Shop Alto Essentials to add pharmacy products to any delivery!

Your partner in navigating the ins and outs of prescriptions — at no extra cost.

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

The term “donut hole” refers to a gap in Medicare Part D prescription medication coverage. Once this coverage gap starts, you will likely pay more out of pocket for your medications. Here’s what to know about the Medicare donut hole, including how it may affect the cost of your prescription medications this year.

The Medicare Donut Hole, Explained

Medicare is a federally-run health insurance program for people age 65+ and people with disabilities, regardless of income. It is different from Medicaid, which is a state and federal program that provides health coverage if you have a very low income.

Part A: coverage for inpatient hospital visits and skilled nursing facility services

Part B: coverage for physician and outpatient hospital services and durable medical equipment (DME) costs, including insulin pumps, blood sugar test stips, some continuous glucose monitors (CGMs), nebulizers, and oxygen equipment

Part C, also known as Medicare Advantage (MA) plans: offered by private insurance companies to provide the same benefits as Medicare Parts A and B; many also offer prescription coverage similar to Part D

Part D: coverage for prescription medications that are commonly dispensed from the pharmacy including respiratory medications and injectable insulin; may cover insulin patch pumps; you can change Part D plans each year

Part D plans have an annual coverage gap known as the donut hole. Once this begins, you will pay more for your medications until you reach the yearly limit on out-of-pocket costs.

The donut hole begins when your Medicare plan has paid a certain amount toward your prescription medications in a given year. This is sometimes referred to as the initial coverage limit. In 2022, the initial limit for prescription drug coverage on Medicare Part D plans is $4,430/year, an increase from $4,130 in 2021. 

Once in the donut hole, you become responsible for no more than 25% of your medication costs until you hit a certain out-of-pocket threshold and can exit the donut hole. For example, if a medication’s total cost is $100 and you pay a $20 copay during the initial coverage period, you will be responsible for paying $25 — 25% of $100 — while in the donut hole.

The out-of-pocket threshold is the amount of money you have to spend out of pocket before you are allowed to leave the donut hole. In 2022, the out-of-pocket threshold for Part D plans is $7,050, an increase from $6,550 in 2021.

The following count toward your total out-of-pocket costs while in the donut hole:

Out-of-pocket expenses for generic and brand-name medications

After you’ve reached the out-of-pocket threshold, you receive “catastrophic coverage.” During this time, your share of medication costs will drop significantly to either 5% of a medication’s cost or a small copay — whichever is higher.

The minimum copay for a one-month supply of generic medication for Medicare Part D plans in 2022 is $3.95, and the minimum copay for a one-month supply of brand-name medication is $9.85.

Medicare Extra Help offers financial assistance with monthly premiums, annual deductibles, and copay costs related to prescription medications. Eligibility is income-based. Those who receive Medicare Extra Help will not enter the donut hole.

To qualify for the program in 2022, annual income is limited to $20,385 for an individual or $27,465 for a married couple living together.

For more information on Medicare and the donut hole, we suggest exploring the following resources.

www.medicare.gov - includes live chat and 1-800-MEDICARE (1-800-633-4227)

The Medicare and You Handbook - includes key deadlines for enrollment and details on coordinating third party coverage from former employers, the military, and Veterans Affairs.

The Medicare Plan Finder - a trusted source for comparing Medicare coverage options.

Your choice of pharmacy can significantly impact the cost of your medications. At Alto, we prioritize your financial wellness alongside your physical health. Here are some ways we go above and beyond to ensure that you’re receiving your medications at the lowest price possible.

We research all your pricing options once we receive a prescription. If it is cheaper to pay cash for your medications, separate from insurance benefits, we’ll let you know so that you can make an informed choice.

We automatically search for potential sources of savings like manufacturer coupons, patient assistance programs, and copay cards and apply them when applicable. If we find any options that require you to apply directly with the program or manufacturer, we’ll let you know.

We continue searching for less expensive medication options even after we’ve researched savings opportunities, coordinating with your doctor to evaluate these options.

To get started or learn more about Alto, call 1-800-874-5881 or reach out through 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.

For the 25 million individuals living with asthma in the U.S., preparing for a trip or time away from home involves a few extra steps. It’s important to pack carefully and make sure you have everything you need to manage your asthma, including medication and medication delivery devices. Additionally, since environmental triggers can worsen certain types of asthma, researching your location and carefully planning your activities and accommodations is key.

