Page 15 - Cover Letter and Medicare Evaluation for Rod Morgan
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Client Data Sheet
Client ID: 6302122 Rx Password Date: November 5, 2021
Please verify the accuracy of the information below and let us know if
To the Client:
changes need to be made.
Client's DOB: 02/15/57
Date that Medicare became or will become primary (when client
has both Part A & Part B): 02/01/22
Client's home zip code: 80433
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? ?
Client's Selection Criteria
Continue to see following physicians:
Dr. Michael Dunn General practice
Client would like to see comparisons of both types of coverage but does not wish to
enroll in an Advantage HMO plan
Prescription Drugs
Current refill schedule: Monthly
Pharmacy: Safewau
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