2025 Centene Wellcare Medicare Certificification Exam

Question 1

Wellcare added which state to its footprint for 2025?

Kentucky

South Dakota

Idaho

Iowa

Question 2

Wellcare offers Medicare Advantage (MA) products to meet the needs of a variety of beneficiaries. We offer:

$0 or low premium on many plans

$0 fitness benefits on all plans

Preventive care including $0 screenings (in-network)

All of these

Question 3

Starting in 2025, a member may move through THREE benefit stages during the plan year. Which benefit stage will no longer exist?

Deductible

Initial coverage

Coverage gap

Catastrophic

Question 4

For 2025, Wellcare has 43 new plans going to market.

True

False

Question 5

Which Low-Income Subsidy (LIS) category is assigned to members whose costs are fully subsidized and receive the most assistance?

One

Two

Three

Four

Question 6

Which Prescription Drug Plan (PDP) is best for a dual-eligible chooser?

Value Script

Value Plus

Classic

Question 7

A Low-Income Subsidy (LIS) member could be assigned one of ____ copay categories depending on the level of need.

Two

Three

Four

Five

Question 8

The Medicare Prescription Payment Plan is a payment option that helps manage out-of-pocket (OOP) Part B costs by allowing members who opt-in to spread costs throughout the benefit year.

True

False

Question 9

Effective 2026, key provisions of the Inflation Reduction Act include Medicare's ability to negotiate directly with drug manufacturers to lower the price of some of the costliest single-source brand-name Medicare Part B and Part D drugs.

True

False

Question 10

Only members with a standalone Prescription Drug Plan (PDP) are eligible to use the Medicare Prescription Payment Plan option.

True

False

Question 11

The Single Sign-On Portal provides access to multiple applications, including CustomPoint®.

True

False

Question 12

As part of Centene's Ethics and Compliance program, Centene requires all contracted brokers/agents to review and agree to its Business Ethics and Code of Conduct Policy.

True

False

Question 13

Which elements are available as part of Wellcare's sales support model?

Online Self-Service

Local Field Sales

Corporate Office

All of these

Question 14

Disciplinary actions stemming from the result of a compliance allegation are always progressive.

True

False

Question 15

Self-reporting of a compliance issue must be made to Corporate Compliance or to a Health Plan Sales Leader and must indicate:

The date of the incident.

The date of the report.

That it is being self-reported.

All of these

Question 16

Beneficiary-facing marketing materials developed by a Third-Party Marketing Organization (TPMO) for multiple Medicare Advantage (MA) organizations or plans can be reviewed by just one MA organization, submitted to the Centers for Medicare & Medicaid Services (CMS) in the Health Plan Management System (HPMS), and opted in by the health plan after distribution.

True

False

Question 17

Marketing benefits in a service area where those benefits are not available is prohibited and considered misleading unless that is unavoidable because of local/regional or media use.

True

False

Question 18

Names and/or logos of provider co-branding partners can be displayed on marketing materials, as long as the current and approved logos are used.

True

False

Question 19

The Third-Party Marketing Organization (TPMO) disclaimer must be used by any TPMO that sells plans on behalf of more than one Medicare Advantage (MA) plan provider. The disclaimer must be: (Select all that apply.)

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).

Electronically conveyed when communicating with a beneficiary through email, online chat, or other electronic means of communication (regardless of content).

Question 20

Materials that include plan comparisons or cost sharing do not require Centers for Medicare & Medicaid Services (CMS) submission.

True

False

Question 21

When prospective Wellcare members check online for the status of their submitted application, which element is optional?

Confirmation Number

Last Name

Date of Birth

Medicare ID Number

Question 22

Which of the following statements about the Scope of Appointment (SOA) is FALSE?

A signed and completed SOA is required to be submitted for all agent-assisted enrollments.

You may not discuss any products not agreed to in advance by the beneficiary.

An electronic SOA submitted in Ascend in a Pending status is considered complete and compliant.

SOAs are required for all personal and individual sales appointments, regardless of the venue or client relationship (e.g., in-home, conference call, library, walk-in to a broker/agent office).

Question 23

Best practices to keep in mind for Dual Eligible Special Needs Plan (D-SNP) and Chronic Condition Special Needs Plan (C-SNP) enrollments include the following: (Select all that apply.)

If a member is not connected to a primary care provider (PCP), always encourage and assist with connecting them to an in-network doctor.

Avoid submitting applications with no PCP to assist these higher-risk members.

Select a PCP that accepts new patients only, even when the enrollee says they have never seen the PCP before.

None

Question 24

Members have several options to pay plan premiums. The best option to ensure regular and timely payments are:

Social Security Administration (SSA)/Railroad Retirement Board (RRB) premium withhold

Electronic Funds Transfer (EFT)

AutoPay

All of these

Question 25

To ensure that credit is received for submitted applications, be sure to always use your _____ on enrollment applications.

National Producer Number (NPN)

Date of Birth

Social Security Number

Driver's License Number

Question 26

When completing enrollments, be sure to collect the member's ____ and ____ to help ensure they receive important resources throughout and beyond their onboarding journey.

Email address

Mobile phone number

Social media username

Fax number

Question 27

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.

30

45

60

90

Question 28

The Pre-Enrollment Checklist (PECL) should be provided and reviewed with your client after enrollment to ensure the enrollee understands important plan benefits and rules.

True

False

Question 29

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.

True

False

Question 30

Any request or distribution of PHI should contain only the minimum amount of PHI required to complete the intended task.

True

False

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2025 Centene Wellcare Medicare Certificification Exam

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