A Guide to Traveling With Asthma

Use the suggestions below to prepare for your next trip and read our previous blog, Managing Your Medications While Traveling, for more on what to consider when traveling with medication.

Travel doesn’t always go as expected, so bring more of your asthma medication than you need. Plan ahead to refill your medication in advance of your trip, if needed. If you are prescribed both a quick-relief medication and a longer-term control medication, make sure you have enough of both. Depending on the severity of your asthma symptoms, you may want to order a medical identification bracelet.

Depending on your plans, you may wish to consult with your healthcare provider to discuss how your upcoming travel may impact your overall health or your asthma treatment needs. Ask if there are any recommended vaccines for your trip. 

An asthma action plan documents your individualized treatment plan. It should include what steps to take if your asthma symptoms intensify, a list of your medications and dosages, and your doctor’s contact information. If you have an existing asthma action plan, make sure it’s up to date. If you don’t already have one, work with your doctor to create one before your trip.

View the American Lung Association’s guide on creating an asthma action plan.

Before departing for your trip, review the details of your health insurance plan. Check whether your plan covers doctor’s appointments or emergency visits to a hospital or urgent care in another state or country.

If you are traveling internationally, be mindful that prescription laws vary by country. It’s a good idea to contact the U.S. embassy of the country you’re visiting for more details. Some countries may only allow a 30-day supply for certain medications and/or require you to carry an official prescription or additional information from your doctor with you.

Allergic asthma accounts for approximately 60% of all asthma cases in the U.S. With this type of asthma, inflammation in the airways and the development of asthma symptoms occurs after exposure to allergens. Common allergens, or allergic asthma triggers, include household dust mites, pet dander, and pollen.

If you have allergic asthma, there are steps you can take before your trip to prevent a flare-up of symptoms. For example, when staying in a hotel, request a room that is non-smoking and pet-free. You can also anticipate exposure to pet dander while in transit by contacting your airline or train company and asking about their policies.

There are tools that share your destination’s pollen forecast, including Accuweather and Pollen.com.

Here’s a list of potential asthma medications and medication delivery devices to pack. Some may not be relevant for your treatment plan, and if you’re unsure what to bring, ask your care team. In addition, confirm which temperature your medications should be stored at and take those guidelines into account when packing.

Enough medication for your trip, plus extra

Medication delivery devices including a nebulizer or spacer (if applicable) - if you are traveling by plane, contact your airline in advance to learn how to pack your nebulizer. If traveling internationally, make sure your device will work with power outlets in your destination.

Your health insurance card and provider’s contact information

Medications should always be packed in your carry-on rather than a checked bag. While the U.S. Transportation Security Administration (TSA)’s current limit on liquids, gels, and creams in a carry-on bag is 3.4 ounces (100 milliliters), there are exceptions for medications. Give yourself extra time to allow for screening of these items. If you use a nebulizer, it will likely require additional screening.

Customs officials may ask for proof of your prescription records if your medications don’t have labels or are from another country. If you are traveling internationally, carry physical proof of your prescription to avoid any issues when passing through security or customs. A prescription label or a copy of your prescription will work. (For most inhalers, the prescription label is on the box rather than the inhaler itself.)

While many pharmacy apps allow you to show digital proof of prescription records on your phone, you should have a physical label or prescription copy in case you do not have internet access.

While at your destination, always carry your quick-relief medication with you in case of an emergency. Take appropriate precautions to limit your exposure to asthma triggers. If your allergic asthma symptoms are triggered by poor air quality and pollution, checking daily air quality reports — included on many weather apps and websites — can help you prepare. Avoid exposure to smoke as much as possible.

If you are visiting a location with high temperatures, be sure to stay hydrated and consume enough fluids.

Alto Pharmacy is here every step of the way to make it easy to manage your asthma symptoms and prepare for travel. Our team of pharmacists is available to answer questions about your asthma medications, and we offer free, same-day delivery and medication management tools like reminders and auto refills in our app.

Reach out by phone at 1-800-874-5881 or in-app messaging to learn how Alto can support your asthma treatment plan.

Living with type 1 or type 2 diabetes does not prevent a healthy pregnancy. Thanks to insulin therapy and effective blood sugar management options, many women with diabetes successfully navigate pregnancy, childbirth, and postpartum. While there are some pregnancy risks and challenges tied to type 1 diabetes specifically, careful planning and proactive diabetes management throughout pregnancy can keep you and your baby healthy.

