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For Black History Month, we’re recognizing pivotal Black leaders in healthcare who’ve paved the way forward for our country and the Black community.

Services that reduce travel and encourage social distancing are now more essential than ever, not only for vulnerable populations but all of us as members of our communities. Alto’s free same-day doorstep delivery ensures you have safe and reliable access to medications in this time of uncertainty. 

Hear first-hand from members of the Alto technology teams.

Alto / Blog

When the pandemic hit, we were thankful to already be in the position to make a meaningful difference for Alto’s working parents. Our Working Parents & Allies Employee Resource Group (ERG) was formed at the beginning of 2020. 

Supporting Working Parents at Alto

With the COVID-19 pandemic forcing the shutdown of schools, offices, and daycare programs this year, working parents have been expected to accomplish Herculean feats of focus. Many parents spend their waking hours with one eye on their computer screens and the other on their children, all while coordinating remote learning, nap times, and video conferences. 

Those who continue to work outside the home must navigate the unpredictable availability of childcare services. Anything from new shutdown orders to a caretaker forced to quarantine can mean a lapse in care. A recent study found that 33% of working parents had no access to childcare at all, a percentage twice as large as in pre-pandemic times. 

At Alto, we serve thousands of working parents, including many who are juggling caring for their children and aging parents. Just as we support them by delivering a better pharmacy experience, we also want to support the hundreds of heroic parents working at Alto and caring for our customers every day. 

ERGs are meant to empower community groups within an organization by directly linking decision makers and implementing policies that support the group’s specific needs. The groups often center around a shared identity or experience and focus on building community, providing support, and contributing to its members’ personal and professional well-being. By creating an open forum for employees to come together, discuss challenges and opportunities, and foster a sense of belonging, ERGs help both individuals and organizations thrive. 

“Now more than ever it’s important to uplift and advocate for parents,” shares co-lead and mother Lidia Valdez. “The parenting landscape has shifted dramatically in 2020 but with the continued sense of community at Alto we can lean on one another for advice and support.” 

For more on how Alto fosters an inclusive culture and company, we invite you to read Diversity at Alto. 

The Mission of Alto’s Parent & Allies ERG

Alto’s Working Parents & Allies ERG came into being just before the pandemic began placing unprecedented demands on parents. It aims to provide an inclusive space for parents and allies to discuss how they’re feeling, speak openly about the challenges they’re facing, and request what they need from Alto. The ERG also helps parents remain informed and up-to-date on the policies and programs that are in place to support them. 

While the ERG’s first initiatives have centered upon providing pandemic-related support—from child care services to remote learning opportunities—these initiatives will continue to grow and evolve along with the needs of working parents at Alto. 

It was quickly apparent that Alto’s working parents—like parents everywhere—were overwhelmed with trying to manage the sudden shift to full-time, in-home childcare and schooling. The ERG responded by launching forums co-hosted by parents and the ERG leadership committee. These support groups were designed to create a safe space for parents and allies to share how they felt amidst a return to virtual learning in the Fall. Following the discussions, we launched a pilot program to offer immediate, tangible support. 

We began by inviting parents to opt into a program facilitating childcare services through UrbanSitter—a site that connects parents with trusted caretakers from their local communities. Interested parents received a stipend to cover membership fees and in-home or remote care costs. Whether parents needed support during a video conference or last-minute care after finding out their child’s daycare was closed, UrbanSitter could provide some relief.

We also rolled out a program with Outschool—a marketplace of live, online classes for students ages three to eighteen. Participating parents could access five hours of classes per week for free, allowing their children to explore interests ranging from math and music to filmmaking, coding, painting, and writing. With over 50,000 classes available, Outschool helps parents focus by keeping their kids engaged with fun, enriching activities. In the words of one Alto parent, “I really enjoyed Outschool for my kids. It’s such a good help; they are engaged and learning new things. Both my children and I love it!”

In addition, parents that needed hardware support for at-home distance learning were provided laptops at no cost. 

After a few months, we asked parents to provide feedback on the pilot program. We found that 71% of parents participated in the program, and 47% felt that the resources had made a positive impact on their lives or increased their ability to be productive and engaged at work. We’ll use this feedback to continue initiatives that have made a difference in the lives of Alto’s working parents while introducing new programs that can provide further support. 

The ERG leadership team also identified opportunities that would spark joy and support parents outside of the Alto community. “Working remotely can often feel isolating so we wanted to create instances for parents and their children to be recognized,” notes co-lead and parent Sandy Obeji. “In addition, we knew it would be important to extend this acknowledgement beyond parents at Alto.“

In October, we hosted a Halloween costume contest aimed at encouraging fun and creativity. Alto parents were invited to share photos of their kids in costumes, and prizes were awarded for the most unique, scariest, and funniest getups. Both adults and kids participated in choosing the winners, arguably providing more fun than a night of trick-or-treating. 

We also coordinated a Holiday Giveback Program to raise money for supplies and gifts for children and families in need during the holiday season. Alto employees were able to donate items to seven organizations—one for each Alto pharmacy location—virtually with the help of You Give Goods. In the end, we exceeded our fundraising goal and Alto matched the total donation to help make the holidays a little brighter for families across the country. 

Initiatives like these are just the beginning, and the Working Parents & Allies ERG has been collecting feedback that will guide our planning for 2021. In addition to extending access to several of the resources mentioned above, we are also exploring workshops for parents centered around current issues and events. 

