Page 15 - Cover Letter and Evaluation for Patti Messerschmitt
P. 15
Client Data Sheet
Client ID: 114301b July 22, 2020
Please verify the accuracy of the information below and let us know if changes need to
be made.
Client's DOB: 09/30/55
Date that Medicare became or will become primary (when
client has both Part A & Part B): 09/01/20
Client's home zip code: 92586
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 wants a Medigap policy + stand-alone drug plan for
supplemental medical coverage
Does this doctor
Client's physicians accept Medicare-
approved rates?
Dr. Michael Truong, Endocrinology Yes
Prescription Drugs Client's pharmacy: Costco
Refill Schedule: Monthly
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