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Alto Pharmacy Technician

Alto Pharmacist

It’s official: Alto Pharmacy is a great place to work! We’re honored to join the community of Great Place to Work-Certified™ companies based on team member feedback and a rigorous assessment of our company’s culture and benefits.

Join us in delivering our industry-leading pharmacy care to millions of people across the country. As a member of the team, you’ll play an integral role in improving our customers’ quality of life and redefining what’s possible in pharmacy. 

Be Part of a Great Place to Work — Join Our Team

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

Read the latest Alto blog posts covering healthcare, family health, managing diseases, and other Alto highlights.

Blog | Alto Pharmacy

At Alto, we’re obsessed with our mission to improve quality of life for everyone who needs the help of medicine. Our mission guides us in all we do and every decision we make. 

Our mission and diversity work are tied together with one word from our mission -- everyone. Too often, only those with significant resources access the best and benefit from innovation in healthcare. We see it everyday in the data. Too many among us continue to struggle with solvable challenges, in our own wellbeing and in the larger healthcare system. These statements and environments have existed in the workplace as well, influencing the products, services, and policies that steer how the organization works for all of us.  Our work is to make Alto different.  Our work is to build and sustain an inclusive culture.  Our work is to attract, develop, reward and retain talent from all the communities we serve as patients and build a product that supports everyone. 

Today marks another step in our diversity, equity, and inclusion journey as we release our first annual diversity report. We share it because this work is central to our mission and in doing so, we use transparency to hold ourselves accountable, as well as hopefully play a part in raising expectations and norms throughout the healthcare and technology industries.

In 2020, across the company we saw a 13ppt increase in women and 7ppt increase in underrepresented groups (Black, Hispanic/LatinX and Native professionals).

As for women in leadership, we saw increases of 3ppts in Women Managers and 1ppt in Product, Engineering and Design driven by both hiring and promotion. At the leadership level, 32% of leaders identify as women.

In 2020, we saw 10ppt increase across our underrepresented managers to 13% Black, 16% Hispanic/LatinX, 2% Native/Indigenious.  In the leadership group, we saw an 8ppt increase to 15% Black and 2% Hispanic/LatinX. 

In 2020, we also established our Alto Advisory Board and our first two anchor members, who will help guide Alto towards our mission, advise on key decisions, and support strategic initiatives. We’ve formed the Advisory Board to support our leadership as we navigate the regulatory landscape, launch new features to modernize the pharmacy experience, and adhere to the highest standards of operational excellence and patient care.  

Dr. Hildreth is the President and Chief Executive Officer of Meharry Medical College, one of the nation’s oldest and largest private historically Black academic health sciences centers. He received his Bachelor’s degree from Harvard University, his Ph.D. in immunology from Oxford University as a Rhodes Scholar, and his medical degree from Johns Hopkins School of Medicine. He was the first Black American in the 125-year history of Johns Hopkins School of Medicine to earn full professorship with tenure and is internationally known for his influential HIV research.

Jennifer Kent served as the Director for the California Department of Health Care Services, where she led the second largest public healthcare system in the nation, with an annual budget of over $100B and serving over 13 million Californians. She oversaw the administration of 24 managed care plans as well as 56 county behavioral health plans. She has also held leadership roles in the Health & Human Services Agency, Governor's Office and has experience in the private sector as a lobbyist, consultant, and association executive. She has more than 15 years of health administration and policy experience in California.

Alto created our DEI strategy with our team aligned to four pillars – Hire, Include, Develop, and Invest.  Each pillar's actions tie to our people and our business. This means the return on investment is clear and goals are aligned to business outcomes.

Medical Health Care Premiums and Part Time Health Care Benefits in SF: 

In order to increase access and affordability to critical health-care services, we asked our broker to offer a special mid-year open enrollment 2020, reducing premiums for most plans by 5%. We reduced out-of-pocket maximums and speciality office visits by an average of 37%. We reduced co-insurance as well as costs for labs, x-Rays, and emergency room visits for our Cigna plan by 50%. Finally, prescriptions copays were reduced by 25% for Brand medications and 75% for Generic prescriptions. This benefits the employee with direct access to care and a better employee experience as compared to direct contribution to the city fund.

We increased our paid parental leave across all US locations to 8 weeks (up from 6 in 2020) for all parents requesting leave as of January 1st.  Throughout 2020 parents and other caregivers were impacted significantly as schools, daycare, and caregivers were closed, isolated, or unable to rely on pre-covid support. We offered laptops to parents who couldn’t afford them for each child to participate in remote learning.  We offered expanded benefits above and beyond FFCRA. Finally, we offered paid sessions for remote learning, tutoring, and experiences for parents and caregivers.

Finally, in December we launched Modern Health with 6 paid coach/therapy sessions and access to a digital wellbeing library and resources to all Altoids.

We launched six ERGs in 2020. Formalizing the work of our original Diversity Committee into six groups: Umoja (Black), Auténtico (LatinX/Hispanic), Women, Proud (LGBTQIA+), Asian/Pacific Islander, and Working Parents. These groups are focused on building community with both those who identify and allies. They support our education, development and investment in our communities. Each has been given a budget, an executive sponsor, and access to other company resources.