There are plenty of reasons to believe that parents are superheroes, but that doesn’t mean we can expect them to perform superhuman tasks. Alto’s Working Parents & Allies ERG was created to help parents find much-needed balance and support during a tremendously difficult time. We look forward to seeing the group grow, aiding ongoing and future initiatives, and continuing to foster a culture where everyone feels included, valued, and supported. 

Interested in learning more about the Working Parents & Allies ERG? Reach out to parents@alto.com. 

If you’re considering IVF or freezing your eggs and unsure of what to expect, this article will break down the basics and offer suggestions for how to prepare. 

IVF and Egg Freezing: What to Expect and How to Prepare

These days, egg freezing and IVF, or in vitro fertilization, are fairly common routes on the journey to parenthood. Yet, that doesn’t mean these fertility treatments are always an easy road. While both treatments helped millions of women conceive, they can require a significant investment of emotion, resources, and time. 

In vitro fertilization is a type of fertility treatment where:

The retrieved eggs are combined with sperm outside of the body in a laboratory 

The embryos (fertilized eggs) are then placed into the uterus with the potential outcome of a pregnancy. 

The main difference between egg freezing and IVF is the timing. Rather than attempting to get pregnant right away, egg freezing gives you the option to store your unfertilized eggs for a later time. When and if you decide you are ready to have a baby, your eggs will be thawed in the lab and the rest of the IVF process will be completed. Freezing healthy eggs at a younger age allows women more flexibility in their family-planning timelines.  

The initial screening and prescribed medications are very similar for IVF and egg freezing. After completing an initial ultrasound and bloodwork, your doctor will prescribe fertility medications to stimulate follicle growth. Follicles are fluid-filled sacs in your ovaries that potentially contain an egg. Your prescription will involve self-injecting hormones on a precisely timed schedule and regular check-ins for additional ultrasounds and bloodwork. For a more detailed understanding of the timeline and medications used during an IVF cycle, see our article,  IVF Medications: Schedule and Side Effects Explained. 

Once your follicles have reached maturity, your doctor will gently guide a thin needle through your vaginal wall and use suction to draw the eggs from the follicles. The 15-45 minute procedure is minimally invasive, and you’ll be sedated to ensure there’s no pain. The retrieved eggs are either frozen and stored for later use or placed in a petri dish with sperm cells so fertilization can take place. The fertilized eggs, or embryos, are then transferred to your uterus through a quick, non-surgical procedure using an ultrasound-guided catheter.  

IVF may include a variety of other parties at each stage. In some cases, an egg donor undergoes the egg retrieval process. The resulting embryos are then transferred to the intended parent’s uterus. Sometimes a gestational carrier carries and delivers a child for another couple or person. The embryo is created via IVF using the eggs and sperm of the intended parents or donors and then transferred into the gestational carrier’s uterus. In all of these cases, the sperm used to fertilize the eggs may come from either a male partner or donor. Your unique fertility journey may or may not include one or more of these variations.

From a biological standpoint, the American Society for Assisted Reproductive Technology recommends being at a healthy weight and avoiding smoking or alcohol use. It’s also important to mentally prepare, as this journey may take more than one cycle and be physically demanding on your body. Here are a few tips to keep in mind when it comes to your emotional well-being: 

Don’t let staying “stress-free” stress you out 

During any type of fertility treatment, it’s natural to feel anxious or apprehensive. You are emotionally invested in the outcome, after all. So the standard advice to avoid stress during IVF may only serve to catch you in a cycle of worrying about your worries. It’s true that stress isn’t good for your health and it negatively impacts your quality of life; however, recent studies have offered reassurance that your stress level is unlikely to affect your chances of IVF success. 

We recommend that you include stress-relieving techniques in your fertility self-care plan, but it’s important to know that some stress is expected and perfectly okay. Rather than trying to avoid anxious thoughts altogether, try to acknowledge whatever hopes and fears arise, then work to let them go through practices that help you feel calm. The key here is to be gentle with yourself. Try light, low-impact movement practices like yoga, walking, or tai chi, or lay in bed and listen to a guided audio meditation. There are meditation programs that focus specifically on supporting the fertility journey, like Expectful and Circle + Bloom, as well as free fertility meditations on Insight Timer. 

If possible, we suggest surrounding yourself with caring individuals who can provide emotional support or assist with injections when needed. Talk about your feelings with your loved ones. And If you know someone else who has gone through egg freezing or IVF, perhaps you can schedule a weekly phone chat or walk through your neighborhood. 

Finding this type of support isn’t always easy, however. If you’re feeling isolated or struggling to find someone to confide in, know that you are part of a community of women who share similar challenges. Your fertility clinic may offer counseling or support groups, or you can find one through Resolve, the National Fertility Association. No matter your circumstances, you don’t have to navigate fertility and family planning alone. 

Many people also find support through blogs and online communities centered around fertility and IVF, like IVF Babble and Pregnantish. While these can be excellent resources, be mindful that not everything you read online will be completely factual or apply to your unique circumstances. Your doctor or pharmacist should be your source for any medical advice. The stories others share will range from joyful to heartbreaking, so check in with where you’re at emotionally before you start browsing. Remember: whether good or bad, these are the experiences of others. Your journey will unfold in its own way. 

Because treatment can change from one day to the next, it’s helpful to have a pharmacy partner that can be just as flexible and deliver medications as needed. For that reason, we recommend selecting a pharmacy that offers free, same-day delivery and expert guidance on fertility medications. 

Alto’s fertility pharmacists are accessible by phone, text, or messaging in our mobile app. We understand that protocols can change with little notice, which is why you will always receive a confirmation and updates from us after we receive your prescription. You can also view your delivery status in our mobile app until our courier team hand-delivers your medications. You can even designate a safe place for us to place your medications for contactless delivery (we can facilitate contact-free signatures as well). 

