Healthcare after employer coverage ends in Madison

Start with the care you need—not a maze of steps

SakeOf is a healthcare membership designed to make paying for and navigating care more direct. Members can begin with an everyday service when it fits, choose a provider for in-person care, and turn to advocacy support when a bill or larger medical expense needs attention.

The practical sequence is simple: identify the kind of care you need, check which SakeOf services you have selected and active, and decide whether virtual care or a local visit is the appropriate next step. Provider availability, clinical suitability, and program rules still shape what can happen.

Use everyday care options when they fit

For common, non-emergency symptoms that are appropriate for virtual care, Zero Copay Telemedicine offers 24/7 access to consultations with board-certified physicians licensed in your state, with no program limit on consultation frequency or duration. A clinician may prescribe medication when appropriate and legally permitted. Telemedicine does not itself include labs, imaging, specialty care, procedures, or in-person follow-up that may be recommended.

If Rx and Prescription Benefits is selected and active, the program provides access to an acute-medication formulary of approximately 70 medications at $0 when program requirements are met and the medication is filled through the participating-pharmacy process. Check the current formulary and pharmacy tool for a specific prescription: medications outside the formulary are not automatically $0 or eligible for community sharing.

Mental Health and Counseling, when selected and active, provides unlimited on-demand telephonic counseling at $0 for included access, with up to three face-to-face consultations per incident when arranged and available. Virtual Primary Care is an optional $15-per-month adjustment and requires active Rx and Prescription Benefits, Zero Copay Telemedicine, and Mental Health and Counseling. It includes a dedicated virtual physician relationship, an annual wellness visit and health-risk assessment, and follow-up support for chronic care and medication management when appropriate for virtual care.

Choose in-person care around Madison

When you need an examination or another in-person service, you can choose among local providers and contact them directly about availability, services, payment arrangements, and prices. Boone Memorial Health lists its BMH Walk-In Clinic at 173 State St. and says it offers walk-in care seven days a week, 8 a.m.–8 p.m.; confirm current availability before visiting.^{www.loganregionalmedicalcenter.com}

For primary care, Boone Memorial Health lists BMH Medical Clinic at 660-A South Main St. and BMH Family Medical Center at 697 Madison Ave. The system lists an outpatient pharmacy at 697 Madison Ave. Check its locations page or call its central appointment line, 304-369-1230, to confirm current hours, services, and appointment options.^{www.loganregionalmedicalcenter.com}

Southern West Virginia Health System lists Madison Medical, a primary-care clinic with a co-located pharmacy, at 471 Main Street and says walk-ins are welcome. Confirm hours and availability, particularly around holidays.^{www.loganregionalmedicalcenter.com} If a clinician recommends a lab, imaging, specialist, or in-person follow-up after virtual care, contact the provider about the service and its price; those services are not included simply because telemedicine is available.

For an emergency, call 911. Boone Memorial Hospital’s emergency department is listed as open 24/7/365 at its Madison campus.^{www.loganregionalmedicalcenter.com} Do not use a routine membership workflow or telemedicine in place of emergency services.

Ask for help when a bill is difficult to sort out

Full Service advocacy can help members verify bills, review whether pricing appears fair, and seek negotiation support. If you receive a confusing charge, gather the bill and related records, then use the membership’s Full Service process to ask what review and support apply to your situation.

Boone Memorial Health provides cost-estimate and price-transparency information, and its site cautions that estimates are not final quotes. Ask the provider what an estimate includes and whether professional or other charges may be separate.^www.cms.gov A provider’s estimate and SakeOf’s advocacy support are distinct: ask the provider about its charges and SakeOf about the services available under your membership.

Understand the path for a larger eligible event

For a larger medical event, first confirm whether the expense is eligible under the active program and what documentation or process applies. The applicable member commitment is part of that process. Voluntary community funding may be available for larger eligible events, subject to program rules; it is not a guaranteed payment amount or outcome.

For pregnancy-related care, the maternity feature may include eligible expenses such as routine prenatal visits, medically necessary prenatal labs, standard diagnostic ultrasounds, delivery, and routine pregnancy-related postpartum care through six weeks after delivery. It applies only when selected, active, and eligible, and expenses above the maternity sharing limit are not included. Review the current program terms before planning care.

Consider other options and take a next step

Depending on your needs, membership options may also include dental and vision discounts, chiropractic or acupuncture, physical or occupational therapy, and durable medical equipment. These options are subject to their own active-program terms; check the applicable details before arranging a service.

• Need help with a common symptom? Check whether Zero Copay Telemedicine is active and whether virtual care is appropriate.
• Need ongoing care or medication support? Review Virtual Primary Care requirements and verify any medication in the current formulary.
• Want to visit a Madison provider? Contact the clinic or pharmacy directly to confirm current hours, availability, and price.
• Have a bill or larger event to sort out? Review the Savings Guide and ask about Full Service, the applicable member commitment, and the event’s program rules.

Use the calculator to explore membership options, the provider search to look for care, or Jordan to ask a question. When you are ready, review the membership options and confirm which services you want active.