Page 11 - Cover Letter and Evaluation for Janet Tuma
P. 11
Client Data Sheet
Client ID: 11419224 February 24,2021
Please verify the accuracy of the information below and let us know if changes need to
be made.
Client's DOB: 08/10/56
Date that Medicare became or will become primary (when
client has both Part A & Part B): 08/01/21
Client's home zip code: 60449
Has client started receiving Social Security or SSDI payments? Yes
After client retires, will he or she have access to health
insurance through a spouse's or ex-spouse's employer plan? No
Client wants to enroll in an Advantage plan
Prescription Drugs Client's pharmacy: Osco Drug
Refill Schedule: Mail-order
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