Updated Well care Certifications 2026
QUESTION AND ANSWER GRADED A+
100% VERIFIED With Rationale
____ are designed to inform the people that attend about Medicare Advantage, Prescription Drug, or
other Medicare programs without going into the specifics of a particular carrier.
C. Educational Events
At ____, brokers/agents offer plan information upon request only while at a table, booth, kiosk, or RV.
B. Informal Sales Events
11. A valid exception to the 48-hour rule for Scope of Appointments (SOA) is if a beneficiary initiates an
unscheduled in-person meeting or places an inbound call.
True
An Election Period Request for Information (RFI) must be resolved within ___ calendar days, or the
application will be denied.
A. 7 calendar days
___ have the Integrated Care Dual Eligible Special Needs Plan (D-SNP) Special Election Period (SEP)
available to them.
A. Full-benefit dual eligible
, 15. Failing to select a Special Election Period (SEP) or selecting the incorrect SEP will create a Request for
Information (RFI) or result in a denied application.
True
A request to the plan from a member or provider for a formal review of an Action (Denial) or Adverse
Plan Determination (Medicare) is ___.
B. An Appeal
All Medicare grievances will be resolved within ___ days from the date the plan is made aware of the
issue.
A. 30
The Medicare Prescription Payment Plan, while not a cost savings program, is a payment option that
could help manage out-of-pocket Part D costs by allowing members who opt-in to spread prescription
expenses across monthly payments.
True
Special Supplemental Benefits for the Chronically Ill (SSBCI) may be available for members on select Dual
Eligible Special Needs Plans (D-SNPs) who have:
D. All of these are required:
Certain chronic conditions
Need intensive care management
Are at high risk for hospitalization
Exclusively aligned enrollment occurs when state policy limits enrollment in a D-SNP to only ___
individuals who receive coverage of Medicaid benefits through the D-SNP and a Medicaid managed care
plan owned and operated by the same parent company as the D-SNP.v
QUESTION AND ANSWER GRADED A+
100% VERIFIED With Rationale
____ are designed to inform the people that attend about Medicare Advantage, Prescription Drug, or
other Medicare programs without going into the specifics of a particular carrier.
C. Educational Events
At ____, brokers/agents offer plan information upon request only while at a table, booth, kiosk, or RV.
B. Informal Sales Events
11. A valid exception to the 48-hour rule for Scope of Appointments (SOA) is if a beneficiary initiates an
unscheduled in-person meeting or places an inbound call.
True
An Election Period Request for Information (RFI) must be resolved within ___ calendar days, or the
application will be denied.
A. 7 calendar days
___ have the Integrated Care Dual Eligible Special Needs Plan (D-SNP) Special Election Period (SEP)
available to them.
A. Full-benefit dual eligible
, 15. Failing to select a Special Election Period (SEP) or selecting the incorrect SEP will create a Request for
Information (RFI) or result in a denied application.
True
A request to the plan from a member or provider for a formal review of an Action (Denial) or Adverse
Plan Determination (Medicare) is ___.
B. An Appeal
All Medicare grievances will be resolved within ___ days from the date the plan is made aware of the
issue.
A. 30
The Medicare Prescription Payment Plan, while not a cost savings program, is a payment option that
could help manage out-of-pocket Part D costs by allowing members who opt-in to spread prescription
expenses across monthly payments.
True
Special Supplemental Benefits for the Chronically Ill (SSBCI) may be available for members on select Dual
Eligible Special Needs Plans (D-SNPs) who have:
D. All of these are required:
Certain chronic conditions
Need intensive care management
Are at high risk for hospitalization
Exclusively aligned enrollment occurs when state policy limits enrollment in a D-SNP to only ___
individuals who receive coverage of Medicaid benefits through the D-SNP and a Medicaid managed care
plan owned and operated by the same parent company as the D-SNP.v
