Wellcare ACTUAL QUESTIONS AND
CORRECT ANSWERS
Which is an example of a top beneficiary complaint that affects Star Ratings? - Correct
answers✔The beneficiary did not understand that enrolling in a Wellcare plan would change their
current Medicare Advantage plan
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. - Correct answers✔True
All three Prescription Drug Plans (PDPs) will offer a five-tier formulary design. - Correct
answers✔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? - Correct answers✔NOT - Serving Government Customers
Once the enrollment is completed, you can save a copy of the application for your reference. -
Correct answers✔False
The Mastery Exam will lock for a period of 48 hours after each failed attempt. - Correct
answers✔False
The TPMO disclaimer must be used by any TPMO that sells plans on behalf of more than one
MA plan provider. The disclaimer must be:
(Select all that apply.) - Correct answers✔All
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: - Correct answers✔Appeal
Which of the following statements about Scope of Appointment (SOA) is FALSE - Correct
answers✔An electronic SOA submitted in Ascend must be in a Pending status prior to beginning
the appointment
Wellcare added which state to its footprint for 2024? - Correct answers✔Delaware
The Prescription Drug Plan (PDP) network is expected to include over ____ total pharmacies -
Correct answers✔60,000
Members are no longer required to pay a partial deductible due to the Inflation Reduction Act -
Correct answers✔False
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 - Correct answers✔True
The Pharmacy Benefit Manager (PBM) migration to Express Scripts effective 1/1/2024 will
impact which plan(s)? - Correct answers✔Both
Wellcare has new All-Dual D-SNP products in AL, AR, FL, GA, KY, LA, MI, MS, NC, NM,
OH, OK, TX, and WI. - Correct answers✔True
Members who have LIS and enroll in other plans will have a premium to pay regardless of the
level of LIS the member is granted - Correct answers✔False
CORRECT ANSWERS
Which is an example of a top beneficiary complaint that affects Star Ratings? - Correct
answers✔The beneficiary did not understand that enrolling in a Wellcare plan would change their
current Medicare Advantage plan
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. - Correct answers✔True
All three Prescription Drug Plans (PDPs) will offer a five-tier formulary design. - Correct
answers✔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? - Correct answers✔NOT - Serving Government Customers
Once the enrollment is completed, you can save a copy of the application for your reference. -
Correct answers✔False
The Mastery Exam will lock for a period of 48 hours after each failed attempt. - Correct
answers✔False
The TPMO disclaimer must be used by any TPMO that sells plans on behalf of more than one
MA plan provider. The disclaimer must be:
(Select all that apply.) - Correct answers✔All
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: - Correct answers✔Appeal
Which of the following statements about Scope of Appointment (SOA) is FALSE - Correct
answers✔An electronic SOA submitted in Ascend must be in a Pending status prior to beginning
the appointment
Wellcare added which state to its footprint for 2024? - Correct answers✔Delaware
The Prescription Drug Plan (PDP) network is expected to include over ____ total pharmacies -
Correct answers✔60,000
Members are no longer required to pay a partial deductible due to the Inflation Reduction Act -
Correct answers✔False
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 - Correct answers✔True
The Pharmacy Benefit Manager (PBM) migration to Express Scripts effective 1/1/2024 will
impact which plan(s)? - Correct answers✔Both
Wellcare has new All-Dual D-SNP products in AL, AR, FL, GA, KY, LA, MI, MS, NC, NM,
OH, OK, TX, and WI. - Correct answers✔True
Members who have LIS and enroll in other plans will have a premium to pay regardless of the
level of LIS the member is granted - Correct answers✔False