We recognized as a leadership team that we needed to educate ourselves. We were not going to rely on those from underrepresented communities to educate us. We embarked on four three-hour sessions focused on learning about diversity and inclusive language, naming our privilege, and starting the work each of us wanted to do. It was only after these sessions, with clear self-awareness and awakening; that began the work of empowering other leaders -- managers and other Altoids on this journey. There is more work to be done, as Neil Frye, Chief People Officer, mentioned in his blog post in late 2020 -- this is not a sprint, nor is it a marathon; it is life-long work.

Focus on Latinx Senior Manager to VP talent; with targeted outreach, activation and networking for opportunistic and open hiring

Expand employee resource group events throughout the year supporting inclusive environment, educating and investing in our communities

Get to full participation in DEI Workshops and launch additional sessions like What’s My Privilege and Moving to Action across the company

Explore new partnerships with Community & Higher Ed Institutions (i.e. Historically Black Colleges and Universities, Hispanic Serving Institutions, etc.)

2020 Diversity, Equity & Inclusion Report

Starting Monday, February 1, residents of the greater Houston metro area can now choose Alto’s same-day doorstep delivery for their pharmacy needs.

Hello, Houston!

Alto’s launch in the Houston market extends our industry-leading patient care model to Texas.

Starting Monday, February 1, residents of the greater Houston metro area can now choose Alto’s same-day doorstep delivery for their pharmacy needs. 

At Alto, we believe it’s our job to ensure you have your medications at the best price, on time and with the support you need. We bring pharmacy to you - no more waiting in line, making an extra trip, or finding out your prescription isn’t ready to be picked up after you’ve already arrived. Our free doorstep delivery means your medications come directly to you on the day and time you select, and most medications are available the same-day. Stay up to date on your courier’s progress with text alerts or in our mobile app. 

Starting a new medication or doing an injection for the first time? Message a pharmacist with your questions, even in the evenings and on weekends. And we’re a full service pharmacy - we stock all major brand, generic, over-the-counter and specialty medications, meaning your entire family’s pharmacy needs can be managed in the Alto app and coordinated into one delivery.

12:30 - 3:30 pm CT (1:00 - 4:00 pm CT for outlying areas) 

6:00 - 9:00 pm CT (7:00 - 10:00 pm CT for outlying areas) 

2:00 - 5:00 pm CT (3:00 - 6:00 pm CT for outlying areas)

Houston area residents interested in using Alto’s services for their medication needs can ask their doctor’s office to send all prescriptions to Alto Pharmacy (via ePrescribe, phone or fax). 

Have existing prescriptions at another pharmacy? Start a transfer online or give us a call at 1 (800) 874-5881, and we’ll handle the switch. 

Need to pick up? Our pharmacy is located at 4950 Terminal Street, Suite 200, in Bellaire.

General customer support hours are Monday - Friday 8:00 am - 11:00 pm CT and Saturday - Sunday 9:00 am - 8:00 pm CT. Patients can reach out to Alto via phone at 1 (800) 874-5881 or app.

Founded in 2015, Alto is a patient-centric digital pharmacy based committed to the health and wellbeing of you and your family. We provide free same-day delivery to your door seven days a week for prescriptions, but, more importantly, offer cost transparency, personalized in-app and phone support, and real-time coordination with doctors and insurance companies to get you the care that you need. Alto is headquartered in San Francisco with offices in Denver and Dallas, and currently delivers across the greater Bay Area, Los Angeles, Orange County, San Diego, Seattle, Denver, Las Vegas, New York City, Houston, Dallas, and Austin.

In May 2020, a major clinical trial found that injections of long-acting cabotegravir, an antiviral medication, were highly successful at preventing HIV when taken as a form of pre-exposure prophylaxis (PrEP). We take a closer look at the study to find out what’s likely giving cabotegravir the edge and what this means for the future of PrEP.

What We Know about Injectable PrEP for HIV Prevention

The world of HIV prevention is rapidly changing, with many milestones in recent years. PrEP, or pre-exposure prophylaxis, lowers risk of sexual transmission of HIV by 99% when taken daily, and has helped prevent many new infections since it was approved by the FDA in 2012. There are several FDA-approved oral options — Truvada®, Descovy®,  and a generic for Truvada — and as of December 2021, PrEP is now available as an injectable treatment option called cabotegravir (Apretude®).

Learn more about PrEP in All About PrEP for HIV Prevention.

Health experts believe this latest breakthrough could significantly increase PrEP use and adherence, as clinical studies found that cabotegravir resulted in 69% fewer new cases of HIV than Truvada, a daily pill. Read on to learn what this means for the future of PrEP.

Cabotegravir is a long-acting PrEP medication administered by injection every eight weeks. Prior to cabotegravir’s FDA approval, two parallel clinical trials assessed its safety and efficacy: HPTN 083 and HPTN 084. HPTN 083 looked at men who have sex with men (MSM) and transgender women, while HPTN 084 focused on cisgender women.

Each study randomly assigned participants to one of two arms: half were given a placebo injection and daily Truvada, while the other half received long-acting cabotegravir injections and a daily placebo pill. While both forms of HIV prevention medication are safe and effective, injectable cabotegravir was found to be 69% more effective at lowering HIV transmission rates among MSM and trans women and 89% more effective among cisgender women compared to the daily pill.

While the news about injectable PrEP is undoubtedly a reason for excitement, oral PrEP continues to offer highly effective prevention for anyone at risk of HIV infection. When taken as prescribed, Truvada® and Descovy® are highly effective at lowering risk of transmission. (The rate of HIV acquisition in the studies was low overall, providing further proof of Truvada’s well-studied effectiveness.) However, many people find it difficult to remember to take a pill every day, and inconsistent use of oral PrEP can sharply reduce its effectiveness. The addition of a long-acting injectable form of PrEP offers an opportunity to improve adherence among those who have trouble with a daily regimen or simply find an injection every eight weeks preferable. 

