INSURANCE INFORMATION

Insurance plans have become more and more complicated and certainly more difficult to fully comprehend. With PPO's, EPO's, and HMO's, understanding exactly what you are covered for can get quite confusing.
It is important to familiarize yourself with your individual coverage by contacting your insurance company and by asking questions

• Use the forms we have provided to fill in the details of your specific plan so that you may have this essential information readily on hand when you need it

Tips:
Make sure to have the enclosed forms in front of you when you are on the phone with your insurance company! Ø Keep a photocopy of your insurance card (front and back) in this section!

• Use the pockets to hold copies of prescriptions, bills, etc.
• Remember…….the more you know, the better prepared you are!

INSURANCE FILL IN FORM
MEDICAL INSURANCE INFORMATION

​Medication Regimen

• The following medication chart is included in order to help you organize your personal medication regimen.
• he different columns allow you to plug in important information, such as the start date, name, and purpose of every prescribed medication.
• Space is also provided for you to fill in the name of the prescribing doctor, as a patient may be under the care of more than one doctor (i.e. surgeon & oncologist) at the same time.
• Filling in the required dose and times of the day to take the medication is helpful as with one glance your doctors' instructions will be clear to you.....no thinking, no checking each individual pill bottle.

Tips:

• Reviewing the medication-related questions included in this section will help you prepare to inquire about your particular medication regimen!

MEDICATIONS CHART(PDF)
MEDICATION QUESTIONS TO ASK YOUR DOCTOR(PDF)
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