Healthcare when you work for yourself in Points

Start with the care you need

SakeOf is a healthcare membership built around a practical sequence: start with the kind of care you need, choose an appropriate care route, and get support understanding the bill. Members can use the membership options they select and keep active, while retaining choice about where to seek in-person care.

For a common, non-emergency illness or symptom that is appropriate for a remote visit, eligible members can use Zero Copay Telemedicine when it is active alongside Rx and Prescription Benefits. The service is available by phone or video through its current partner, subject to state licensing, availability, and clinical appropriateness. If a clinician recommends an exam, test, or other follow-up, plan for that as a separate care step.

Build an everyday-care routine

For an immediate, appropriate urgent-care question, telemedicine can be a low-friction first step. Prescriptions may be issued when clinically appropriate and legally permitted; medication costs follow the active Rx program. Labs, imaging, in-person follow-up, and specialty care are not included simply because a telemedicine clinician recommends them.

For ongoing primary-care needs, review whether Virtual Primary Care is available in the membership options you are considering and confirm its current details before relying on it. It can be part of a broader routine, alongside local in-person care when an exam, testing, or hands-on treatment is needed.

If counseling would be useful, the optional Mental Health and Counseling service provides unlimited telephonic counseling on demand at no member cost when selected and active, with prerequisites that include active Rx and Prescription Benefits and Zero Copay Telemedicine. Up to three face-to-face consultations per incident may be arranged when available. More intensive behavioral-health care, psychiatry, and medication costs are not automatically included in this service.

Choose in-person care around Points

ZIP code 25437 is associated with Points in Hampshire County. The verified local care locations in the research are in nearby communities, rather than Points itself. Hampshire Memorial Hospital is listed as an active critical access hospital in Romney; contact the facility to confirm whether it provides the service you need, appointment availability, and payment arrangements.

The Hampshire County Health Department is in Augusta and publishes its contact details and hours through the state health department. Contact the department to check current clinical services, appointment requirements, schedules, and fees before visiting. These are useful starting points for local care, but they do not establish that every service is offered at either location.

You may choose providers beyond these local resources. If using Medicaid or WVCHIP, the West Virginia Medicaid Provider Directory lets you search by location, provider, specialty, or program; confirm a provider’s participation and availability directly. WV PATH is the state portal for screening and applying for programs including Medicaid and WVCHIP.

Make bills easier to understand

When a bill is confusing or seems out of line, SakeOf Full Service advocacy can support bill verification, fair-price review, and negotiation. Keep the itemized bill, including service dates, provider details, and CPT or HCPCS codes when available. SakeOf may also request clinical or billing records and a signed medical-record release to review eligibility, medical necessity, and fair pricing.

Submit complete requested documents within six months of the service date. Submit a balance bill, denial, or payment demand within 10 days of receiving it. For a hospital service, ask the facility for an estimate for the specific service and ask which charges may be separate. Hospital standard-charge files and estimates can help with planning, but they do not guarantee your individual price or final out-of-pocket amount. CMS explains hospital price-transparency requirements and consumer resources.^www.cms.gov

Plan for a larger eligible medical event

For a larger eligible event, Full Service advocacy and bill review can help the member understand charges and fair pricing. Eligible expenses may also be considered for voluntary community funding under program rules. A member commitment applies; review the current Program Guide and membership materials for the commitment and applicable event rules rather than assuming an amount or outcome.

Before care when time allows, gather provider estimates, ask which professional or ancillary charges may be billed separately, and contact SakeOf about the relevant review process. Eligibility, fair-price review, and any voluntary funding depend on documentation and program rules; none is guaranteed.

Check options that match your household’s needs

Members planning for pregnancy should review the maternity rules before conception: pregnancy must begin after the continuous 12-month maternity waiting period is complete. The newborn should be added to membership within 30 days of birth, and maternity support is subject to its limit and other program rules.

Other options worth checking in the membership materials include dental and vision discounts, PT/OT, and durable medical equipment. Potentially eligible equipment can include medically necessary walkers, crutches, wheelchairs, prescribed braces, hospital beds, nebulizers, and CPAP machines ordered by a qualified provider. Chiropractic and acupuncture share an eight-visit annual limit and a $240 annual maximum across the enrolled membership; community sharing is limited to the lesser of the approved fair-price amount or $30 per eligible visit. Confirm each option’s current terms, selection requirements, and provider arrangements.

Your next steps in Hampshire County

• Use the calculator to compare membership options and estimated costs for your situation.
• Read the Savings Guide and check the current Program Guide for terms that matter to your care plans.
• For local in-person care, call Hampshire Memorial Hospital in Romney or the Hampshire County Health Department in Augusta to verify services, appointments, and payment arrangements.
• Use the West Virginia Medicaid Provider Directory to look for participating providers, then confirm participation directly.
• Ask Jordan a question or review membership options before enrolling.