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A comprehensive set of questions and answers for wellcare agents preparing for the mastery test exam. It covers key areas related to wellcare's products, services, and policies, including prescription drug plans, enrollment procedures, and compliance guidelines. Designed to help agents achieve a passing score of 85% or higher on the exam.
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The plan is expected to have one of the lowest premiums in the country! - ✔✔✔ Correct Answer > Value Script Key areas you as an agent have control over and impact upon regarding Star Ratings for quality are: - ✔✔✔ Correct Answer > All of these The Prescription Drug Plan (PDP) network is expected to include over total pharmacies. - ✔✔✔ Correct Answer > Sixty Thousand CVS Caremark Mail Order will be in-network for 2024. - ✔✔✔ Correct Answer > False At the end of this course, there will be a Mastery Exam. Agents must achieve a passing score of 85% or higher to successfully complete this course. - ✔✔✔ Correct Answer > True
Which Prescription Drug Plan (PDP) product has the richest formulary with the most adherence generics on Tier 1? - ✔✔✔ Correct Answer
Value Plus Wellcare's 2024 product expansion represents a % increase from
Both PDP & MAPD 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. - ✔✔✔ Correct Answer > Value Plus Wellcare expanded our county footprint in states for 2024 - ✔✔✔ Correct Answer > Five
Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing. - ✔✔✔ Correct Answer
True When completing an application, you should ensure that you enter the provider ID of a specialist and not a primary care provider (PCP). - ✔✔✔ Correct Answer > False Agents may be investigated after being suspected of noncompliant activity reported through a: - ✔✔✔ Correct Answer > Complaint
Tracking Module (CTM), Grievance, and Secret Shop Finding Which of the following statements about completing telephonic enrollments is FALSE? - ✔✔✔ Correct Answer > Must include most of the required elements necessary to complete the enrollment. 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. - ✔✔✔ Correct Answer > True When completing an enrollment, be sure to use the correct enrollment application for the desired plan year. - ✔✔✔ Correct 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. - ✔✔✔ Correct Answer > True Members who fail to pay the required premiums before the end of the grace period (Wellcare has a three-month grace period) will be terminated. - ✔✔✔ Correct Answer > True 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. - ✔✔✔ Correct Answer > 60 What are some examples of steps that can be taken when safeguarding and securing PHI and PII? - ✔✔✔ Correct 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. When explaining the provider network for D-SNPs and C-SNPs: - ✔✔✔ Correct 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.
understand that enrolling in a Wellcare plan would change their current Medicare Advantage plan. Providers may create co-branded marketing pieces using the Wellcare name and logo, as long as they are using the current, approved logo. - ✔✔✔ Correct Answer > 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 Answer > Included in any marketing materials, including print materials and television advertisements developed, used, or distributed by the TPMO. Verbally conveyed within the first minute of a sales call. Prominently displayed on TPMO websites (regardless of content). Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part D plan premiums. - ✔✔✔ Correct Answer > False