Healthcare when you work for yourself in Charleston

A practical membership for everyday care

SakeOf gives members a way to organize everyday healthcare around useful services and their choice of provider. Depending on the features selected and active, that can mean getting timely advice for an urgent concern, finding a medication through an acute formulary, building a virtual primary-care relationship, or asking for help when a bill is difficult to understand.

The next step is straightforward: use the calculator and Savings Guide to compare membership options with the care you expect to use. Then use provider search for an in-person provider or ask Jordan which membership features fit the questions you have. SakeOf combines direct services with advocacy and a program for larger eligible medical events, so members can plan for both routine needs and more involved situations.

Get timely advice for urgent, non-emergency needs

When Zero Copay Telemedicine is selected and active, members can access urgent-care consultations 24/7 through the current service partner. The partner describes unlimited medically appropriate consultations with board-certified physicians licensed for the member’s state. A clinician can help assess a concern and advise whether in-person care is appropriate. For a possible emergency, seek emergency care.

Rx and Prescription Benefits can complement that care. When selected and active and program requirements are met, approximately 70 commonly prescribed acute medications on the current formulary may be available at $0 through the participating-pharmacy process. Check the current formulary and pharmacy tool for the specific medication before filling it. A medication outside the formulary is not automatically $0; separate active programs are needed for medications outside the acute benefit when they are to be included.

Build a continuing care routine

Virtual Primary Care offers a dedicated physician relationship, an annual virtual wellness visit, health-risk assessment and stratification, and chronic-care follow-up and medication-management support when clinically appropriate for virtual care. It provides a continuing virtual option for routine care and follow-up. The feature requires Rx and Prescription Benefits, Zero Copay Telemedicine, and Mental Health and Counseling to remain active.

Mental Health and Counseling provides 24/7 telephonic counseling access for members and eligible enrolled dependents when the feature and its required companion features are active. Included telephonic counseling has a $0 member cost; up to three face-to-face counseling consultations per incident may be arranged when available. Counseling access is a useful way to seek support, while psychiatry, inpatient behavioral health, and medication costs are separate unless another active program expressly includes them.

Choose local care for in-person services

For a visit that calls for an exam, lab, or imaging, Charleston-area members can choose an in-person provider. Southern West Virginia Health System lists a Sand Plant Road site in Kanawha County with family medicine, pediatric care, walk-in and same-day care, laboratory, and X-ray services. Alum Creek Pharmacy is listed at the site, including a drive-through. Contact the provider to confirm the service, current hours, availability, and payment arrangements before traveling.

The Kanawha-Charleston Health Department is a public-health resource at 108 Lee Street E, Charleston, WV 25301, and the state lists its phone as 304-344-5243. Call to confirm hours and whether it provides the service you need. Charleston also has CAMC hospital and outpatient locations, including facilities in or near 25301. For a hospital service, ask for a service-specific estimate and confirm which facility and professional charges it includes. CAMC’s posted standard charges and estimates may not represent a patient’s final out-of-pocket cost and may exclude separately billed provider services.^www.cms.gov

When contacting any provider, ask what the visit or service includes, whether an appointment is needed, and how payment is handled. For lab, imaging, or hospital care, clarify whether separate professional or facility charges may apply. These questions help you compare the service you need with the estimate you receive.

Get help making sense of a bill

If a bill is confusing or seems out of line with the service, SakeOf Full Service can help members with bill verification, fair-price review, and negotiation support. Gather the itemized bill, any estimate, and the provider’s explanation of what was performed. You can ask the provider about unclear entries and whether separate charges are still pending, then ask SakeOf about advocacy support.

CAMC lists Patient Financial Services at 304-388-7530 for estimate questions. Request an estimate for the specific service and ask which facility and professional charges it includes. SakeOf advocacy is subject to the applicable member commitment and program rules; it provides support for review and negotiation without promising a particular price or result.

Plan for larger needs and choose a next step

For larger eligible medical events, the program guide explains how the applicable member commitment works and how voluntary community funding may support eligible expenses. If you are planning care, ask SakeOf to help you understand the process and gather provider estimates and billing details early. Eligibility and support depend on the program’s rules and review.

Other optional features can address different household priorities: Maternity Care, dental and vision discounts, chiropractic and acupuncture, physical and occupational therapy, and durable medical equipment. Each feature has its own monthly adjustment and applies when selected and active under its terms. Use the calculator and Savings Guide to compare options, use provider search to explore care, or ask Jordan for help deciding what to review next.

For West Virginia Medicaid and WVCHIP, WV PATH supports screening and applications. The West Virginia Bureau for Medical Services also publishes Medicaid member resources, including information about managed care, transportation, and renewals.^bms.wv.gov