For more tips on how to select your pharmacy, read “What to Consider When Selecting a Fertility Pharmacy.” 

The IVF journey can be challenging, but we’ll be with you every step of the way. Alto’s dedicated fertility specialists are here to answer your questions, guide you through your first injections, and work with your physician to ensure your egg freezing or IVF treatment plan is followed correctly. Visit us at alto.com/fertility or reach out via phone, text, or the app to learn more. 

Following prevention guidelines like mask-wearing, social distancing, and handwashing is still the surest way to stay safe. In addition, here are seven strategies to follow during the COVID-19 pandemic if you have asthma.

Seven Strategies for People with Asthma During COVID-19

As COVID-19 infection rates surge across the country, asthma is making its way into news headlines. Research published in the Journal of Allergy and Clinical Immunology at the end of November suggests that people with asthma may be at reduced risk of contracting the coronavirus. 

The researchers stressed that further study is needed, and possible explanations are still being explored. But the news may be welcome for people with asthma—a chronic lung condition that causes inflammation in the airways—who are facing an additional threat to their lungs from COVID-19, which primarily affects the respiratory system.  

This singular study is no reason to relax on preventative measures, however. The CDC has warned that those with moderate-to-severe asthma who do contract COVID-19 may be at a higher risk of serious complications, including asthma attacks, pneumonia, and acute respiratory distress.

Following prevention guidelines like mask-wearing, social distancing, and handwashing is still the surest way to stay safe. However, in addition to doubling down on these efforts, here are seven strategies to follow during the COVID-19 pandemic if you have asthma:

Right now, prevention is still our best defense against serious illness from COVID-19. Though rising infection rates may mean that restrictions will tighten in the short term, eventually, the gradual phases of reopening will begin again. Remember that most reopening guidelines center on those who are not at a higher risk of COVID-19 complications. Anyone who is considered high risk due to age or an underlying medical condition, including moderate-to-severe asthma, should continue to take extra precautions as reopening in their area unfolds and adhere to the CDC’s recommendations for their specific condition. 

The coronavirus can survive on some surfaces for hours or even days; however, surface transmission does not seem to pose nearly as significant a risk as person-to-person contact. Nevertheless, the CDC advises cleaning high-touch surfaces regularly. 

This recommendation can present an issue for people with asthma. Many chemical sprays used to clean indoor spaces can trigger an asthma attack—a sudden onset of inflammation in the airways that can cause difficulty breathing, coughing, wheezing, and chest tightness.  

If possible, ask someone else in your household to disinfect surfaces and objects for you. If you need to take care of it yourself, be sure to choose disinfectants that are less likely to trigger an asthma attack. The Environmental Working Group (EWG) provides recommendations for green cleaning products and includes asthma safety ratings. 

When using cleaners or disinfectants inside, open as many doors and windows as possible. Use only the amount of product recommended on the label and follow the instructions carefully. It can also help to use wipes or a dampened towel rather than a spray to avoid inhaling aerosols while cleaning. 

The CDC recommends keeping an emergency supply (30 days’ worth) of your asthma medications on hand so you don’t risk running out if you need to quarantine, become sick, or otherwise can’t make it to the pharmacy. 

If you fill your prescription with Alto, we want to assure you that we are fully prepared to deliver your asthma medications throughout the COVID-19 pandemic. We offer free, contactless drop-offs with every single prescription, so you’ll receive your refills on time from the comfort and safety of home. 

There has been misleading information circulating online about inhaled corticosteroids (i.e. Flovent, Qvar, Pulmicort, and Asmanex)—a standard asthma treatment—possibly increasing the risk of contracting COVID-19. At the same time, other articles suggest ICS as a potential treatment for COVID-19. 

Experts are clear: there is not enough evidence to prove these assertions, and discontinuing treatment or misusing medications poses a real danger to people with asthma. If you have any concerns about your medications, continue to use them as prescribed, and reach out to your healthcare provider. Alto’s pharmacists are also on call to answer your questions by phone, text, or in-app chat. 

The symptoms of an asthma attack (wheezing, shortness of breath, chest tightness, and coughing) bear some similarities to the emergency warning signs of COVID-19 (trouble breathing, pain or pressure in the chest, confusion, and bluish lips or face)

If you’re experiencing asthma symptoms that do not respond to your treatment plan or symptoms that could indicate COVID-19 infection, seek immediate medical attention. For more information on the common symptoms of COVID-19 and other seasonal respiratory illnesses, read “Cold, Flu, or COVID-19? Your Seasonal Symptom Guide.” 

Find Ways to Cope with Stress and Anxiety

We are living in undoubtedly stressful times. Stress and strong emotions can be asthma triggers, so it’s essential to find ways to cope with anxiety during the pandemic and beyond. 

It’s impossible to avoid stress altogether, so don’t fall into a pattern of stressing about your stress. It’s much more helpful to regularly check-in with your emotional state and take steps to course-correct when you begin to become overwhelmed. 

Meditation, movement, healthy sleep habits, and social connection are effective ways to become more resilient during stressful situations. You might also consider practicing mindful breathing or another relaxation technique that you can use to calm your body and mind during a stressful situation. Your chosen method can be as simple as gradually lengthening and deepening your breathing or mentally telling each part of your body to relax. 

Leaning on the support of friends and family can help reduce stress and provide a sense of safety. However, if stress and anxiety become difficult to manage, don’t hesitate to reach out for professional help. The CDC offers this list of resources for finding a counselor in your area. 

