Page 13 - Cover Letter and Medicare Evaluation for Heidi Bathon
P. 13
Client Data Sheet
Client ID: 771287 Rx Password Date: November 3, 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: NA
Date that Medicare became or will become primary (when client
has both Part A & Part B): Already has both
Client's home zip code: 21230
Has client started receiving Social Security or SSDI payments? NA
After client retires, will he or she have access to health insurance
through a spouse's or ex-spouse's employer plan? NA
Client's Selection Criteria
Does the Medicare
web site indicate that
Continue to see following physicians: this doctor accepts
assignment?
Physicians from Johns
Hopkins Medicine
Client has guaranteed right to buy a Medigap policy
Prescription Drugs
Current refill schedule: Mail order
Pharmacy: CVS
5