Navigating Pregnancy With Type 1 or Type 2 Diabetes

Here’s an overview of what pregnancy with type 1 or type 2 diabetes may look like — from fertility to childbirth and beyond — to help you explore your family building options.

Many people with diabetes wonder how the condition will impact their fertility. Having diabetes does not mean you will have more difficulty conceiving. Consistently high blood sugar levels are the main way that diabetes can make it challenging to get pregnant. 

Some research has found that women with type 1 diabetes are more likely to have irregular menstrual cycles or delayed ovulation — factors that affect your fertility — but these health issues are also linked to elevated blood sugar. 

High blood sugar can be managed, and informing your doctor of your plans to build or expand your family early on can help you maintain healthy blood sugar levels before you start trying to conceive.

While every pregnancy carries the possibility of complications, type 1 diabetes is linked to the following.

Preeclampsia — Preeclampsia is a pregnancy complication characterized by high blood pressure that can result in liver or kidney damage. Women with type 1 diabetes may face a greater risk for this complication since they often have higher baseline blood pressure before pregnancy.

Insulin resistance — Hormonal changes during pregnancy can make your body less effective at using insulin, resulting in decreased glucose produced from the liver. (This can lead to the development of gestational diabetes in women without preexisting diabetes during pregnancy.) As the placenta grows, insulin resistance increases. This can affect your blood sugar levels.

Miscarriage — Women with type 1 diabetes have a higher risk for miscarriage — the loss of a baby before 20 weeks — or stillbirth — the loss of a baby after 20 weeks. Birth defects caused by high blood sugar may be a contributing factor.

Macrosomia — Macrosomia refers to a newborn with a higher-than-average birth weight, which can make childbirth more difficult for a mother.

Birth defects affecting your baby’s heart, brain, spine, kidneys, digestive system, limbs, and mouth

In addition, without effective diabetes management, pregnancy can intensify preexisting diabetes-related complications.

These risks are manageable, however, it’s important to prepare for pregnancy in advance of trying to conceive and to stay vigilant about diabetes management throughout this journey. Preconception planning allows you to work toward health goals and ensure that you have an appropriate care team and medication protocol in place.

When planning a pregnancy, consult your healthcare provider before trying to conceive to review your blood sugar levels, make any necessary adjustments to your treatment plan, and evaluate potential diabetes-related health complications. If you become pregnant unexpectedly, contact your provider as soon as you learn of your pregnancy to discuss blood sugar monitoring, medication changes, and other factors that can lower your risk of pregnancy complications.

Here are some action items to focus on in the months leading up to conception. This is intended to be a high-level guide. Consult your care team for a more individualized plan.

Your A1C levels are your average blood sugar levels over a period of two to three months. Your blood sugar levels can impact the development of your baby’s organs during the first 8-12 weeks of your pregnancy, so it’s even more important to maintain healthy blood sugar levels before pregnancy. As you plan for pregnancy, ask your doctor to clarify your A1C goals and how long to maintain them before you try to conceive.

Review your treatment plan and make necessary medication adjustments

Not all medications and supplements are safe to take during pregnancy. Speak with your care team about each medication and supplement you take before trying to conceive. Never stop taking a prescribed medication without first consulting your doctor.

Since there are considerations specific to type 1 diabetes during pregnancy, you may want to look for a healthcare professional who works at the intersection of diabetes treatment and maternal health.

Consider working with an endocrinologist — a physician who treats hormone-related conditions such as diabetes — who focuses on treating pregnant women with diabetes. Alternatively, some OB/GYNs have specialized training in managing diabetes during pregnancy.

You may also benefit from working with a diabetes educator, a healthcare professional certified to coach individuals living with diabetes. They can offer individualized guidance about navigating pregnancy with the condition.

Vigilant monitoring of your insulin needs and blood sugar levels is the most important thing you can do to have a healthy and safe pregnancy. As your pregnancy progresses, pay attention to changes in how much insulin you need. Many women with diabetes experience lower blood sugar during pregnancy. Continue to revisit your treatment plan with your care team and confirm the recommended dosage and frequency of insulin. 

There are diabetes supplies that can make it easier to check your blood sugar more frequently. Many pregnant women with diabetes use a continuous glucose monitor (CGM), an electronic device that collects glucose readings every five minutes throughout the day. Talk to your doctor to learn if a CGM is an appropriate option for you.