When it comes to medical advice, rely on your healthcare provider, not the internet. Our understanding of how the coronavirus works is changing every day, so falling down a rabbit hole of outdated information could cause unnecessary anxiety. Stick to reputable, timely sources like the CDC, and always consult your doctor if you have any concerns.

Our team of patient care pharmacists at Alto is also available to chat if questions come up. We’ll make sure that you’re always able to access the medications you need throughout COVID-19—with free home delivery. Reach out any time via text, phone call (1-800-874-5881), or in-app messaging.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

Lesbian, gay, bisexual, transgender, and queer parents-to-be have many options to become parents today. In this blog post we'll share an overview of the options as well as how Alto can help you in the path to parenting.

A Guide to LGBTQ+ Family Building

Assisted reproductive technology (ART) has expanded the paths to parenthood for all types of family structures. Whether exploring fertility as a single person, within a couple, or as a family unit, parenthood is now possible for more people than ever before.

A 2018 study found that 48% of LGBTQ+ millennials (aged 18-35) were actively planning to grow their families, compared to 55% of non-LGBTQ+ millennials. Researchers noted that this gap had narrowed significantly compared to older generations—the result of advances in technology and the movement for equality. 

Still, LGBTQ+ families confront unique challenges in an industry that often fails to center their needs. However, as more and more LGBTQ+ people seek to become parents through ART, the face of fertility is shifting. 

Lesbian, gay, bisexual, transgender, and queer parents-to-be have many options to become parents today, including using a donor or surrogate for one or more components of biological conception (eggs, sperm, and uterus).

That being said, many options come with formidable costs so determining how to pay for treatment is an important part of planning. Family Equality Council shares this list of family-building grants that can help make ART more affordable. Your clinic may also offer financial assistance programs and payment plans. If prescription fertility medications are part of your treatment, we’ll comb through the available discount and rebate programs to ensure you get the lowest possible price. 

To clarify which of the many paths-to-parenthood might be right for you, it can help to seek out an organization such as Family Equality Council that can provide specialized advice for LGBTQ+ families. It’s also essential to choose a clinic and doctor who can understand your needs and put you at ease. 

For LGBTQ+ couples exploring using a donor, it’s also essential to research the laws in your state regarding legal parentage procedures after your baby is born. For a starting point, you can learn about the laws in your area through Movement Advancement Project’s interactive ART law map; however, you should also speak with an experienced LGBTQ+ family lawyer in your state. 

Every budding family follows a unique path. It may include natural conception, adoption, foster care, or ART. For those considering the latter, here are some of the places your ART journey might take you. 

For those whose bodies cannot produce sperm or are experiencing infertility, a donor can be used. There are two ways to obtain donor sperm: from someone you know or from a sperm bank.

If you use a known donor—often a friend, family member, or other acquaintance—it’s crucial that you fully discuss the relational complexities involved and consult with a lawyer who specializes in working with LGBTQ+ families in your state. When choosing an unknown donor through a sperm bank, the donation’s legalities are less complex because the donor has already surrendered their parental rights. 

If you or your partner plan to carry the pregnancy, donor insemination is the process of placing the donated sperm inside the vagina or uterus to facilitate fertilization. There are two methods of insemination that may be used: 

Intrauterine insemination (IUI) is a simple medical procedure performed by a medical doctor where the sperm is placed directly into the uterus by using a very small tube passed up through the cervix.

With intravaginal insemination (IVI), the sperm is placed directly into the vagina. You can often perform IVI at home; however, many people choose to have a medical professional complete the insemination to increase the chances of success. 

Parents-to-be who were not born with ovaries or are experiencing infertility can use an egg donor. Like with sperm donors, an egg donor can be a known donor or be found through an agency. Again, when using a known donor, be sure to thoroughly discuss the arrangement’s details and consult with a lawyer who specializes in working with LGBTQ+ families in your state.

With both known and unknown egg donors, the egg must be fertilized in a lab and placed in a uterus through a medical procedure known as in vitro fertilization (IVF). 

Intended parents who cannot or will not be carrying the pregnancy for any reason can use a gestational carrier. The gestational carrier will have the embryos (eggs fertilized by sperm) transferred into their uterus, then carry and deliver the baby.

Choosing a gestational carrier is a critical decision that can take time. After all, your relationship will last the better part of a year. An agency can help you meet and screen candidates until you find the right match. 

IVF  is one of the most common fertility treatments. It involves combining an egg and sperm in a laboratory dish then transferring the resulting embryo into a uterus. IVF can be performed with donor sperm, donor eggs, or donor embryos. 

Reciprocal IVF, also known as co-maternity, is a specific instance of IVF where one partner provides the egg and the other carries the pregnancy. In this way, one partner is genetically related to the child while the other becomes biologically bonded through pregnancy. 

Egg or sperm freezing, also known as cryopreservation, is available to preserve future fertility for those looking to delay pregnancy or undergo gender affirmation treatment. Because gender affirmation treatment may affect fertility, it’s important to discuss the possibility of freezing your sperm or eggs with your doctor before undergoing treatment if you may want children who share your DNA in the future. For those currently undergoing Hormone Replacement Therapy (HRT), there may still be options available to preserve your fertility. Talk with your doctor about which choices may be right for you. 

There are many routes available to expand your family. Ultimately, every journey has the same destination in mind: the beautifully chaotic, utterly unique, yet completely universal journey of parenthood.

