Healthcare after employer coverage ends in Comfort

Start with the care you need

SakeOf is a healthcare membership built around a more direct way to pay for and navigate care. Instead of making every decision start with an insurance process, members can use selected services for everyday needs, choose providers for in-person care, and seek help when medical bills are difficult to understand.

A practical first step is to match the need to the care path: a common, non-emergency illness may be appropriate for telemedicine; ongoing care may call for a primary-care relationship; and an exam, lab, imaging, specialist visit, or hospital service may mean arranging local in-person care. Which SakeOf services apply depends on the options selected, active membership, eligibility, and program rules.

Use everyday-care options when they fit

When Zero Copay Telemedicine is selected and active, the current service partner offers 24/7 telemedicine for medically appropriate, non-emergency concerns, with no program limit on consultation frequency or duration. A clinician can determine whether remote care is appropriate and whether a prescription is clinically appropriate and legally permitted. If you are experiencing an emergency, call 911 or seek emergency care.

Rx and Prescription Benefits, when selected and active and program requirements are met, provide access to an approximately 70-medication acute formulary at $0 through participating pharmacy locations. A medication must be on the formulary and prescribed as required; other medications can have separate costs. The local BMH Comfort Pharmacy may be useful for community pharmacy services, but confirm whether it can fill a particular prescription and what it will cost before relying on it.

Mental Health and Counseling, when selected and active with the required services, offers unlimited telephonic counseling on demand at $0 member cost, including access to master's-level counseling professionals for members and eligible enrolled dependents. Up to three face-to-face counseling consultations per incident may be arranged when available. Virtual Primary Care, when selected and active with its required bundle, adds a dedicated physician relationship, an annual virtual wellness visit, and ongoing follow-up and medication-management support when clinically appropriate for virtual care.

Connect SakeOf care with local providers

For care that needs an in-person exam, lab work, imaging, a specialist, or another local service, choose a provider and ask directly about availability, services, charges, and payment arrangements. SakeOf's everyday virtual services do not make those separate services included; a clinician may recommend in-person follow-up or testing, with costs handled separately.

In Comfort, Boone Memorial Health lists its clinic at 6952 Coal River Road, Suite C, with primary care, preventive care, chronic disease management, sick visits, and treatment for minor illnesses and injuries. Its listing gives weekday hours of 8 a.m.–4 p.m. and walk-in hours of 8 a.m.–3 p.m.; call to confirm current availability. The clinic lists 304-369-1230 for appointments and 304-307-3116 as its clinic phone.

The adjacent BMH Comfort Pharmacy is listed at 6952 Coal River Road, Suite A, with weekday hours of 9 a.m.–5 p.m. It lists prescriptions, medication counseling, synchronization, monitoring, and refill services; call 304-837-3777 to verify hours and prescription availability. Boone Memorial Health also lists a hospital and other locations in the county. Boone Memorial Hospital's emergency department is listed as open 24/7/365; call 911 for emergencies.

For another county option, Southern West Virginia Health System's Madison Medical lists primary care, walk-ins, and a co-located pharmacy; check its location page or call ahead for current availability. The Boone County Health Department says residents can call to schedule a mobile-health visit in their area. Ask each provider what services are available and what charges or payment arrangements apply.

Get help when a bill needs a closer look

When a medical bill is confusing or seems out of line, SakeOf's Full Service advocacy can help members with bill verification, fair-price review, and negotiation support. Keep the itemized bill and relevant provider documents together; itemized bills should show service dates, provider information, and CPT or HCPCS codes when available. SakeOf may request clinical or billing records to review a submission.

Submit complete documents within six months of the service date, and submit a balance bill, denial, or payment demand within 10 days of receiving it. Keep membership current, fund required asks, and pay any applicable member commitment or feature-specific responsibility. These steps give the review team information to assess the bill; an outcome is not guaranteed.

Plan ahead for a larger eligible medical event

For a planned higher-cost service, contact SakeOf in advance when reasonably possible. You can ask about the applicable member commitment and how voluntary community funding may work for a larger eligible event. Eligibility and any funding depend on the Program Guide and review; do not assume an estimate, provider charge, or recommended service will be treated as an eligible event.

For local hospital services, Boone Memorial Health links to price-transparency information and a cost estimator, and lists financial-assistance materials. Ask the hospital whether an estimate applies to the specific services planned and whether it includes professional or other charges. Contact the provider or its business office about actual pricing, payment arrangements, and assistance.

Choose other options for your household

Members can also consider maternity care, dental and vision discounts, chiropractic and acupuncture, physical and occupational therapy, and durable medical equipment options. Each is an optional feature: it applies only when selected, active, eligible, and subject to program rules. The listed monthly adjustments are $18 for maternity care, $9 for dental and vision discounts, $14 for chiropractic and acupuncture, $11 for physical and occupational therapy, and $7 for durable medical equipment.

To compare your next steps, use the SakeOf calculator and Savings Guide, search for providers, or ask Jordan about membership options. For West Virginia program screening and applications, WV PATH includes Medicaid and WVCHIP; state member resources explain Medicaid benefits, transportation, managed care, and renewals.