Healthcare after employer coverage ends in Martinsburg

Make healthcare decisions around the care you need

SakeOf is a healthcare membership that brings together practical services and options: selected everyday-care features, your choice of provider, help making sense of bills, and voluntary member-to-member community funding for eligible medical expenses. Instead of starting with a billing maze, start with your need: a quick clinical question, ongoing primary care, a prescription, an in-person visit, or help with a larger bill.

Full Service is designed for support across everyday medical needs and larger health events. Major Medical Only is also available. Your enrollment choices determine which features are active and what your monthly price is. The current handbook lists a $50 per-member monthly base fee; your final quote also depends on your program, household, community ask, selected features, and any applicable Full Service commitment adjustment. Use the calculator to see your enrollment quote.

Choose everyday-care features that fit

For a question that may be handled remotely, selected and active Zero Copay Telemedicine or Virtual Primary Care can provide a convenient starting point. They are separate optional features: Zero Copay Telemedicine is listed at an additional $8 per month, and Virtual Primary Care at $15 per month. Check your membership selections and access instructions so you know which service is available to you.

The optional Rx and Prescription Benefits feature is listed at $10 per month. Review the active feature details for the medication and arrangement you need. Other useful options include Mental Health and Counseling ($6 per month), dental and vision discounts ($9), chiropractic and acupuncture ($14), physical and occupational therapy ($11), and durable medical equipment ($7). These optional features apply when selected and active; explore membership options to see what fits your needs.

Mental Health and Counseling may include problem assessment, supportive counseling and follow-up when available, crisis support, and referrals when more care is needed. Psychiatry, inpatient behavioral health, emergency psychiatric care, neuropsychological testing, residential substance-use treatment, and medication costs are not included just by selecting counseling; another active benefit or program would need to apply.

Choose local in-person care in Martinsburg

For an examination, lab work, imaging, specialty care, or hospital services, choose a provider based on the service and your circumstances. Shenandoah Community Health is at 99 Tavern Road in Martinsburg and describes a sliding-fee discount program. Contact the health center to ask about the care you need, eligibility, documentation, appointment steps, and fees.

WVU Medicine Berkeley Medical Center, at 2500 Hospital Drive, provides emergency and specialty services; its main number is 304-264-1000. For planned care, ask about the specific service, an estimate, billing, and financial-assistance policies. Standard hospital charges, a service-specific estimate, and a final patient bill are different kinds of information.

UPMC-GoHealth Urgent Care lists a Martinsburg Commons location at 83 Retail Commons Parkway and reports walk-in services. Confirm current hours, availability, and payment arrangements with the location. For emergency care, contact emergency services or go to an emergency department.

The Berkeley County Health Department is at 122 Waverly Court in Martinsburg. It lists clinical services including immunization and family-planning programs; ask the department about current availability, appointment requirements, eligibility, and fees. The Martinsburg VA Medical Center is at 510 Butler Avenue and offers primary and specialty services. VA care has enrollment and eligibility requirements, so confirm your status and next steps with VA.

Get practical help with a confusing bill

Full Service includes advocacy, bill verification, fair-price review, and negotiation support. If a bill is unclear or seems unusually high, gather the itemized bill and ask SakeOf to help review the documentation and identify next steps. This gives you support for understanding the bill while keeping your choice of provider for care.

An itemized bill is required for submissions and should show service dates, provider information, and CPT or HCPCS codes when available. SakeOf may also request clinical notes, medical records, diagnosis or procedure details, billing records, or a signed medical record release to review eligibility, medical necessity, and fair pricing. Submit complete documents within six months of the service date. Submit balance bills, denials, or payment demands within 10 days of receiving them.

Plan for eligible larger medical expenses

With Full Service, an eligible medical expense may be considered for voluntary community funding after the applicable member commitment. The Program Guide, documentation, and review process determine eligibility, so a particular expense or amount of funding is not guaranteed. A useful first step is to keep itemized records and send required documents promptly so the review can proceed.

For members planning maternity care, the maternity feature is available with Full Service when offered and selected, at an additional $18 per month. It requires at least 12 months of continuous active membership with maternity continuously selected and active before conception. The member responsibility is $5,000 per eligible pregnancy, with community sharing up to $25,000 after that responsibility, subject to program rules. The benefit period is pregnancy through six weeks postpartum for pregnancy-related care.

Choose your next step

• Quick question or ongoing care: Check whether telemedicine or Virtual Primary Care is selected and active, then confirm how to use it.
• Local clinic visit: Ask Shenandoah Community Health about services, its sliding-fee program, eligibility, and fees.
• Hospital care: Call Berkeley Medical Center at 304-264-1000 about the specific service, an estimate, and billing policies.
• Public programs: Berkeley County’s Department of Human Services handles applications and services including Medicaid, WVCHIP, and non-emergency medical transportation. WV PATH supports screening for and applying to programs including Medicaid and WVCHIP. ^bms.wv.gov
• Explore SakeOf: Use the calculator for a personalized quote, review the Savings Guide, search for a provider, ask Jordan a question, or compare membership options.