As you assemble a team you trust to guide your path forward, we’ll be here to support you if prescription medications become part of your plan. Our team of specialists has experience working with the LGBTQ+ community and receives training on how the nuances of the fertility experience may vary for each individual. We’d be happy to manage your medication needs so you can focus on your family during this life-changing time. Visit us at alto.com/fertility or reach out via phone, text, or the app to learn more. 

Last year, we built a feature to show patients all of their medication pricing options, including when paying cash might be cheaper. Here are two surprising trends we've discovered since.

Two Engineers Crunch the Numbers: When Is It Cheaper to Pay Cash for Your Medication?

Tom Cahill and Ashley Qian, Sr. Software Engineers

In 2019, we launched a streamlined flow in our patient app to handle a surprising scenario: when the out-of-pocket price for a medication is less than the insurance copay.

Since launching our price selection feature last year, we've saved thousands of patients money by bringing this disparity to their attention. On average, patients save 30% off their total copay when their out-of-pocket price for a medication is cheaper than the insurance copay. The average savings per prescription is $23.30. 

While several factors impact how drug pricing works, here are two trends we’ve seen in the data so far.

These Two Therapeutic Classes Are Most Likely to Be Cheaper Out of Pocket

A therapeutic class is a method of categorization that groups medications based on the conditions that they are intended to treat. Here's what we found when we aggregated prescriptions by therapeutic class:

Across the 394,367 prescriptions we examined, roughly 0.5% had lower out-of-pocket costs. Comparing different therapeutic classes, anti-parasitic drugs (example: permethrin) appear most likely to have a cheaper out-of-pocket price by a fairly wide margin at 2.94% of cases. Cardiac/cardiovascular drugs (example: rosuvastatin calcium aka Crestor) and blood medications (example: tranexamic acid) stand out as well with over 1% of cases.

Looking at the results in terms of median percentage savings, a few classes stand out as having a fairly high disparity between prices: anti-histamines, contraceptives, anti-neoplastics and anti-infectives. 

Brand Medications Are Less Likely to Be Cheaper Out of Pocket

You're up on Family Feud, and Steve Harvey asks you to name some differences between brand-name and generic medications. The first thing that probably comes to mind is cost: In general, one expects generic medications to be cheaper than their brand-name alternatives. We might expect brand name medications to incur higher copays and thus a larger opportunity for Alto to provide savings. However, we see a surprising trend in our data:

In fact, only .01% of brand name medications we've delivered since shipping this feature had lower out-of-pocket prices (compared to .6% for generics).

So what gives? The cash price we’re able to offer for a medication is mostly determined by the cost we paid a wholesaler or manufacturer to buy it. The copay set by insurance plans, however, is often impacted by behind-the-scenes negotiations between the drug manufacturer and the pharmacy benefit manager, or PBM. As a result, the cash price isn't always strongly correlated with the insurance copay:

Among a set of equivalent products, the one with the cheapest cash price might not be the one with the lowest insurance copay, and that difference can be significant enough to make it worthwhile to forego using insurance.

As engineers who are tasked from time to time with investigating issues with our billing system, we've experienced our fair share of bewilderment at the surprising outcomes we sometimes see. The complexity of pricing is why we've invested so heavily in making sure both our internal tools and patient-facing applications present users with the information they need to understand their options and make well-informed decisions.

We have countless opportunities to help our patients achieve better health outcomes, save money, and be more informed about their choices when it comes to their medication. There’s a lot of exciting work to do, and if this sounds interesting to you, please reach out to us on LinkedIn. We’d love to hear from you!

Here’s our best advice for coping with the stress of uncertainty and keeping the spirit of the season alive from home. 

Staying Healthy During a Challenging Holiday Season

The holiday season has a way of stirring up equal parts stress and cheer. We eagerly anticipate cherished traditions and festive gatherings while taking on a dizzying array of tasks—from shopping to decorating to making travel plans. 

But this year, we’re not simply falling into familiar patterns of holiday stress. As experts urge us to limit holiday gatherings due to a new wave of COVID-19 infections, many of us are contemplating whether we should hold tight to our traditions or honor a simple holiday at home.  

The month of December is often rife with temptations to overcommit, overindulge, and overspend. This year, we have a rare opportunity to simplify our to-do lists and cut ourselves some slack. Rather than trying to do it all, find ways to incorporate your favorite traditions without piling on the stress. 

If you love the spirit of gift-giving but feel stressed about the financial burden, you might try crafting homemade presents or setting up a family gift exchange. Similarly, if you daydream all year about the holiday meal but feel hopeless about cooking it yourself, consider supporting a local restaurant offering your favorite dishes to-go. 

We put a lot of pressure on ourselves to create picture-perfect holidays. But our upcoming celebrations may look very different from past years. Challenge yourself to let this season be a little messy. Experiment with ways to keep your favorite traditions alive and cultivate the spirit of togetherness from afar.

Sure, you might burn your first attempt at grandma’s famous cookies, or your family video call might cut out, but try to see the beauty—and the humor—in this year’s small setbacks. After all, laughter has been shown to decrease stress hormones and positively impact overall health. 

The holidays coincide with the darkest days and coldest weather of the year. Seasonal affective disorder (SAD) is a mood disorder triggered by the winter gloom that can cause depression, fatigue, and social withdrawal, despite the season’s insistence on holiday cheer. 

If you find yourself with a case of the winter blues, research has shown that bright lighting can uplift your energy and mood. Try to expose yourself to sunlight every day. The sun’s rays stimulate the production of serotonin—a brain chemical known to increase feelings of happiness and well-being. 

