Page 13 - Cover Letter and Evaluation for Amy Prack
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Client Data Sheet
Client ID: 3233662560 May 14, 2019
Please verify the accuracy of the information below and let us know if changes need to
be made.
Client's DOB: 12/21/56
Date that Medicare became or will become primary (when Part B to start on
client has both Part A & Part B): 9/1/19
Client's home zip code: 43221
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. Steven Huff Family Practice Yes
Dr. Steven Katz Opthalmology Yes
Client wishes to compare both types of supplemental coverage
Prescription Drugs
Pharmacy Giant Eagle
Refill schedule Monthly
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