Page 11 - Cover Letter and Evaluation for Russell Wild
P. 11
Client Data Sheet
Client ID: 114182 October 28, 2020
Please verify the accuracy of the information below and let us know if changes need to
be made.
Client's DOB: 12/25/55
Date that Medicare became or will become primary (when
client has both Part A & Part B): 12/01/20
Client's home zip code: 19119
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 prefers Medigap policies + stand-alone drug plans
Prescription Drugs Client's pharmacy: CVS, etc.
Refill Schedule: Monthly
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