Page 17 - Cover Letter and Evaluation for Raquelle Myers
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Client Data Sheet
Client ID: 61798333b June 17, 2020
Please verify the accuracy of the information below and let us know if changes need to
be made.
Client's DOB: 08/08/55
Date that Medicare became or will become primary (when
client has both Part A & Part B): 08/01/20
Client's home zip code: 98333
Has client started receiving Social Security or SSDI payments? No
After client retires, will he or she have access to health
insurance through a spouse's or ex-spouse's employer plan? No
Client prefers to have a Medigap policy + stand-alone drug
plan for supplemental medical coverage
Prescription Drugs Client's pharmacy: Olympic Pharmacy
Refill Schedule: Monthly
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