As Debra Birnkrant, M.D., director of the Division of Antivirals in the FDA’s Center for Drug Evaluation and Research, said in December, “This injection, given every two months, will be critical to addressing the HIV epidemic in the U.S., including helping high-risk individuals and certain groups where adherence to daily medication has been a major challenge or not a realistic option.”

Alto is here every step of the way to make it as easy as possible to follow the treatment plan your doctor recommends. Our pharmacists have deep expertise in HIV treatment and prevention and can help you get started with oral PrEP. We will coordinate with your doctor and your insurance provider, if applicable, to ensure that you’re receiving the best PrEP option for your needs at the best price, and the Alto app can help you stay on track with tools like reminders and auto refills.

To learn more, reach out any time through Alto’s in-app messaging or phone at 1-800-874-5881.

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.

Editor’s Note: This post was originally published in 2021 and has been updated for accuracy and completeness.

Chronic obstructive pulmonary disease (COPD) is a long-term inflammatory condition that obstructs the airflow from the lungs. Here’s what you need to know about keeping your lungs healthy to avoid or manage COPD. 

Understanding Chronic Obstructive Pulmonary Disease (COPD)

The delicate, branching structures of the lungs bear a striking resemblance to trees. The air you breathe travels down your windpipe, or trachea, and enters the lungs through two large tubes known as bronchi. Just like the roots and limbs of a tree, these tubes divide again and again into smaller bronchioles before finally ending in clusters of tiny air sacs called alveoli—what you might consider the leaves. 

Chronic obstructive pulmonary disease (COPD) is a long-term inflammatory condition that obstructs the airflow from the lungs and makes it difficult to breathe. Although it's the third leading cause of death in the U.S., the good news is that it can be prevented and treated to slow the progression and maintain quality of life. Here’s what you need to know about keeping your lungs healthy to avoid or manage COPD. 

COPD refers to a group of progressive lung diseases, meaning the condition becomes worse over time. The most common are emphysema and chronic bronchitis, and many people with COPD have both of these conditions. 

Emphysema destroys the fragile air sacs in the lungs, which impairs the airflow. The air carrying carbon dioxide out of the body cannot be adequately expelled and some remains trapped in the lungs. Fresh, oxygen-rich air is then blocked from entering the lungs, causing gradually worsening shortness of breath, even while at rest.

According to the Mayo Clinic, most people with emphysema also have bronchitis, which causes inflammation and narrowing of the bronchial tubes. With bronchitis, mucus builds up in the lungs, spurring a persistent cough. 

The CDC reports that sixteen million Americans have trouble breathing due to COPD. However, they estimate that the actual number includes millions more who have not yet been diagnosed. 

In the vast majority of people with COPD, lung damage is caused by cigarette smoking. According to the COPD Foundation, about 90% of people with COPD are current or former smokers. However, damage can also be caused by long-term exposure to irritating gases or particulate matter, including air pollution and workplace exposure to dust, smoke, or fumes. 

An estimated five percent of people with COPD have a deficiency in a protein known as alpha-1-antitrypsin, which causes the lungs to deteriorate and can also affect the liver. People with severe asthma can also progress into COPD. 

The most telling—and distressing—symptom of COPD is difficulty breathing. According to the Mayo Clinic, another major symptom is a constant cough that produces a lot of mucus. Additional symptoms may include chest tightness, wheezing, frequent respiratory infections, and fatigue. Severe COPD can cause swelling in the ankles, legs, and feet and weight loss. 

As a progressive disease, symptoms often begin mildly and may be confused for the common cold. But rather than clearing up after a week or two, the coughing and shortness of breath will continue to worsen over time and make daily activities more difficult. 

Unfortunately, by the time COPD symptoms appear, there may already be significant lung damage. Symptoms will continue to escalate, particularly if smoking or exposure to lung irritants continues. With proper intervention and treatment, however, most people with COPD can slow the disease’s progression and maintain their quality of life. 

People with COPD often experience flare-ups known as exacerbations. During these episodes, symptoms become much more severe for several days or weeks and may require treatment with antibiotics, oral corticosteroids, and even hospitalization. 

Respiratory infections or inflammation triggers—such as air pollution, secondhand smoke, dusts, fumes, or other toxic substances—are common causes of exacerbations. Anyone who experiences a marked increase in coughing, difficulty breathing, or mucus in the lungs should seek immediate medical attention. 

The best way to prevent COPD is to never smoke or stop smoking now. Quitting isn’t easy for most people, so it’s a good idea to enlist your healthcare provider’s support.  They may recommend nicotine replacement products or medications that can help. 

The CDC offers a variety of resources that can help you quit smoking, including a free text message program (text QUIT to 47848) and their quitSTART app, which is available for both Android and iOS. The Mayo Clinic outlines ten tips to help you resist the urge to smoke that you may find helpful as you get started. 

It’s also important to avoid secondhand smoke exposure and occupational exposure to chemical fumes and dust. If you work with any type of lung irritant, the Mayo Clinic advises talking with your supervisor about the best ways to protect yourself, like using respiratory protective equipment. 

