2025 Wellcare ACT Mastery Exam with Questions and Correct Answers Verified Solutions
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Course
Wellcare Mastery
Institution
Wellcare Mastery
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
All Prescription Drug Plans (...
2025 Wellcare ACT Mastery Exam with
Questions and Correct Answers\ Verified
Solutions
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
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
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.
Brokers/Agents can access and download enrollment materials through CustomPoint. -
Answer 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. - Answer Educational
Materials that include plan comparisons or cost-sharing do not require CMS submission.
- Answer 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? - 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
A Low-Income Subsidy (LIS) member will be assigned one of ____ copay categories
depending on the level of need. - Answer Four
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