Page 13 - Cover letter and evaluation for Marcelle Nesci
P. 13
Client Data Sheet
Client ID: 1216293888 January 11. 2019
Please verify the accuracy of the information below
Client's DOB: 08/15/52
Date that Medicare became or will become primary (when
client has both Part A & Part B): 03/01/19
Client's home zip code: 10566
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's Selection Criteria Does the Medicare
web site indicate that
this doctor accepts
Continue to see following physicians:
Medicare-approved
rates?
Dr. Michael Bergstein Otolaryngology Yes
Dr. Yan Ling Gao Neurology Yes
Gail Maltman Nurse practitioner Yes
Dr. Arthur Pidoriano Jr. Orthopedic surgery Yes
Dr. James Trapasso Internal medicine Yes
Client wishes to compare both types of supplemental coverage
Prescription Drugs
Pharmacy CVS
Refill schedule Monthly as well as mail-order
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