Healthcare when you work for yourself in Sutton

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

SakeOf is a healthcare membership and a smarter alternative to the traditional insurance-first way of paying for and navigating healthcare. It brings together practical everyday-care options, provider choice, and support when a bill or larger medical event needs attention.

For a new, non-emergency concern, begin with the simplest appropriate care option available to you. Depending on which benefits you select and keep active, that might mean Zero Copay Telemedicine for a virtual visit, or an in-person appointment when an exam, test, or hands-on care makes more sense. For emergencies, seek emergency care.

In Sutton, Community Care of Flatwoods lists primary care, walk-in care for acute non-life-threatening concerns, chronic disease management, behavioral health, and pharmacy services. Call 304-765-4400 to ask about current services, hours, appointment availability, and charges before you go. [[cite:]]

Build an everyday-care routine around active options

Zero Copay Telemedicine can be a convenient starting point for appropriate concerns. Rx and Prescription Benefits may support eligible medications through the program’s participating-pharmacy process. Check the current pharmacy tool and formulary before filling a prescription: a medication’s price and eligibility depend on the active program and its rules.

Mental Health and Counseling can offer problem assessment, supportive counseling, follow-up when available, and crisis support. If ongoing primary-care follow-up would help, Virtual Primary Care is a separate option that adds $15 per month and includes virtual primary-care access through the current service partner. Its current intended bundle requires active Rx and Prescription Benefits, Zero Copay Telemedicine, and Mental Health and Counseling.

Virtual Primary Care may include a wellness visit and health-risk assessment, chronic-care follow-up, medication review, and care coordination when clinically appropriate for virtual care. It does not make every in-person visit, lab, imaging service, specialist appointment, or medication part of the virtual service. Confirm how a particular need would be handled before arranging care.

Choose local in-person care when you need it

You choose your provider when in-person care is appropriate. In Sutton, Community Care of Flatwoods is at 266 Skidmore Lane and lists a pharmacy at the same site. The clinic lists 304-765-4400 for clinic questions; its pharmacy lists 304-765-4488. Ask each directly about current hours, services, appointment requirements, prescription availability, and charges. [[cite:]]

The Braxton County Health Department is at 617 Old Turnpike Road in Sutton and lists 304-765-2851 as its contact number. Contact the department to check its current clinical, public-health, and environmental-health services and hours. [[cite:]]

For hospital-level services, Braxton County Memorial Hospital in Gassaway reports 24-hour emergency care, inpatient care, and outpatient surgery. Its directory includes billing and financial-counselor contacts. A hospital charge file is not a final quote: ask the facility for an estimate and ask what professional or other charges may be separate. [[cite:]]

Use support when bills get complicated

If you receive a bill for care, Full Service advocacy can help with bill verification, fair-price review, and negotiation support. Keep the itemized bill and relevant provider records together; an itemized bill is required for submissions and should include service dates, provider information, and CPT or HCPCS codes when available.

Additional records, clinical notes, billing details, or a signed release may be requested to review eligibility, medical necessity, or fair pricing. Submit complete documents within six months of the service date. If you receive a balance bill, denial, or payment demand, submit it within 10 days of receiving it. Support is subject to the membership’s program rules; it is not a promise that a particular bill will be paid or reduced.

Know how eligible larger events are handled

For a larger eligible medical event, the program applies its relevant member commitment and may invite voluntary community funding under its rules. The standard event commitment is $500; eligible physical or occupational therapy visits under the PT/OT feature use that feature’s $35 member responsibility instead. Review the current Program Guide for the rules that apply to your membership and event.

When planning care, ask providers for an itemized estimate and keep records of services and charges. This gives you useful information to review and share if you seek program support. Eligibility, documentation, and fair-price review depend on the details of the event and the program rules.

Check options and take a local next step

Other options may be useful for a household. The maternity feature may apply to specified prenatal, delivery, and postpartum expenses when selected, active, eligible, and within program rules. Dental and vision discounts, chiropractic or acupuncture, and durable medical equipment may also be available through membership options; check the current membership details for terms.

The PT/OT feature requires medically necessary care from an appropriately licensed therapist and has a shared 12-visit annual limit and $780 annual maximum across the enrolled membership. A physician order, referral, or documented plan of care may be required. For local public-program questions, Braxton County’s Department of Human Services provides information about Medicaid, WVCHIP, and non-emergency medical transportation. WV PATH is the state portal for screening and applying for Medicaid and WVCHIP. ^bms.wv.gov

• Use the calculator to explore membership options and costs.
• Read the Savings Guide to understand how the membership works.
• Use provider search to look for care, then confirm services and charges directly.
• Ask Jordan a question or review membership options before enrolling.