Staying active will not only improve your overall health; it will also strengthen your lungs. The American Lung Association recommends getting thirty minutes of moderate physical activity five days a week. Both aerobic and muscle-strengthening exercises will benefit your lungs, so you can include anything from brisk walking to weight lifting to vigorous household cleaning. 

Lastly, make sure to get your annual flu vaccine each fall, as well as a pneumococcal vaccine, to prevent infections that can weaken your lungs. 

While there is no cure for COPD, treatment can ease symptoms and lower the risk of complications like heart disease, lung cancer, respiratory infections, pulmonary hypertension, and depression. 

COPD can be treated with medications, supplemental oxygen therapy, and surgery. However, many people with mild forms of the disease may only need to quit smoking and avoid other inflammation triggers. 

The most common medications used to treat COPD include: 

Bronchodilators, which usually come in inhalers and relax the muscles around the airways to make breathing easier. 

Inhaled corticosteroids, which help to reduce airway inflammation and prevent exacerbations. 

Oral steroids are sometimes used in short courses during periods of exacerbation to prevent further worsening of symptoms.

Phosphodiesterase-4 inhibitors are used for severe COPD. These medications decrease airway inflammation and relax the airways.

Theophylline may be used when other treatments are ineffective or if cost is a factor. It may help improve breathing and prevent exacerbations but can cause side effects like nausea, headache, rapid heartbeat, and tremors.

Antibiotics may also be used to treat respiratory infections but are generally not recommended for prevention. 

Often, a combination of these medications is used to treat COPD. Inhaled medications are taken using a device called an inhaler, which allows the medication to be absorbed straight into your lungs. If you’re prescribed a new inhaler, one of Alto’s pharmacists can walk you through how to use it.  Not all inhalers work the same way, so learning the proper technique is crucial for ensuring adequate therapy.

People with COPD are also generally prescribed a pulmonary rehabilitation program. These individually tailored programs combine exercise, nutrition advice, and counseling to prevent exacerbations, slow the progression of symptoms, and improve quality of life.

Those with insufficient oxygen reaching their blood may benefit from supplemental oxygen therapy. It involves using a lightweight, portable device to deliver oxygen directly to your lungs as needed.

Surgery may be an option for those with severe COPD, particularly severe emphysema. It’s usually reserved for when other types of treatment have failed. 

Because breathing is so elementary, it’s easy to take it for granted. But so many of the activities we enjoy—and life itself—depend on the healthy function of our lungs. 

When breathing becomes difficult, life can change drastically, so it’s important to find support. That may mean sharing your feelings with a close friend or family member, joining a support group for people with COPD, or enlisting the help of a mental health professional. 

Above all, it’s critical to follow your treatment to avoid worsening symptoms. At Alto, we want to make getting the COPD medications you need as easy as possible, so we offer free hand-delivery, automatic savings investigations, and user-friendly medication management through our website and app. We always have a team of pharmacists on-call to answer your questions by phone, text, or chat, and we’ll even remind you when your inhaler or other medications are due for a refill, then schedule a time to drop them off. 

If you’re interested in learning more about how Alto can support your COPD treatment plan, our team is available from 9 am – 12 midnight ET Monday – Friday, and 10 am – 9 pm ET on weekends. Download the mobile app for secure messaging or call 1-800-874-5881. 

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.

Continuous glucose monitoring (CGM) devices are designed to make diabetes treatment less burdensome. Here’s how it works, who it benefits most, and how you can go about getting a CGM device for yourself. 

Using Your Continuous Glucose Monitoring Device

Diabetes is known as a silent disease because it often advances gradually and nearly imperceptively. Without treatment, diabetes causes abnormally elevated blood sugar levels, a condition that can eventually have life-threatening consequences. The problem is that the signs and symptoms of high blood sugar are often so subtle that they fly completely under the radar. 

For a more in-depth explanation, read, “What’s the Difference between Type 1 and Type 2 Diabetes?”

The Little Device Providing Round-the-Clock Diabetes Care 

To slow the disease’s progression and minimize serious complications, most people with type 1 and type 2 diabetes must use a device to monitor their blood glucose levels regularly. If their blood sugar is too high or too low, medications or lifestyle interventions must be used to keep it within a safe range. People with diabetes can live long and healthy lives by keeping their blood sugar in check. However, it’s not always easy for those with more advanced conditions who may need to test their blood sugar multiple times a day. 

Continuous glucose monitoring (CGM) devices are designed to make diabetes treatment less burdensome on people who require frequent glucose testing or who are on intensive insulin therapy with tight blood sugar control. Here’s how it works, who it benefits most, and how you can go about getting a CGM device for yourself. 

Before CGM, self-monitoring of blood glucose involved using a traditional blood glucose meter (BGM), which provides a single reading by pricking a finger for a sample of blood. CGM devices, on the other hand, collect glucose readings every five minutes throughout the day via a sensor worn on the body with a tiny wire that is inserted under the skin. Rather than testing blood, it measures the amount of glucose present in the fluid between cells, known as interstitial fluid. 

There are several types of CGM devices approved by the FDA for use in the United States. Generally, they consist of a subcutaneous sensor with an attached transmitter, which sends wireless data to a receiver, such as a monitor or mobile app. By taking approximately 288 readings per day, CGM devices can reveal patterns not easily captured by a single finger prick. 

CGM devices also use past data to predict dips or spikes in blood sugar and alert a wearer to take corrective steps. Data is recorded over time, allowing both the wearer and their healthcare providers to monitor blood glucose fluctuations and identify patterns that can help them make better decisions about nutrition, medications, and other lifestyle factors. 

