WELLCARE ACT MASTERY
CERTIFICATION FINAL EXAM STUDY
GUIDE 2026 | COMPLETE QUESTIONS |
VERIFIED ANSWERS | GRADED A + | PASS
GUARANTEED | RECENT EDITION
Which option is the preferred method to submit enrollment? -
ANSWER Ascend Web/Mobile Application
When discussing prescription drug coverage, you should: - ANSWER Explain
how to use the formulary to look up limitations and exclusions (e.g., step therapy,
quantity limits).
Confirm coverage of the beneficiary's current and/or anticipated prescriptions.
Explain formulary tiers as well as drug copayment amounts.
For drugs that are not covered by the new plan, explain the Transition Fill program
and how to request a coverage exception.
Which is an example of a top beneficiary complaint that affects Star Ratings? -
ANSWER The beneficiary did not understand that enrolling in a WellCare plan
would change their current Medicare Advantage plan.
, Members who fail to pay the required premiums before the end of the grace period
(Well-care has a three-month grace period) will be terminated. - ANSWER True
A grievance request, or any evidence concerning a grievance, must be fi led 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
You can help prevent grievances by: - ANSWER Always confirming
availability of the beneficiary's primary and specialist providers by using the
provider search tool available on the plan's website.
Always use plan materials to clearly explain plan benefits and cost (including
medications) and check for understanding.
Always confirm a beneficiary's intent to enroll before accepting their enrollment
application.
A broker/agent may be terminated for cause if they fail to comply with a
compliance investigation, encourage others to avoid the compliance interview
process, or fail to provide truthful or complete information. - ANSWER True
Well-care expanded our county footprint in _____ states for 2024. -
ANSWER Five
All Prescription Drug Plans (PDPs) will continue to offer $0 Tier 1 preferred cost-
sharing through Express Scripts Pharmacy (Mail Order). - ANSWER True
,With the Pharmacy Benefit Manager (PBM) migration to Express Scripts effective
1/1/2024, existing members can continue to use their current ID card 1/1/2024 and
beyond. - ANSWER False
For Prescription Drug Plan (PDP) Medication Home Delivery, the ____ plan will
continue to off er a discount (2.5 x 30-day preferred retail copay) for Tier 2, 3, and
6 prescriptions. - ANSWER Value Plus
Which is the Prescription Drug Plan (PDP) Preferred Mail Order network for
2024? - ANSWER Express Scripts Pharmacy
The beneficiary (or their authorized representative) must indicate the product
types to be discussed during the appointment on the Scope of Appointment (SOA).
- ANSWER True
Prior to the beginning of the enrollment process, a broker/agent is required to
cover certain beneficiary-specific information, including but not limited to: -
ANSWER All of these
The Single Sign-On Portal provides access to several applications, including
Custom Point - ANSWER True
An SEP is a period outside of the ICEP, AEP, or MA OEP when beneficiaries can
enroll based solely on life events that qualify for an SEP period. -
ANSWER True
, The Mastery Exam will lock for a period of 48 hours after each failed attempt. -
ANSWER False
When an enrollment application is completed in Ascend, brokers/agents can
complete a Health Risk Assessment (HRA) directly in Ascend after the enrollment
application, through the Value-Based Enrollment (VBE) portal. -
ANSWER True
Brokers/Agents MUST complete a Well-care Contract Recertification case in
Centene Workbench (CWB) every two years. - ANSWER False
Brokers/Agents can submit a support ticket online through their Centene
Workbench portal. - ANSWER True
Well-care added which state to its footprint for 2024? - ANSWER Delaware
What are some examples of steps that can be taken when safeguarding and
securing PHI and PII?
(Select all that apply.) - ANSWER Shred documents that contain PHI or PII
using appropriate means.
Never leave laptops, PHI, or PII in an unattended vehicle.
Do not include PHI or PII in the subject line or body of an email.
Secure emails that contain PHI or PII.
