You have
MEDICARE HOMEWORK
to do...
Filling out this form will help us be more prepared for you &
also shorten your Medicare Appointment by 15-30 minutes !
Also, take the time to read the whole page...
Do we need to sign you up for Medicare? You'll need a SS account, read below
Pre-Appointment Intake Form
Where to go
7030 Poe Ave.
Dayton, Ohio 45414
Look for our Office
on Poe Ave.
(we share the same entrance as Ziebart, across the I-75 from Miller Lane.)
You can see us from I-75 on the East side
(we have a 45 foot sign on the
front that says
Medicare Planning of Dayton)
What to Bring
1. A list of Doctors
you need to see.
Don't forget your Eye Dr, Dentist, OB, etc...
(The doctors name & office location)
(If you see a Nurse Practitioner or a Physician Asst.
We will need the name of the doctor they work under or are billed under.)
2. A full list of your Prescriptions
with the actual Name on the bottle, the dosage, & how many per day.
3. IF YOU HAVE IT,
Your Red, White, & Blue Medicare card.
4. Your ssa.gov Login
If we have to sign you up for Medicare you will need this login info. Please make sure you login before your appt and know your password.
If you don't have an account, make one.
(check out instructions below on how to make an account. )
5. Your Work Health Insurance Details
If you have the option on staying on work insurance coverage, we will need to compare your current health insurance vs. Medicare.
(check what details you will need below)
6. Medicare JUNKMAIL
Bring in your Medicare junk mail.
We have a great place for it!
If we need to sign you up for Medicare
(this will save you two hours
at the SS office)
YOU WILL NEED YOUR SS.GOV LOGIN USERNAME AND PASSWORD FOR YOUR MEDICARE APPOINTMENT WITH US
HERE IS HOW TO GET SIGNED UP FOR A FREE SS ACCOUNT
- If you don't have a login for ssa.gov (my social security account) you will need one.
Follow these steps to get an account:
1. Go to ssa.gov
2. Top right corner, click Sign Up
-Left Box, click my Social Security box
-Scroll down and click on Create an Account
- Click Create an Account on the next page with Login.gov
Bring your SOCIAL SECURITY LOGIN INFO to your appointment IF we are going to sign you up for Medicare.
If you are still planning to work after Age 65
** We need to compare your work insurance details and Medicare to see what option is best for you.
YOU WILL NEED 3
THINGS TO COMPARE
1. How much is your Monthly Premium?
(how much is taken out of your paycheck for healthcare? )
2. How much is your Deductible?
3. What is the Max out of Pocket?
For 80% of people on work insurance, Medicare is better and/or cheaper coverage than your
work coverage.
Knowing these 3 items we can truly compare which is best!
If you need to change or cancel your appointment,
we ask you to please call the office ASAP
so we can put someone else needing an appt. in your slot. Thank You!
THE MEDICARE COMPLIANCE STATEMENT
We do not offer every plan in your area.
Please contact Medicare.gov or 1-800-medicare to get information on all your options.
“Plans are insured or covered by a Medicare Advantage (HMO, PPO, PFFS) organizations with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare.”
OUR OFFICIAL COMPANY STATEMENT
We do offer Any Plan and Company in your area. The above statement is what we have to put on our website to be Medicare Compliant. Yes, we think what you are thinking also...
We can help you figure out Medicare so it is Not Confusing and find the best plan for you based upon your personal situation. Your Doctors, Medications, Budget, Travel Habits, and anything else that matters to your personal situation.
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