While CGM can have significant advantages for people with both type 1 and type 2 diabetes, it isn’t the right choice for everyone. The devices can be costly and aren’t always covered by insurance. 

However, CGM can be a gamechanger for those who need to test their blood sugar frequently throughout the day. Not only will they avoid the discomfort of multiple finger pricks, but they may also find that the supplies needed for a traditional BGM are actually more costly than a CGM device over time.

It’s important to note that using a CGM device does not mean that you will no longer need to prick your finger at all. Some models may need to be calibrated using a traditional fingerstick glucose meter to ensure accuracy while getting used to the new device.

If you are curious about using a CGM device, your doctor can help you weigh the pros and cons and decide whether it’s the right choice for you. Should you choose to move forward with CGM, your doctor will need to prescribe one of the several FDA-approved devices available.

Once you’ve received your CGM device, you’ll need to insert the sensor just beneath your skin using the provided applicator. Typically, sensors are placed in the abdomen or upper arm. You should be sure to cleanse the insertion area with soap and water or alcohol first and carefully follow the instructions provided with your device. The applicators are designed to make the whole process quick and simple. 

The sensor will remain in place for several days before it needs to be replaced. The exact duration will depend on your model. Recently, a new type of sensor was developed that must be inserted by your healthcare provider but can remain in place for ninety days. Talk with your doctor about which option is best for you. 

If you are using a receiver, you will need to keep it within five to eight feet of the sensor. As long as it remains within range, the sensor will transmit data to the receiver throughout the day and night, usually every five minutes.  Some devices use Bluetooth or cloud-based technology to send glucose readings directly to compatible smartphones or tablets, eliminating the need for a separate receiver.

An alarm will sound if your glucose level goes above or below the target range you’ve set. The monitor or mobile app will also display a line graph showing how your glucose level has changed over the past several hours. 

Your CGM device can also predict future glucose levels based on past data. Arrows on the screen will indicate which direction your glucose level is heading. Over time, this real-time flow of information can help you become more aware of how diabetes affects your body. For example, you might discover that your glucose levels fluctuate after eating certain foods or engaging in strenuous exercise. In addition, your healthcare provider can also use the data to adjust your insulin dosing and optimize your overall diabetes regimen. 

With all this information may come confusion at first. You should expect a bit of a learning curve as you get used to CGM. Alto’s care team and pharmacists are always an easy in-app message or phone call away should you have any questions as you learn the ins and outs of your device. In no time at all, you’ll find yourself switching out sensors and analyzing trends with ease. 

Heart disease is the leading cause of death for women in the United States. Here’s what our pharmacists think every woman should know about protecting and supporting their hearts. 

What Every Woman Should Know About Heart Health

We’re used to seeing dramatic Hollywood depictions of heart attacks in men. But heart disease is the leading cause of death for women in the United States. The American Heart Association reports that one woman dies of heart disease every minute in America. 

Harvard Health reports that this “heart attack gender gap” can have serious consequences for women. With less awareness of crucial heart-health risk factors and warning signs, many women lack effective prevention strategies or delay life-saving care. 

Though heart disease is deadly, it is also largely preventable. Making heart health part of the conversation for women has the power to save lives. Here’s what our pharmacists think every woman should know about protecting and supporting their hearts. 

The first step in building a heart-health strategy is understanding your individual risk for heart disease. Make sure to undergo any necessary screenings, and discuss risk factors like high blood pressure, high cholesterol, smoking, and age with your doctor at your annual checkup. You’ll want to go over your lifestyle and family history and identify your key health numbers, such as blood pressure, cholesterol, and blood sugar levels. 

According to the American Heart Association, research has uncovered a link between heart disease and pregnancy-related complications. Talk with your doctor if you were diagnosed with diabetes or hypertension during pregnancy or if you had an early delivery. These factors may increase your risk of cardiovascular disease in the future, so it’s essential to be aware and take steps to mitigate that risk. 

All women must understand the signs of a heart attack and the importance of seeking immediate medical attention. Research suggests that women tend to downplay symptoms and delay treatment—a life-threatening issue during a heart attack when every minute counts. 

According to the CDC, the most common signs of a heart attack for both men and women are chest pain or pressure; sharp pain in the jaw, neck, or back; and shortness of breath. However, only about 60% of women experience chest pain or discomfort during a heart attack. Studies suggest that women are more likely to experience less recognizable symptoms like nausea, dizziness, cold sweats, and unexplained fatigue. 

If you experience any discomfort in your chest or upper body or simply feel that something isn’t right, it’s crucial to seek emergency medical attention. Treatment is most effective if given within one hour of the onset of symptoms, so take these symptoms seriously and do not delay care. 

The CDC reports that approximately 200,000 preventable deaths occur each year in the United States due to heart disease and stroke. That’s why it’s so important to put heart-health strategies into place early. Try to augment your diet with plenty of vegetables, fruits, healthy fats, and fiber-rich whole grains while limiting sodium, saturated fats, alcohol, and sugar. Aim for balanced nutrition that you can maintain over time; a little dietary leeway is your best bet for success in the long term. 

Numerous studies have connected poor sleep to heart disease. Not only does a lack of sleep put stress on the body, but it also makes you less likely to exercise and make other healthy choices. If you constantly find yourself cutting back on sleep to tend to your to-do list, it’s time to prioritize rest. 