Most individuals with diabetes require more insulin throughout pregnancy since insulin resistance typically increases as your pregnancy progresses. You may find it helpful to use an insulin delivery method that eliminates the need for multiple daily injections such as an insulin pump. Additionally, an insulin pen allows for faster administration of insulin injections throughout the day.

Having a birth plan in place can help you prepare for any scenario during labor and delivery. Here is some diabetes-related information to include.

Who will monitor your blood sugar levels during and after labor and delivery?

What diabetes supplies do you need to pack in your bag, if delivering at a hospital or medical facility?

What is the procedure for women who use an insulin pump at your chosen hospital or medical facility? (if applicable)

What is the procedure for women who use a CGM at your chosen hospital or medical facility? (if applicable)

Blood sugar levels can fluctuate during labor and delivery. They often rise during labor but drop just before or immediately after delivery. Your care team can help you prepare for these possibilities. If using an insulin pump or CGM, speak with your doctor about protocol for continuing to wear these devices during delivery.

Many women assume that they will struggle with breastfeeding due to their diabetes. However, you can breastfeed while living with type 1 or type 2 diabetes. The condition may delay breast milk production but this should improve with time.

Keep in mind that breastfeeding takes up energy, which can affect your blood sugar levels and insulin needs. Some research has found that lactation can increase the risk of overnight hypoglycemia, or severely low blood sugar. Make sure that someone around you understands the signs of hypoglycemia and how to address it.

Above all, remember that you aren’t alone in navigating the challenges of type 1 or type 2 diabetes during pregnancy. In addition to your care team and loved ones, the following organizations can help you connect with other women who understand this experience.

Beyond Type 1 and Beyond Type 2 are global online communities for individuals living with diabetes.

JDRF is a destination for type 1 diabetes support and community, with opportunities to connect locally with those affected by type 1 diabetes.

A diabetes pharmacy partner you can rely on

At Alto, we make it as easy as possible to manage diabetes throughout your family building journey. We offer free, same-day delivery of medications and supplies right to your doorstep, and our dedicated diabetes team is here to answer any questions you may have.

Reach out any time via phone at 1-800-874-5881, or in-app messaging.

Pulmonary hypertension is a condition in which blood pressure in the arteries that lead from the heart to the lungs becomes too high. Over time, the increased pressure can strain the right ventricle — the chamber of the heart that pumps blood that is low in oxygen to the lungs — potentially increasing an individual’s risk for heart failure.

Pulmonary Hypertension, Explained

Though certain forms of pulmonary hypertension do not have a cure, there are effective treatment options that can ease symptoms and help improve your quality of life. Here’s what to know about recognizing and treating pulmonary hypertension.

To understand pulmonary hypertension, it’s helpful to know how blood naturally flows from the heart to the lungs. The right ventricle — the heart’s lower right chamber — pumps blood without oxygen to the lungs through a large blood vessel called the pulmonary artery. After entering the lungs, the blood releases carbon dioxide and acquires oxygen. It then flows through pulmonary arteries to the left side of the heart.

Pulmonary hypertension occurs when the pulmonary arteries become narrowed, obstructing the flow of blood. This causes blood pressure in the pulmonary arteries to rise, which strains the heart’s right ventricle. In the long term, the right ventricle gradually grows weaker and becomes less effective at pumping blood to the lungs. In some cases, this may lead to the development of heart failure.

Pulmonary hypertension is a progressive condition. Symptoms become more severe over time without effective treatment, and getting a diagnosis at an early stage is critical.

Pulmonary hypertension causes and risk factors

There are different types of pulmonary hypertension. While not all cases of pulmonary hypertension have a known cause, it frequently intersects with other health conditions.

The inflammation and loss of capillaries caused by advanced chronic obstructive pulmonary disease (COPD) may increase pulmonary artery pressure, resulting in pulmonary hypertension. For individuals living with both conditions, COPD flare-ups can worsen symptoms of pulmonary hypertension. Other lung conditions including pulmonary fibrosis have been linked to pulmonary hypertension.

Pulmonary hypertension often occurs in connection with certain types of heart disease including aortic valve disease, left heart failure, mitral valve disease, and congenital heart disease.

The following health conditions have also been linked to the development of pulmonary hypertension.