You may also want to consider stringing up your holiday lights, even if you’re not expecting company. Psychology experts confirm that brightly colored lights and festive decorations can have a positive effect on our mood. 

It’s natural to feel a sense of loss over missed family traditions, but try not to dwell on what this holiday won’t have. Instead, focus your attention on what you’re thankful for this year. 

Expressions of gratitude cause our brains to release dopamine and serotonin, two mood-enhancing brain chemicals that promote feelings of pleasure and reduce stress. Whether you recount happy moments from your day or share appreciation for the people you encounter, remembering that good still exists during difficult times is a powerful stress reliever. 

Limiting this year’s holiday gatherings is one way to prioritize your and your loved ones’ health. However, it’s also essential to make time for self-care practices that reduce the physical effects of stress. 

In the short term, stress actually boosts the immune system. When our bodies are in fight or flight mode, we’re more prone to injuries that we need to heal quickly. It’s chronic stress that eventually puts enough strain on the body to have the opposite effect: increasing inflammation and reducing our ability to fight off infection. 

Make sure to get adequate sleep, stay active, and eat well. Not only will these habits help keep your immune system strong, but they also support physical and emotional resilience. A deep breathing practice can help you lower stress hormone levels and boost your resistance to infection. 

There are many deep breathing techniques, but the crucial element is to move beyond shallow chest breathing and allow the air coming through your nose to fill your lungs until your lower belly rises. You can practice while lying down or standing in line at the grocery store for an instant dose of relaxation.

Many of us are making difficult choices this holiday season. Just remember that we may be back to packed social calendars and travel itineraries by next year. The choices we make now will support many wonderfully chaotic holiday seasons to come. 

We want you to stay safe and avoid long pharmacy lines this holiday season, so we offer free, contactless delivery with every prescription. If you have questions, our team is available 9 am - 9 pm PT Monday - Friday, and 10 am - 6 pm PT on weekends; reach out via phone, text, or the app.

Staying Healthy During a Challenging Holiday Season 

As you gear up for a flurry of gift-giving and family video calls, there are a few important healthcare items to prioritize on your ever-lengthening to-do list. 

Your End-of-Year Health Checklist

The holiday season can descend with the sudden force of a blizzard, seemingly blanketing the world in twinkly lights and festive cheer overnight. Though this year we can’t gather together in the usual ways, many of us are still anticipating a hectic season full of reimagined traditions. As you gear up for a flurry of gift-giving and family video calls, there are a few important healthcare items to prioritize on your ever-lengthening to-do list. 

If you have money in a flexible savings account (FSA), it won’t roll over at the end of the year, meaning any unused funds will be lost. Make sure to spend those dollars before the deadline on December 31st. If you have prescriptions that are ready to be refilled, that’s a great way to use your available funds. 

Don’t forget—your year-end FSA receipts are available for easy download under “Payment Details” within the Alto app and your online account. No need to hang on to unruly paper receipts. We’re keeping track of your prescription spending details for you.  

Even if you’re not traveling for the holidays this year, the final weeks of December can be a whirlwind. Take stock of your prescription medications now to ensure that you’re covered through the season’s celebrations. If you have a refill due around holiday time, you might consider setting up your delivery window a little early to avoid forgetting in the midst of your holiday fun. 

If you’re planning for extended travel and need to adjust your refill dates accordingly, reach out and let us know as soon as possible. We will do our best to coordinate with your insurance so you can focus on getting from point A to point B. 

Many of us look forward to the onset of the new year as a chance to start fresh or make healthy changes. However, those changes may be less welcome when they involve your medical costs. Here are two variable to keep in mind that may affect your healthcare spending in the new year: 

With most health plans, your deductible—the amount you are responsible for paying out of pocket before your insurance starts covering the costs—resets on January 1st. As you put together your holiday budget, you may want to plan for a temporary uptick in medical costs until your 2021 deductible has been met. 

Insurance companies often update their medication coverage and pricing at the start of each year. We’ll always show you your out-of-pocket costs before you confirm your delivery window and we’re here to help you re-examine your options if you have any concerns. 

Don’t let last-minute prescription worries diminish your holiday cheer. Take care of these end-of-year details now so you can immerse yourself in the spirit of the season—no matter where it takes you. As always, we’ll be here to help coordinate refills, schedule deliveries, and find the lowest price on your medications. If you need support, we’re just a call, text (1-800-874-5881), or in-app message away. 

In this article, we’re going to focus on the where, why, and how of storing your insulin medication safely.

Taking Care of Your Insulin

For those living with type 1 diabetes and for many with type 2, taking insulin is a part of daily life. That’s because people with diabetes either do not produce insulin on their own or their bodies cannot use it effectively. For more on the role insulin plays in the body and essential facts about how it’s used as medication, we recommend reading, “Understanding Insulin: The Basics.” In this article, we’re going to focus on the where, why, and how of storing your insulin medication safely.

Insulin is one medication you can’t just toss into your medicine cabinet. That’s because insulin is a protein dissolved in water. Like any protein, your insulin can spoil if it isn’t kept cool. However, unlike the mystery food container at the back of your fridge, spoiled insulin won’t make you sick. The danger is that your medication may be rendered ineffective, causing your blood glucose levels to climb higher than you expect. 

For that reason, most of the storage guidelines detailed below revolve around temperature and expiration date. The bottom line: treat your insulin more like a perishable food item than your run-of-the-mill medicine stash. 

You should always store new or unopened insulin in the refrigerator (at a temperature between 36°F and 46°F). Take a peek at the expiration date listed on your medication and place it in your refrigerator as soon as you can. It’s important to discard your insulin once it reaches its expiration date, even if it is unopened.  