The American Heart Association recommends getting seven to nine hours of sleep every night to help your body function at its best. Smartphones and other screens are known to disrupt sleep if used at bedtime, so try to power down as early as you can. You might also try using a blue-light blocking filter on your devices at night. Apple devices have a built-in blue-blocking function called “Night Shift,” or you can try out popular apps like Twilight or f.lux. 

It’s also vital that women find ways to manage stress in their daily lives. According to the Mayo Clinic, women's hearts are impacted by stress and depression more than men’s. Stress causes inflammation in the body, which has been linked to heart-health risk factors like high blood pressure and lower “good” HDL cholesterol. It also negatively impacts sleep and may make you less likely to exercise and eat well. 

A comprehensive report on “Stress in America” by the American Psychological Association found that exercise and listening to music were the most popular stress reducers for both men and women. However, women are more likely to find social and sedentary activities relaxing, such as spending time with friends or reading. While daily physical activity is a crucial heart-health strategy, it’s also essential for women to reach out to their social networks and find time to relax and unwind. 

Last year, Harvard Health reported on a recent study, which suggested that women are less likely to be prescribed aspirin, statins, and certain blood pressure medications than men. Experts attribute this discrepancy, in part, to the general lack of awareness about heart disease in women, which can cause both healthcare providers and patients to miss critical warning signs. 

All men and women, regardless of age, should routinely visit their doctor for the necessary heart-health screenings. During these visits, ask your doctor about your individual risk for heart disease, and discuss the risks and benefits of taking cardiovascular medications, if necessary. It’s also crucial to listen to your body and not minimize or explain away any early warning signs of heart trouble. Take any symptoms seriously and seek immediate help. 

While it’s essential to be your own advocate when it comes to your health, we’re here to support you with exceptional pharmacy care every step of the way. If you are prescribed medications for your heart, our pharmacists would be happy to walk you through dosage instructions and answer your questions. We’ll look for any available savings so you can be sure you’re getting the lowest price, and we’ll deliver your medications to your home for free. Simply tell your doctor to send your new prescription to Alto or contact our care team, and we’ll transfer your existing prescriptions for you. 

Here’s what you need to know about potential changes to your coverage when your plan updates on January 1st. 

What You Need to Know About Your Insurance in the New Year

With a new year comes new insurance benefits, copay costs, and deductible resets. Here’s what you need to know about potential changes to your coverage when your plan updates on January 1st. 

It is common for insurance companies to adjust their rates and offerings each year and then allow people to select new plans or renew their current coverage. The process enables insurers to update their plans based on inflation, the introduction of new medications, and other market changes. It also provides each of us an opportunity to assess and adapt our health insurance needs every year. 

If you had health insurance this past year, you likely went through an “open enrollment” period in the fall. During that time, you learned how your plan was changing and which key benefits would continue. You then had the opportunity to renew your current plan for another year or switch to a new option altogether. 

Why are insurance renewals important right now?

Most health insurance plans operate on a calendar year, meaning any changes take effect on January 1st. We recommend reviewing any recent changes to your plan to avoid unwelcome surprises later. 

Which insurance updates might impact me the most?

As you review your yearly changes, you’ll want to make special note of the following, as these updates could affect your budget: 

Your premium is the cost of your health insurance plan each month. It’s common for your premium to change slightly from year to year, so be sure to double-check if yours is going up.

Your deductible is the amount you have to pay for healthcare services before your insurance starts to help cover the costs. For example, if your deductible is $2,500, you will need to pay that amount for covered services on your own before your copay kicks in. Some plans have a combined deductible, covering both medical and prescription costs, and other plans will have a separate deductible for prescription medication costs.

Your deductible resets at the beginning of the year, which could mean a significant uptick in your healthcare expenses until you spend enough to cover your deductible. Make sure to budget accordingly. 

Your copays and coinsurance—the amount you’ll owe for healthcare services after you’ve exceeded your deductible—may also change. Different types of health services can have different copays, so look closely at the ones you think you’ll use most often. 

A formulary is a list of generic and brand-name medications that are covered by your insurance company. The list includes tiers that indicate which medication versions are preferred by your insurer and therefore offered at a lower out-of-pocket cost for you. 

If you have current prescriptions, you’ll want to make sure that your plan still covers your specific medications. You may also want to find out if there is a cheaper version of your medication available that you can discuss with your healthcare provider. If you fill your prescription with Alto, we’d be happy to investigate the options for you and let you know if there are alternatives that could lower your costs. 

For more on decoding common insurance terms, we recommend this helpful glossary from JDRF. 

What can I do if I find out my medications are more expensive?

Combing through insurance updates can be confusing, especially if you discover that you have to pay more for your medications this year. If copay changes and deductible resets affect your out-of-pocket expenses, we’ll search for any available savings, so you’ll know you’re getting the lowest price. 

If your insurance company requires a written request from your doctor to keep you on the same medication because of formulary tier changes, we’ll work with your doctor to proactively file the paperwork. Plus, we’ll keep you informed the whole way. 

Read more about prior authorizations and how we can help here. 

Yes! Your updated health insurance plan may come with new benefits that can save you money and enhance your health. Look for bonus perks like free annual exams and preventative care; discounts on fitness and nutrition programs, gym memberships, chiropractic care, and massage; savings on health products; and reduced vision care rates. Often, people forget to use these benefits, which can mean money left on the table.

