FALSE
✔✔All three Prescription Drug Plans (PDPs) will offer a five-tier formulary design. -
✔✔TRUE
✔✔The _________ plan is expected to continue to offer members a cost-effective
option, with one of the lowest premiums in the nation! - ✔✔Value Script
✔✔Wellcare Mutual of Omaha co-branded plans are offered in _____ states. - ✔✔Five
✔✔Wellcare offers Medicare Advantage (MA) products to meet the needs of a variety of
beneficiaries. We offer: - ✔✔All of these
✔✔All Traditional Medicare Advantage Prescription Drug (MAPD) plans with drug
coverage include a $0 copay Tier 6 at all in-network pharmacy locations. - ✔✔TRUE
✔✔Only members with a standalone Prescription Drug Plan (PDP) are eligible to use
the Medicare Prescription Payment Plan option. - ✔✔FALSE
✔✔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
✔✔Disciplinary actions stemming from the result of a compliance allegation are always
progressive. - ✔✔FALSE
✔✔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
✔✔A Scope of Appointment (SOA) is valid _____ following the beneficiary's signature
date. - ✔✔12 months
