WELLCARE ACT MASTERY EXAM SET 2025 QUESTIONS
WITH SOLUTIONS GUARANTEE A+
✔✔The Wellcare preferred pharmacy network includes Walgreens, CVS, and some
grocery chains in 2024. - ✔✔True
✔✔Wellcare continues to expand its reach by offering more products in a wider
geography. ____ new Wellcare plans are going to market. - ✔✔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. -
✔✔Zero
✔✔Which of the Prescription Drug Plan (PDP) products is new to the 6-tier formulary
structure for 2024? - ✔✔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. - ✔✔Zero
✔✔Members are no longer required to pay a partial deductible due to the Inflation
Reduction Act. - ✔✔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. - ✔✔True
✔✔All Prescription Drug Plans (PDPs) will feature a $0 Tier 1 benefit when filled at
preferred pharmacies. - ✔✔True
✔✔____ Prescription Drug Plans (PDPs) will be offered across all 50 U.S. states and
Washington, D.C. - ✔✔Three
✔✔Noting the correct enrollment period on enrollment applications helps in preventing
delayed enrollment processing. - ✔✔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. - ✔✔True
✔✔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.
, ✔✔Key areas you as a broker/agent have control over and impact upon regarding Star
Ratings for quality are: - ✔✔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. - ✔✔False
✔✔When completing an enrollment, be sure to use the correct enrollment application
for the desired plan year. - ✔✔True
✔✔Providers may create co-branded marketing pieces using the Wellcare name and
logo, as long as they are using the current, approved logo. - ✔✔False
✔✔Although options for capturing and submitting SOAs vary by health plan, Wellcare
accepts SOAs in which of the following methods? - ✔✔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. - ✔✔True
✔✔Which of the following is not considered a grievance? - ✔✔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. - ✔✔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. - ✔✔Educational
✔✔Materials that include plan comparisons or cost-sharing do not require CMS
submission. - ✔✔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? - ✔✔Member Payments
✔✔The Pharmacy Benefit Manager (PBM) migration to Express Scripts effective
1/1/2024 will impact which plan(s)? - ✔✔Both PDP & MAPD
✔✔A Low-Income Subsidy (LIS) member will be assigned one of ____ copay categories
depending on the level of need. - ✔✔Four
WITH SOLUTIONS GUARANTEE A+
✔✔The Wellcare preferred pharmacy network includes Walgreens, CVS, and some
grocery chains in 2024. - ✔✔True
✔✔Wellcare continues to expand its reach by offering more products in a wider
geography. ____ new Wellcare plans are going to market. - ✔✔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. -
✔✔Zero
✔✔Which of the Prescription Drug Plan (PDP) products is new to the 6-tier formulary
structure for 2024? - ✔✔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. - ✔✔Zero
✔✔Members are no longer required to pay a partial deductible due to the Inflation
Reduction Act. - ✔✔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. - ✔✔True
✔✔All Prescription Drug Plans (PDPs) will feature a $0 Tier 1 benefit when filled at
preferred pharmacies. - ✔✔True
✔✔____ Prescription Drug Plans (PDPs) will be offered across all 50 U.S. states and
Washington, D.C. - ✔✔Three
✔✔Noting the correct enrollment period on enrollment applications helps in preventing
delayed enrollment processing. - ✔✔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. - ✔✔True
✔✔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.
, ✔✔Key areas you as a broker/agent have control over and impact upon regarding Star
Ratings for quality are: - ✔✔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. - ✔✔False
✔✔When completing an enrollment, be sure to use the correct enrollment application
for the desired plan year. - ✔✔True
✔✔Providers may create co-branded marketing pieces using the Wellcare name and
logo, as long as they are using the current, approved logo. - ✔✔False
✔✔Although options for capturing and submitting SOAs vary by health plan, Wellcare
accepts SOAs in which of the following methods? - ✔✔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. - ✔✔True
✔✔Which of the following is not considered a grievance? - ✔✔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. - ✔✔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. - ✔✔Educational
✔✔Materials that include plan comparisons or cost-sharing do not require CMS
submission. - ✔✔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? - ✔✔Member Payments
✔✔The Pharmacy Benefit Manager (PBM) migration to Express Scripts effective
1/1/2024 will impact which plan(s)? - ✔✔Both PDP & MAPD
✔✔A Low-Income Subsidy (LIS) member will be assigned one of ____ copay categories
depending on the level of need. - ✔✔Four