As you make your health plan for the coming year, don’t forget the benefits of choosing a better pharmacy. With a simple switch to Alto, you’ll get insurance support, price investigations, and your medications hand-delivered for free. Plus, you can call or message our pharmacists any time for quick advice. If 2021 saw you waiting in line or on hold to access pharmacy support, let this be the year that the care you need comes directly to you.

Ready to switch to a better pharmacy? Our team is available to answer your questions from 9 am – 12 midnight ET Monday – Friday, and 10 am – 9 pm ET on weekends; reach out by in-app secure messaging or phone.

Editor’s Note: This post was originally published in January 2021 and has been updated for accuracy and completeness.

If you’re considering fertility treatment for the first time, it’s important to understand the financial hurdles you may be facing. In this article, we’ll explore some of the financial options available and how we at Alto can help. 

Managing the Costs of Fertility Treatment

For hopeful parents who are struggling to conceive, the costs of pursuing fertility treatment can often seem insurmountable. Though assisted reproductive technology (ART) makes it possible for many people experiencing infertility to become parents, the emotional and financial stakes are high. 

If you’re considering fertility treatment for the first time, it’s important to understand the financial hurdles you may be facing. However, there are ways to manage or lower the costs so you can move forward on your path to becoming a parent. In this article, we’ll explore some of the financial options available to intended parents pursuing ART and how we at Alto can help. 

If You Have Health Insurance, Start There

Unfortunately, not all insurance plans cover fertility treatments. As you dig into your plan’s details, you may find that some options are covered with contingencies, while others are not covered at all. It’s best to contact your insurance provider for an in-depth explanation of your fertility coverage. 

Be prepared to ask questions about whether your plan covers diagnostic testing, medications, treatments, and consultations. Ask if there is a cap on coverage or a waiting period required to try certain treatments. You want to walk away with a comprehensive understanding of what your out-of-pocket costs might be.

Several states have enacted legislation that requires insurance providers to cover infertility treatments. The American Society of Reproductive Medicine maintains this online database with information by state.

Many fertility clinics now offer no- or low-interest financing. As you seek out the clinic that’s right for you, inquire about what cost-assistance services are available. It’s perfectly reasonable to seek out a clinic that makes you feel confident and fits your budget.

There are also companies that provide personal loans specifically for fertility treatments, with flexible monthly payment options. At Alto, we’ve worked with companies like Lending Club, CapExMD and Origin Finance to help our customers get the fertility medications they need. (Great news: the Origin application fee is waived for Alto customers!)

Most companies allow you to apply online and some even provide budgeting tools on their websites so you can get an idea of what your monthly payments might be. 

There are grants available through government programs, nonprofits, and private companies that can help cover fertility treatment costs. Many are designed to benefit intended parents who demonstrate financial need while others were created to support specific groups, such as veterans or the LGBTQ+ community. There are even some that will award money to those willing to share their infertility story. 

These grants won’t usually cover all of your costs, but they can provide a significant boost. CoFertility keeps a database of fertility grants and other funding opportunities, as does RESOLVE: The National Infertility Association. 

Fertility medications can represent a significant portion of your total treatment costs. At Alto, we’ll always advocate for you to ensure you get the lowest possible prices on your medications. We’ll run a thorough insurance benefits investigation and if your insurer requests a prior authorization, we can work with your doctor’s office to submit it on your behalf. Plus, we’ll remind you to collect any available manufacturer rebates with a monthly email.

If you’re uninsured, we can help you apply for income-based assistance programs like the Compassionate Care Program offered by EMD Serono. Even if you are still in the planning stages of your fertility journey, the earlier you can apply to the program, the better. Ideally, you will want to have approval before your fertility prescriptions are sent to your pharmacy. 

We accept ACH (direct) payments and offer a one percent discount for anyone who prefers this option over using their credit card. And don’t forget—with Alto, delivery of your medications is always completely free.

With mail-order pharmacies, you usually have to order your fertility medications all at once to ensure your precisely timed doses don’t get hung up in the mail. Because it’s difficult to predict exactly how much medication you will need, you often end up ordering excess. Not only will these leftovers add to your out-of-pockets costs, but you’ll also end up with wasted medication that you'll have to dispose of when you're done with treatment.

When you fill your prescriptions with Alto, we’ll hand-deliver your medications from our local fulfillment centers. That means we can deliver your medications every few days, avoiding overorders and minimizing how much you spend. 

Finally, we know that your time is the most valuable resource you have, so we’re focused on giving as much back to you as we can. Send us a simple message through the Alto app when you have a question, and keep all your medication information—plus expert advice—at your fingertips using our mobile app. You can also schedule refills and track your shipments from our pharmacy to your doorstep in real time. If you suddenly need to add a day of injections, there’s no need to stress or go running to the pharmacy. We’ll handle the details and coordinate delivery to your doorstep. 

If you’re interested in learning more, you can request a price quote online. Our care team and fertility specialists would be happy to answer your questions about navigating fertility medications. We know that the start of your ART journey can feel full of uncertainty, but we’re here to do whatever we can to make the process easier and more affordable. 

For more on choosing the right fertility pharmacy for your journey, read, “What to Consider When Selecting a Fertility Pharmacy.”

While it’s not always possible to predict the course of your fertility treatment, it can be helpful to set goals and parameters. Is there a maximum number of in vitro fertilization (IVF) cycles you’re willing or able to try? Are there other options you’d like to pursue first, such as intrauterine insemination (IUI)? What are the scenarios where you might try using donors or a gestational carrier, or consider fostering or adoption?