To ensure your insulin is not subject to temperature fluctuations in the refrigerator, getting a temperature sensor may be a good idea. Also, try to store your insulin on the center shelf—the area most consistent with the thermostat setting—rather than on the top shelf or door compartments.

Whenever you receive a new type of insulin, review the instructions for your specific prescription with your pharmacist. If you fill your prescription with Alto, you can check your medication’s details and instructions at any time in the Alto app or your online account. Plus, our care team is always a quick text, in-app chat, or call away.

Since injecting cold insulin can be uncomfortable, it’s okay to keep the open vial, cartridge, or pen you are currently using at room temperature (between 56°F and 80°F) for about a month. 

In general, you will need to discard your insulin 28 days after opening it, but be sure to check the information provided with your specific medication or reach out to your pharmacist to confirm. Label your vial, cartridge, or pen with the date you first open it so you’ll have no problem remembering when it’s time to throw it away. 

Always check both the original expiration date listed on your medication and the date of opening before every use. Do not use expired insulin. You should also inspect your insulin before every use, looking for any changes in color or clarity as well as any crystals or clumps. If you notice changes or have any doubts, use a new vial, cartridge, or pen. 

While you’re on the move, it’s still essential to keep your insulin from getting too hot or too cold. You want your insulin to remain between 36°F and  80°F. Keep in mind, even if the temperature outside isn’t extreme, your insulin can quickly heat up if left in a parked car or intense sun.  

If your insulin has been frozen or exposed to extreme heat, you should not use it—even if it has cooled back down or thawed. There’s a high probability that your insulin will be ineffective, and a blood sugar spike could catch you off guard. 

Carry your insulin with you in an insulated bag (remember—treat it like perishable food) and keep all your medication supplies in your carry-on if you’re traveling by plane, train, or bus. It’s always a good idea to make sure your prescription label is visible, especially if you’ll be going through airport security.

No one wants to stand in line at the pharmacy month after month. But insulin’s temperature sensitivity doesn’t lend itself well to being shipped through the mail—you don’t want it spending hours sitting on your doorstep or the back of a mail truck.

When you choose Alto for your prescriptions, we’ll deliver your insulin by hand using temperature-controlled packaging. You can choose a delivery window when you know you’ll be available to receive your package and place it in the refrigerator right away. We’ll monitor your medication’s temperature as it makes its way to you, and you can track our progress the whole way via text message or the app. Best of all, our delivery service is completely free. 

We’re here to make managing your insulin prescription easy. Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; reach out via phone, text or the app.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

The Disproportionate Impact of HIV in America

It has been a year full of seismic shifts. A series of core-shaking events ranging from a global pandemic to an upwelling of the Black Lives Matter movement has exposed deeply entrenched inequities in our society. 

We need only look at the statistics emerging from the COVID-19 pandemic to see these inequities at work. According to the CDC, Americans who are Black, Hispanic/Latinx, American Indian, and Alaskan Native are nearly three times more likely to become infected with COVID-19 than white Americans and approximately five times more likely to be hospitalized due to infection. 

Rather than being an anomaly, studies have revealed a health gap between white Americans and Americans of color so wide that it has been named a public health crisis. This divide is perhaps most evident in the disproportionate impact of the HIV epidemic.

The Story of HIV, Told Through the Numbers

Advances in HIV treatment and prevention over the past several decades are reason to feel hopeful. The number of people infected with HIV each year has plummeted by more than two-thirds since the height of the epidemic in the 1980s, and we’ve dramatically transformed the outlook for those living with HIV. However, our efforts to combat the HIV epidemic have stalled in the face of a serious issue—HIV prevention and treatment are not accessible to everyone who needs them. 

According to the CDC, Black Americans are the most affected racial or ethnic group with a lifetime HIV risk of one in twenty for men and one in forty-eight for women (compared to an overall risk of one in ninety-nine for all Americans). Gay and bisexual Black men have been hit hardest of all: it’s estimated that if current infection rates continue, one in two will contract HIV in their lifetime. Gay and bisexual Hispanic/Latino men face a similarly distressing statistic, with an estimated one in four at risk of HIV infection. 

These numbers paint a bleak picture, yet Jonathan Mermin, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, offers hope. “As alarming as these lifetime risk estimates are,” he says, “they are not a foregone conclusion. They are a call to action.”

There is a complex set of socioeconomic factors—such as income, housing, and occupation—that impact a person’s risk of contracting HIV and affect the quality of care they receive. In the United States, HIV infections are mainly concentrated in urban areas and among those of a lower socioeconomic status. 

Like COVID-19 and HIV, poverty rates in the United States reveal clear racial and ethnic disparities. The data shows that one in four Black Americans and Native Americans live in poverty and one in five Hispanics/Latinos. For white Americans, the number is one in ten. 

There are significant barriers to accessing quality healthcare for those living in poverty, including financial insecurity and fear of discrimination. Many services that help to decrease HIV transmission rates—such as prevention education, substance abuse counseling, STI treatment, and antiretroviral therapy (ART)—remain mostly out of reach for these communities. In this way, the people who are most vulnerable to HIV infection continue to face an ever-growing risk. 

An HIV diagnosis today is vastly different than it once was. With antiretroviral therapy (ART), a person living with HIV can suppress the virus and stop the progression of HIV disease. Not only will maintaining viral suppression help them stay healthy, but it also means they will have effectively no risk of transmitting HIV to others. 

