Page 13 - Cover Letter and Evaluation for Mary Beth Parsons
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Client Data Sheet
Client ID: 7710023360 Rx Password Date: March 9, 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: 01/06/56
Earliest date that Medicare will become primary (when client has
both Part A & Part B): 01/01/21
Client's home zip code: 77802
Has client started receiving Social Security or SSDI payments? No
After client retires, will he or she have access to health insurance
etwork and $10,000 in-a
through a spouse's or ex-spouse's employer plan?
Client's Selection Criteria
Does the Medicare
web site indicate that
Continue to see following physicians: this doctor accepts
assignment?
Dr. Elizabeth Berigan Internal Medicine Yes
Dr. George Hutton Neurology Yes
Dr. Terry Perkins Ophthalmology Yes
Client wishes to evaluate Medigap coverage as well as Medicare Advantage plans
Prescription Drugs
Current refill schedule: Mail order
Pharmacy: CVS Pharmacy