CERTIFICATION FINAL EXAM STUDY
GUIDE 2026 | COMPLETE QUESTIONS |
VERIFIED ANSWERS | GRADED A + | PASS
GUARANTEED | RECENT EDITION
Which option is the preferred method to submit enrollment? -
ANSWER Ascend Web/Mobile Application
When discussing prescription drug coverage, you should: - ANSWER Explain
how to use the formulary to look up limitations and exclusions (e.g., step therapy,
quantity limits).
Confirm coverage of the beneficiary's current and/or anticipated prescriptions.
Explain formulary tiers as well as drug copayment amounts.
For drugs that are not covered by the new plan, explain the Transition Fill program
and how to request a coverage exception.
Which is an example of a top beneficiary complaint that affects Star Ratings? -
ANSWER The beneficiary did not understand that enrolling in a WellCare plan
would change their current Medicare Advantage plan.
, Members who fail to pay the required premiums before the end of the grace period
(Well-care has a three-month grace period) will be terminated. - ANSWER True
A grievance request, or any evidence concerning a grievance, must be fi led 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
You can help prevent grievances by: - ANSWER Always confirming
availability of the beneficiary's primary and specialist providers by using the
provider search tool available on the plan's website.
Always use plan materials to clearly explain plan benefits and cost (including
medications) and check for understanding.
Always confirm a beneficiary's intent to enroll before accepting their enrollment
application.
A broker/agent may be terminated for cause if they fail to comply with a
compliance investigation, encourage others to avoid the compliance interview
process, or fail to provide truthful or complete information. - ANSWER True
Well-care expanded our county footprint in _____ states for 2024. -
ANSWER Five
All Prescription Drug Plans (PDPs) will continue to offer $0 Tier 1 preferred cost-
sharing through Express Scripts Pharmacy (Mail Order). - ANSWER True
,With the Pharmacy Benefit Manager (PBM) migration to Express Scripts effective
1/1/2024, existing members can continue to use their current ID card 1/1/2024 and
beyond. - ANSWER False
For Prescription Drug Plan (PDP) Medication Home Delivery, the ____ plan will
continue to off er a discount (2.5 x 30-day preferred retail copay) for Tier 2, 3, and
6 prescriptions. - ANSWER Value Plus
Which is the Prescription Drug Plan (PDP) Preferred Mail Order network for
2024? - ANSWER Express Scripts Pharmacy
The beneficiary (or their authorized representative) must indicate the product
types to be discussed during the appointment on the Scope of Appointment (SOA).
- ANSWER True
Prior to the beginning of the enrollment process, a broker/agent is required to
cover certain beneficiary-specific information, including but not limited to: -
ANSWER All of these
The Single Sign-On Portal provides access to several applications, including
Custom Point - ANSWER True
An SEP is a period outside of the ICEP, AEP, or MA OEP when beneficiaries can
enroll based solely on life events that qualify for an SEP period. -
ANSWER True
, The Mastery Exam will lock for a period of 48 hours after each failed attempt. -
ANSWER False
When an enrollment application is completed in Ascend, brokers/agents can
complete a Health Risk Assessment (HRA) directly in Ascend after the enrollment
application, through the Value-Based Enrollment (VBE) portal. -
ANSWER True
Brokers/Agents MUST complete a Well-care Contract Recertification case in
Centene Workbench (CWB) every two years. - ANSWER False
Brokers/Agents can submit a support ticket online through their Centene
Workbench portal. - ANSWER True
Well-care added which state to its footprint for 2024? - ANSWER Delaware
What are some examples of steps that can be taken when safeguarding and
securing PHI and PII?
(Select all that apply.) - ANSWER Shred documents that contain PHI or PII
using appropriate means.
Never leave laptops, PHI, or PII in an unattended vehicle.
Do not include PHI or PII in the subject line or body of an email.
Secure emails that contain PHI or PII.