Once you have an idea of your budget, coverage options, and potential out-of-pocket costs, create a roadmap that outlines your treatment goals in relation to your financial, physical, and emotional well-being. 

Remember—dealing with infertility issues can take an emotional toll, especially if some options feel out of reach financially. Know that you are not alone, and there is a community of other hopeful parents you can lean on. Support groups like RESOLVE and The Fertility Tribe offer virtual meetups and online community groups. It’s also essential to lean on loved ones for emotional support during this time. The journey you’re taking isn’t easy, but you certainly won’t be walking it alone. 

Would you like to learn more about how Alto can help you manage your fertility treatment costs? Visit alto.com/fertility or give us a call at 1-800-874-5881. Our team is available 9 am – 12 midnight ET Monday – Friday, and 10 am – 9 pm ET on weekends. We’re ready to be your partner through it all, from your first cycle to your last. 

Whether you’re pregnant, trying to conceive, or thinking about adding to your family, experts recommend starting to take a prenatal vitamin right away. Here’s what you should know if you’re ready to take a prenatal vitamin for the first time.

What to Look for in a Prenatal Vitamin

Whether you have recently found out that you are pregnant or are just starting to consider the possibility, prenatal self-care can feel a lot more complicated. Everything you do now has implications for two (or more!). 

The good news? A simple prenatal vitamin can help put your mind at ease. It’s one of the easiest and most effective ways to ensure you get the key vitamins and minerals needed to nourish your baby through a healthy pregnancy. 

Whether you’re pregnant, trying to conceive, or thinking about adding to your family, experts recommend starting to take a prenatal vitamin right away. By beginning early, you’ll help seed your body with the nutrients it needs for the earliest stages of fetal development. Here’s what you should know if you’re ready to take a prenatal vitamin for the first time.

With a wide range of over-the-counter prenatal supplements to choose from, we recommend consulting with your healthcare provider about the ideal choice for you. In some cases, your doctor might even prescribe a prenatal vitamin based on your unique nutritional needs. If you’re starting to do your research, here are the key nutrients your doctor will likely recommend supplementing. 

As you tour the ingredient label on any prenatal supplement, folic acid should be your first stop. This B vitamin helps the body make new cells and prevents congenital disabilities that affect a baby’s brain and spinal cord. 

Folic acid’s role in fetal development is crucial, so the CDC recommends all women of reproductive age take at least 400 micrograms per day. Birth defects of the brain and spine, known as neural tube defects, usually occur during the earliest weeks of pregnancy, often before many women know that they are pregnant.  

You will find that most over-the-counter prenatal supplements contain between 400 and 800 micrograms of folic acid. Sometimes, your provider may want you to take a little more, however any product with 1,000 micrograms of folic acid or more requires a prescription. 

You may also see this vitamin listed as “folate,” a general term for vitamin B9. Folic acid is a synthetic version of folate that is more stable when exposed to heat and easily absorbed by the body. 

Iron is a mineral that helps your body make blood cells that supply oxygen to your growing baby. It also helps prevent anemia, which occurs when your blood has too few healthy red blood cells. Your body needs more iron than usual during pregnancy because your total blood volume increases. The Mayo Clinic recommends supplementing with 27 milligrams of iron a day. 

Developing babies need calcium for bone growth. If you’re not getting enough, your own bone density could suffer. The general guideline is to take 1,000 milligrams per day while pregnant or nursing, which is the equivalent of three to four servings of dairy. Calcium can also be found in greens like spinach and broccoli. If you’re concerned that you’re not getting enough calcium in your diet, be sure to look for this mineral in your prenatal supplement. 

Vitamin D helps with calcium absorption and bone growth. The Mayo Clinic recommends that you get 600IUs of Vitamin D per day. 

Omega-3 fatty acids include docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). These essential fats support heart and neurological health. DHA, in particular, is known to support fetal brain development. 

While dietary sources like fatty fish are the best source of omega-3’s, this can present an issue if you want to limit fish consumption while pregnant. Some fish contain high levels of mercury, which can impair brain development in babies. For that reason, researchers at the Women's and Children's Health Research Institute advise that you take the recommended 200 milligrams of DHA a day in supplement form. 

The Mayo Clinic also suggests looking for a prenatal vitamin that includes vitamins C, A, and E; B vitamins; zinc; and iodine. Penn Medicine created this helpful chart to find the recommended daily allowance while you’re pregnant or lactating, but it’s important to consult with your doctor about your needs. 

The Mayo Clinic cautions against taking extra doses of your prenatal vitamin or doubling up on multivitamins as this could be harmful to your baby. You should always take your prenatal vitamins as directed by your doctor. If you forget to take a dose, don't worry, there is no need to double up. Just take your next dose at your regularly scheduled time.

A quality prenatal vitamin combined with a healthy, balanced diet is the best way to ensure your body and growing baby get all the nutrients they need. Talk with your healthcare provider to develop a plan to eat well and supplement your nutrition before and during pregnancy. 

Prenatal vitamins pack a powerful punch, which can make them tough to stomach for some people. The iron in prenatal vitamins can cause constipation, so it helps to drink plenty of fluids, get physical activity daily (if your healthcare provider gives you the okay), and eat more fiber. If constipation becomes a problem, talk with your doctor. Trying another form of iron or a stool softener can help with constipation. 

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What Every Woman Should Know About Heart Health

What You Need to Know About Your Insurance in the New Year

Managing the Costs of Fertility Treatment

What to Look for in a Prenatal Vitamin

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