Healthcare before Medicare in Squire

Plan care around what you need

SakeOf is a healthcare membership built to help you make practical care decisions. Depending on the services and features selected and active in your membership, you can start with everyday care options, choose where to go for in-person services, and get help understanding medical bills. Full Service adds advocacy and fair-price review, along with voluntary community funding for eligible larger medical expenses.

Start by identifying the need: a routine question, prescription, ongoing follow-up, test, or planned procedure. Then compare membership options with the calculator or Savings Guide. If you are ready to look for care, use provider search and contact the provider about the exact service, location, availability, and price.

Use everyday services when they fit

Zero Copay Telemedicine can provide a convenient option for appropriate routine questions or follow-up when the feature is selected and active. Rx and Prescription Benefits can help with eligible prescription needs under their program rules. Mental Health and Counseling is another optional service. Check the details of the selected feature when planning care, including whether a particular service or medication is part of it.

Virtual Primary Care offers a dedicated physician relationship with ongoing virtual follow-up support, an annual virtual wellness visit and health-risk assessment, and chronic-care follow-up or medication-management support when clinically appropriate for virtual care. It requires Rx and Prescription Benefits, Zero Copay Telemedicine, and Mental Health and Counseling to remain active for the bundled service tier. Review membership options to see whether this combination fits the kind of ongoing care you want.

Virtual options give you a place to start for appropriate care that can be handled remotely; they do not replace the in-person service you may need for an exam, test, or procedure. For emergencies, seek emergency care.

Choose in-person care in McDowell County

No healthcare facility located within Squire was verified in the research. Verified resources are in other McDowell County communities, so plan for the location that offers your service and call before traveling. Welch Community Hospital in Welch is identified by West Virginia as the county’s only acute-care hospital. Its state listing includes a 24/7 emergency room and outpatient services. ^dhhr.wv.gov

For a clinic, lab, imaging service, specialist, or hospital visit, you choose the provider. Call to confirm that the location offers the specific service, ask about appointment availability and payment arrangements, and request a written estimate. Ask what the estimate includes and whether professional, facility, laboratory, or other charges could be separate. Welch Community Hospital’s official page links to standard charges and shoppable services; posted information may not capture every charge. ^www.cms.gov

If you want to check whether a provider participates in West Virginia Medicaid, use the state provider directory and confirm participation with the provider. ^{www.wvmmis.com}

Put bill advocacy and fair-price review to work

With Full Service, SakeOf advocacy can help you review medical bills, verify billing details, seek fair pricing, and get negotiation support. Gather the itemized bill and any related provider paperwork. An itemized bill is required and should include service dates, provider information, and CPT or HCPCS codes when available. SakeOf may also request medical records or other documentation to review eligibility, medical necessity, and fair pricing.

Submit complete documents within six months of the service date. Submit a balance bill, denial, or payment demand within 10 days of receiving it. These deadlines help ensure the review has the information it needs. To get started, collect what you have and ask SakeOf or Jordan which documents to submit.

Know the path for a larger eligible expense

For a larger eligible medical event, Full Service combines advocacy and fair-price review with a member commitment and voluntary community funding. The standard event commitment referenced in the program rules is $500. Eligibility depends on the expense and event rules, so ask how they apply to your planned or unexpected care before making assumptions. Community funding is voluntary and a particular funding result is not guaranteed.

For planned care, comparing estimates for the specific service can help you understand the expected charges before scheduling. Ask the provider what is included, then contact SakeOf with questions about the membership process and documents for review.

Match optional features to your household

Optional features can be selected for needs you expect to use. Maternity Care may include eligible prenatal care, delivery, and routine pregnancy-related postpartum care through six weeks after delivery. The pregnancy must begin after the continuous 12-month maternity waiting period. Routine newborn facility and physician charges before initial discharge may be reviewed within the maternity event when billed as part of delivery; care after discharge is separate. Add the newborn to the membership within 30 days of birth.

Other options include dental and vision discounts, chiropractic and acupuncture, physical and occupational therapy, and durable medical equipment. Under the PT/OT feature, eligible visits share a 12-visit annual limit and a $780 annual maximum across the enrolled membership. Eligible visits have a $35 feature-specific member responsibility in place of the standard $500 event commitment. Each feature has its own rules and applies when selected and active.

Take a useful next step

• Compare membership options: Use the calculator and Savings Guide to explore services and features that fit your needs.
• Find a provider: Use provider search, then call to confirm the service, location, availability, and payment details.
• Get personal help: Bring questions about membership options or how to get started to Jordan.
• Explore public programs: WV PATH supports screening and applications for Medicaid and WVCHIP. The McDowell County DoHS Office in Welch lists assistance with Medicaid, WVCHIP, and non-emergency medical transportation; ask the office about current arrangements and eligibility. ^dhhr.wv.gov