Wellcare ACT Mastery Exam (Latest 2023/
2024 Update) Version 1 | Questions and
Verified Answers| Grade A| 100% Correct
Q: Any request or distribution of PHI should contain only the minimum amount of PHI
required to complete the intended task.
Answer:
True
Q: Member PHI can be stored on an external hard drive or a cloud storage service like Google
Drive or Apple Cloud.
Answer:
False
Q: When completing an enrollment, be sure to use the correct enrollment application for the
desired plan year.
Answer:
True
Q: When completing an application, you should ensure that you enter the provider ID of a
specialist and not a primary care provider (PCP).
Question 17Select one:True
Answer:
False
Q: Once the enrollment is completed, you can save a copy of the application for your reference.
Answer:
False
Q: Members are no longer required to pay a partial deductible due to the Inflation Reduction
Act.
Answer:
True
Q: Wellcare expanded our county footprint in _ states for 2024. Answer: Five Q: All Prescription Drug Plans (PDPs) will feature a $0 Tier 1 benefit when filled at preferred pharmacies. Answer: True Q: For Prescription Drug Plan (PDP) Medication Home Delivery, the plan will continue
to offer a discount (2.5 x 30-day preferred retail copay) for Tier 2, 3, and 6 prescriptions.
Answer:
Value Plus
WellCare ACT Mastery Exam (Latest 2023/
2024 Update) Version 2 | Questions and
Verified Answers| Grade A| 100% Correct
Q: Which elements are available as part of Wellcare’s Sales Support model?
a. Online
b. Local
c. Corporate
d. All of these
Answer:
d. All of these
Q: Key areas you as a broker/agent have control over and impact upon regarding Star Ratings
for quality are:
a. Member Satisfaction/Experience
b. Complaints
c. Rapid Disenrollment
d. All of these
Answer:
d. All of these
Q: Which of the following is not an example of Protected Health Information (PHI)?
a. Medical records
b. Payment history
c. Library card
Answer:
c. Library card
Q: Which option is the preferred method to submit enrollment?
a. Centene Workbench Upload
b. Ascend Web/Mobile Application
c. Fax/Paper
Answer:
b. Ascend Web/Mobile Application
Q: With which types of inquiries can Wellcare’s Corporate Sales Support team assist?
a. Application and Enrollment
b. Onboarding and Certifications
c. Commissions
d. All of these
Answer:
d. All of these
Q: 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:
a. Appeal
b. Grievance
Answer:
a. Appeal
Q: The Prescription Drug Plan (PDP) network is expected to include over __ total
pharmacies.
a. Sixty Thousand
b. Thirty Thousand
c. Twenty Thousand
Answer:
a. Sixty Thousand
WellCare ACT Mastery Exam (Latest 2023/
2024 Update) Version 4 | Questions and
Verified Answers| Grade A| 100% Correct
Q: Any request or distribution of PHI should contain only the minimum amount of PHI
required to complete the intended task.
Answer:
True
Q: 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
Q: Agents may be investigated after being suspected of noncompliant activity reported through
a: (Select all that apply.)
Answer:
Complaint Tracking Module (CTM),Grievance, and Secret Shop Finding
Q: Centene continues to expand its reach by offering more products in a wider geography. __
new Wellcare and Ascension Complete plans are going to market.
Answer:
Forty-eight
Q: There are _ LIS copay categories that could be assigned to a member, depending on the level of need. Answer: Four Q: Which standalone Prescription Drug Plan is best for a dual-eligible chooser? Answer: Classic Q: Centene has new PPO D-SNP product expansion in CT, IN, KS, KY, MS, OH, OK, PA, SC, and a new HMO D-SNP in LA. Answer: True Q: Centene’s 2023 product expansion represents a % increase from 2022.
Answer:
3
Q: For 2023, Ascension Complete added 27 new counties to their footprint.
Answer:
True
Q: The _ plan is expected to have one of the lowest premiums in the country!
WellCare ACT Mastery Exam (Latest 2023/
2024 Update) Version 3 | Questions and
Verified Answers| Grade A| 100% Correct
Q: When explaining the provider network for D-SNPs and C-SNPs:
Answer:
Avoid submitting applications with no primary care provider (PCP) to assist these higher-risk
members.
If a member is not connected to a primary care provider (PCP), we should always encourage and
assist with connecting them with an in-network doctor
Q: If a requested effective date is available for the special election period being selected, ensure
you are requesting a date within the correct time frame for the member based on their eligibility
date or change date needed.
Answer:
True
Q: Wellcare’s _ plan is designed for Low-Income Subsidy members.
Answer:
Classic
Q: Which LIS category is assigned to members whose costs are fully subsidized and who
receive the most assistance?
Answer:
Three
Q: The _ plan is expected to have one of the lowest premiums in the country!
Answer:
Value Script
Q: The Wellcare preferred pharmacy network includes Walgreens, CVS, and some grocery
chains in 2024.
Answer:
True
Q: Wellcare continues to expand its reach by offering more products in a wider geography.
_ new Wellcare plans are going to market. Answer: Twenty-three Q: 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
Q: Which of the Prescription Drug Plan (PDP) products is new to the 6-tier formulary structure
for 2024?
Answer:
Classic
WellCare ACT Mastery Exam (Latest 2023/
2024 Update) Version 5 | Questions and
Verified Answers| Grade A| 100% Correct
Q: Which of the following actions are you required to do when contacted regarding an
allegation of noncompliant activity?
Answer:
All of these
Q: Dual-eligible and LIS beneficiaries that are not at-risk may use a Dual-Eligible SEP once
per each of the __ calendar quarters only.
(Select all that apply.)
Answer:
a. First
b. Second
c. Third
Q: An agent who has never had any verbal warnings cannot be issued a Corrective Action Plan.
Answer:
F
Q: When explaining the provider network for D-SNPs and C-SNPs:
(Select all that apply.)
Answer:
a.
Avoid submitting applications with no primary care provider (PCP) to assist these higher-risk
members.
b.
If a member is not connected to a primary care provider (PCP), we should always encourage and
assist with connecting them with an in-network doctor.
Q: 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:
T
Q: 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.
Answer:
60
Q: When enrolling a D-SNP beneficiary, be sure to verify plan enrollment eligibility and that
the Medicare Savings Program (MSP) level is eligible for the requested plan.
Answer:
T
Q: Key areas you as an agent have control over and impact upon regarding Star Ratings for
quality are:
Answer:
All of these
Q: Lead-generating activities (either directly or indirectly) facilitated by a third-party marketing
organization (TPMO) need to include a notice to the beneficiary that their information may be
shared with a licensed agent for future contact.