For those at risk of infection, pre-exposure prophylaxis (PrEP), an HIV prevention method available by prescription, can virtually eliminate that risk. However, unless we ensure HIV prevention, testing, and treatment are widely available and affordable, we will continue to see tens of thousands of new infections year after year. 

Want to learn more about PrEP? We explain the basics in “All About PrEP for HIV Prevention.”

These are significant issues to tackle, but we can each do our part by talking with our doctors if we’ve never had an HIV test or if we think we may be at risk of infection. We can support organizations like NMAC and Black AIDS Institute that work to make HIV services more accessible to communities of color. And we can encourage our elected officials to help fight HIV through government funding and programs. 

Lastly, we should avoid perpetuating the fear and stigma that’s often associated with HIV. When we talk about HIV openly and neutrally, we help create a culture where everyone feels safe to seek testing and care. 

Looking for a supportive partner to help manage your HIV medications? We’re here for you. You can reach out and talk with an HIV specialist between 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; call or text 1-800-874-5881, or download the mobile app for secure messaging.

Managing your health during the pandemic is a long game. Here are five important heart health strategies to put into play during the COVID-19 pandemic.

Your Heart Health Playbook During COVID-19

What We Know about Heart Health and COVID-19

We mostly hear about how COVID-19 affects the lungs. But any serious viral infection can put stress on the heart by forcing it to work faster and harder as the body mobilizes to defend itself. Even more troubling, COVID-19 infection can cause blood clots in the heart’s arteries or attack and weaken the heart muscle itself. 

Anyone who is already managing high blood pressure or heart disease should take the potential for damage to their cardiovascular system seriously. Just don’t let vigilance and caution spiral into fear. While the gravity of the link between COVID-19 and cardiovascular health should not be understated, there are proactive ways you can support your heart and protect yourself from infection. 

Remember—managing your health during the pandemic is a long game. It’s crucial that you continue to take your medications as prescribed and receive necessary medical care. With this in mind, here are five important heart health strategies to put into play during the COVID-19 pandemic.

Five Heart Health Strategies During COVID-19

For months now you’ve been wearing a mask, social distancing, and avoiding crowded areas whenever possible. We know it hasn’t been easy, but keep it up. According to Penn Medicine cardiologist Helene Glassberg, MD, “The number one thing is to continue what you're doing, which is staying at home when possible, practicing safe distancing, and seeking medical attention if you're having problems.” Dr. Glassberg also recommends exercising caution as states experiment with loosening restrictions, advising, “Stay the course for as long as you can to stay well.”

There have been conflicting news reports involving some blood pressure medications and COVID-19. Despite what you might have read, don’t stop taking your medications without consulting your doctor. Not only is that never a good idea, but several recent studies indicate that there is no cause for concern when it comes to these medications. 

The confusion stemmed from the fact that two common classes of blood pressure drugs, known as angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs), affect the same pathways in the body that the coronavirus takes to reach the lungs and the heart. Multiple types of both medications are available—commonly prescribed ACE inhibitors include lisinopril, captopril, and benazepril, while common ARBs include losartan, valsartan, and azilsartan. 

For a while, experts were unsure if these shared pathways meant that these medications might either help or harm people with the virus. According to Harvard Health, three different studies have found no evidence of harm for people infected with COVID-19 who continue to take ACE inhibitors and ARBs. While there is still research to be done, experts recommend that people already taking these medications should continue to do so. 

The same advice goes for any medications or lifestyle interventions that your doctor has prescribed. If anything, it is more important than ever to remain diligent with your cardiac care plan and stay in communication with your doctor. 

The prospect of sitting in the waiting room at the doctor’s office can be anxiety-provoking right now. While avoiding the doctor might feel like a safe choice in the short-term, skipping your appointments or ignoring symptoms could mean putting yourself at risk of serious health issues like heart attack and stroke, and increasing the danger of complications should you be exposed to COVID-19. 

Talk with your doctor about what safety measures have been put in place to protect you from COVID-19 exposure during your visits. Together you can assess the risks and create a plan to continue monitoring your blood pressure and heart health. Telehealth, which allows you to meet with your doctor via phone or video, may be an option and is often covered by insurance. 

If you pair virtual doctor visits with free hand-delivery of your prescription medications through Alto, you can avoid both the waiting room and long lines at the pharmacy. Transferring your prescriptions to Alto is easy and free—we’ll take care of the work for you. We’ll ask you to choose a convenient delivery window, and one of our couriers will bring your medications straight to your door at no additional cost. We can even provide completely contactless delivery if you prefer. 

Don’t Drop the Ball on Your Healthy Habits

Even though we’ve been at it for months, staying motivated to keep up healthy habits from home can still be a struggle. The stress and anxiety so many of us are feeling right now may affect our energy levels or cause us to lose interest in our usual activities. When facing distressing news reports or personal hardship, it’s tempting to self-soothe in various unhealthy ways. It’s okay to indulge sometimes, but try not to slide too far into less healthy coping mechanisms for the sake of your heart and your emotional well-being.

Blog

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IVF and Egg Freezing: What to Expect and How to Prepare

Seven Strategies for People with Asthma During COVID-19

A Guide to LGBTQ+ Family Building

Two Engineers Crunch the Numbers: When Is It Cheaper to Pay Cash for Your Medication?

Staying Healthy During a Challenging Holiday Season

Your End-of-Year Health Checklist

Taking Care of Your Insulin

The Disproportionate Impact of HIV in America

Your Heart Health Playbook During COVID-19

Diversity At Alto: Building an Inclusive Healthcare Company and Culture

An Inside Look at a Sales Career with Alto

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