2025 Wellcare Mastery Test – 100 Prep Questions
and Correct Answers/ Wellcare Mastery Exam
Latest 2025-2026 Practice Questions and
Answers/ Medicare Wellcare ACT Mastery Test
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
Wellcare's 2024 product expansion represents a __% increase from 2023. -
ANSWER-One
The 2024 Inflation Reduction Act (IRA) Part D Benefits include reduced insulin
copays for all insulins and insulin-combination products that are on the formulary,
regardless of tier, and are included in the $35 cap for one month's supply. -
ANSWER-True
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
pg. 1
,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
pg. 2
, 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.
pg. 3
and Correct Answers/ Wellcare Mastery Exam
Latest 2025-2026 Practice Questions and
Answers/ Medicare Wellcare ACT Mastery Test
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
Wellcare's 2024 product expansion represents a __% increase from 2023. -
ANSWER-One
The 2024 Inflation Reduction Act (IRA) Part D Benefits include reduced insulin
copays for all insulins and insulin-combination products that are on the formulary,
regardless of tier, and are included in the $35 cap for one month's supply. -
ANSWER-True
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
pg. 1
,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
pg. 2
, 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.
pg. 3
