Healthcare after employer coverage ends in Point Pleasant

Start with care, not a billing puzzle

SakeOf is a healthcare membership built around a more direct way to arrange everyday care and work through medical costs. Start with what you need: help with a common symptom, a prescription, ongoing follow-up, an in-person appointment, or support understanding a bill. Then consider which active membership options and providers fit that situation.

You choose the provider for in-person services. SakeOf’s role includes selected direct-care options and, through Full Service, support with bill verification, fair-price review, and negotiation. For planned care, contact the provider to confirm the service, appointment availability, and expected price. When reasonably possible, contact SakeOf in advance about planned higher-cost care.

To explore your choices, use the calculator and Savings Guide, search for a provider, or ask Jordan a question. These are practical ways to understand membership options before deciding whether to enroll.

Use active options for everyday care

Zero Copay Telemedicine offers 24/7 access by phone or video for common, non-emergency illnesses and symptoms appropriate for remote care. While active, eligible urgent-care telemedicine consultations have a $0 member cost, with no program limit on consultation frequency or duration. Access depends on clinician availability, technology, state licensing, and clinical appropriateness. The feature requires active Rx and Prescription Benefits.

A telemedicine clinician may prescribe when clinically appropriate and legally permitted. The cost of a prescription follows the active Rx program. If the clinician recommends an examination, lab, imaging, specialist, or other in-person service, that recommendation does not arrange the separate service; you can choose a provider and confirm availability and price.

Mental Health and Counseling provides unlimited telephonic counseling on demand at $0 for included counseling access when active. The feature requires active Rx and Prescription Benefits and Zero Copay Telemedicine. It may also offer up to three face-to-face counseling consultations per incident when arranged and available. Psychiatry, inpatient behavioral health, emergency psychiatric care, neuropsychological testing, residential substance-use treatment, and medication costs are not included merely because counseling is active.

Virtual Primary Care, when active with its required bundled features, provides virtual primary-care access, an ongoing physician relationship, an annual virtual wellness visit, and follow-up for chronic care or medication management when appropriate for virtual care. It requires active Rx and Prescription Benefits, Zero Copay Telemedicine, and Mental Health and Counseling.

Choose a provider for in-person care

When your needs call for an examination, test, or other in-person service, you choose where to seek care. Ask the provider whether it offers the service you need, whether you need an appointment, and what the expected charges include. For planned testing or treatment, ask whether professional, laboratory, facility, or other charges may be billed separately.

In Point Pleasant, the Mason County Health Department is listed at 216 5th Street and can be reached at 304-675-3050. Contact the department to confirm current services, hours, appointment requirements, and fees.^{health.wv.gov} If you are looking for a hospital, clinic, urgent care, or pharmacy, verify the provider’s current location, services, availability, and payment arrangements directly before traveling.

For an emergency, call 911 or seek emergency care. For non-emergency care, use the provider and service that fit your situation, and confirm the expected price before planned care when possible.

Get support reviewing a medical bill

If a bill is difficult to understand or seems unexpectedly high, gather the itemized bill, any estimate, and related records. SakeOf Full Service can support bill verification, fair-price review, and negotiation. Use the membership’s process to request help. This is advocacy and review support; it does not promise a bill change or a particular funding outcome.

Providers may have their own financial counseling or assistance processes. Ask the facility directly about current eligibility, application requirements, and which charges may qualify. For planned hospital care, request an estimate and check whether professional or ancillary charges are separate. CMS provides information about hospital price transparency for consumers.^www.cms.gov

Understand support for larger eligible needs

For larger eligible medical events, the membership process may involve an applicable member commitment and voluntary community funding, subject to program rules and review. Member responsibilities include keeping the membership current, funding required asks, paying the applicable commitment, and submitting complete itemized bills and requested documents promptly. Contact SakeOf ahead of planned higher-cost care when reasonably possible to understand the process.

Potentially eligible categories include medically necessary illness or injury care, emergency and urgent care, diagnostics, labs, imaging, hospitalization, surgery, and medically necessary ambulance services, subject to program terms and individual review. Eligibility is based on the program rules and documentation; do not assume that a service or expense will be eligible.

If you are planning a pregnancy, an active maternity feature may include specified routine prenatal care, medically necessary testing, delivery-related care, and routine pregnancy-related postpartum care through six weeks after delivery, up to the feature’s sharing limit. Check the applicable feature rules and limit before making plans.

Choose your next step in 25550

• For a common, non-emergency symptom: Check whether Zero Copay Telemedicine and its required Rx feature are active, then consider whether remote care is appropriate.
• For ongoing follow-up: Review Virtual Primary Care and its required bundled features; choose a local provider if you need in-person care.
• For a prescription: Confirm that the Rx feature is active, then check medication cost and availability with the pharmacy you choose.
• For planned testing or treatment: Ask the provider about availability, total expected charges, and separate professional or laboratory fees; contact SakeOf in advance for higher-cost planned care when reasonably possible.
• For a confusing bill: Gather the itemized statement and ask SakeOf about Full Service support.
• To compare options: Use the calculator and Savings Guide, search for a provider, or ask Jordan a question.

West Virginia residents can use WV PATH to screen for and apply for Medicaid and WVCHIP; eligibility and program benefits vary.^bms.wv.gov