Page 13 - Cover Letter and Evaluation for Judy Thomas
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Client Data Sheet
Client ID: 8481059424 Rx Password Date: October 16, 2018
Please verify the accuracy of the information below and let us know if
To the Client:
changes need to be made.
Client's DOB: 04/12/43
Date that Medicare became or will become primary (when
client has both Part A & Part B): Already enrolled
Client's home zip code: 80121
Has client started receiving Social Security or SSDI Yes
payments?
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
Continue to see following physicians: that this doctor
accepts assignment?
Dr. Brian Bishop Internal medicine Yes
Dr. William Sauer Cardiology Yes
Dr. Stephen Ruyle Urology Yes
Dr. Susan Loeb-Zeitlin Ob/Gyn Yes
Unable to find in
Dr. Kirsten Healy Cardiology Medicare provider
directory
Client wishes to compare PERA Retiree Plans with Medigap policies
Prescription Drugs
Refill schedule: Mail Order & monthly
Pharmacy: King Soopers
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