Page 11 - Cover Letter and Evaluation for Dr. Maury Rosenstein
P. 11
Client Data Sheet
Client ID: 88100433 December 17, 2018
Please verify the accuracy of the information below and let us know if changes need to
be made.
Client's DOB: 07/11/53
Date that Medicare became or will become primary (when
client has both Part A & Part B): 12/01/18
Client's home zip code: 25306
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's Selection Criteria
Does the Medicare
web site indicate that
Continue to see following physicians: this doctor accepts
assignment?
Dr. Kishore Challa Cardiologist Yes
Dr. Anton Plakseychuk Orthopedic surgeon Yes
Client is interested only in Medigap policies
Prescription Drugs
Client's drug coverage is through his employer plan
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