Liver disease can cause high blood pressure in the veins leading to the liver, also referred to as portal hypertension. This condition may expose blood vessels in the lungs to toxic substances, potentially damaging the small arteries of the lungs and leading to a form of pulmonary hypertension known as pulmonary arterial hypertension.

Rheumatic disorders such as scleroderma and lupus

Thromboembolic disease, a condition characterized by a blood clot in a large pulmonary artery

Some cases of pulmonary hypertension may have a genetic component. For those who have a family health history of pulmonary hypertension, it’s even more imperative to seek early evaluation for a diagnosis if symptoms appear.

Pulmonary hypertension affects individuals of all ages and sexes, but it is significantly more common in young adults, and approximately twice as common in women as in men.

Symptoms of pulmonary hypertension often do not appear until the condition has progressed to a later stage. For many individuals, the first symptom is shortness of breath during daily activities. Other common symptoms include fatigue, dizziness, fainting spells, swelling in the ankles, abdomen, or legs, and chest pain.

As the condition progresses further, it becomes increasingly difficult to carry out daily activities, and you may experience difficulty breathing even while at rest.

Pulmonary hypertension is linked to the following health conditions or complications.

Right-sided heart enlargement and heart failure, as pulmonary hypertension causes the heart to pump harder than normal to carry blood through narrowed arteries

Increased risk for blood clots in the small arteries in the lungs

Treatment and prevention of pulmonary hypertension

Treatment for pulmonary hypertension often consists of a combination of medications, oxygen therapy, and lifestyle changes.

The following medications may be used in the treatment of pulmonary hypertension.

Anticoagulants, or blood thinners, like warfarin allow blood to flow more freely through the arteries by decreasing blood clot formation.

Diuretics including furosemide (Lasix®), torsemide (Demadex®), and spironolactone (Aldactone®) reduce swelling and make it easier to breathe by removing excess fluid from the bloodstream.

Inotropic agents like digoxin can improve the heart's pumping ability.

Vasodilators including nifedipine (Procardia®), diltiazem (Cardizem®), epoprostenol (Flolan®, Veletri®), and treprostinil (Tyvaso®, Remodulin®, Orenitram®) lower pulmonary blood pressure and can help improve the heart’s ability to pump blood.

Soluble guanylate cyclase (sCG) stimulators such as riociguat (Adempas®) help your body release more nitric acid to relax vascular smooth muscle and increase the amount of blood your heart can pump.

Endothelin receptor antagonists such as bosentan (Tracleer®), macitentan (Opsumit®), and ambrisentan (Letairis®) widen your blood vessels.

Phosphodiesterase-5 (PDE5) inhibitors such as sildenafil (Revatio®, Viagra®) and tadalafil (Adcirca®, Cialis®, Alyq™) control blood flow to the pulmonary arteries and relax the blood vessels.

Supplemental oxygen, or oxygen therapy, can relieve shortness of breath and increase your tolerance for physical activities. There are several devices used in oxygen therapy. Your doctor can guide you in choosing the right oxygen delivery system based on your health needs, lifestyle, and insurance benefits. You may be prescribed one oxygen device to use at home and one to use when you are on the go.

Dietary considerations - Certain foods can help you manage pulmonary hypertension. Opt for foods that are high in potassium, magnesium, and fiber, and limit foods that contain refined sugar, saturated fats, cholesterol, and sodium.

Exercise considerations - Physical activity is integral to a heart-healthy lifestyle, and those with pulmonary hypertension can improve circulation by walking, but the condition may prevent more strenuous forms of exercise. Stop any activity that causes shortness of breath, dizziness, or chest pain, and check with your doctor about recommended exercises.

Maintain a healthy weight - Pulmonary hypertension can lead to fluctuations in weight. It may be more difficult to gain weight due to the energy required to breathe. Conversely, fluid retention can lead to weight gain. As part of managing the condition, track your weight each day and inform your doctor if you gain two pounds in one day or five pounds in one week.

Avoid lifting or pushing objects greater than 20 pounds, as this may increase the pressure in your arteries and lungs.

Refrain from smoking and limit your alcohol consumption.

You can prevent certain forms of pulmonary hypertension by following a heart-healthy lifestyle and proactively managing related health conditions such as high blood pressure, coronary heart disease, and COPD.

At Alto, we make it as simple as possible to manage your risk for chronic health conditions and to stay on top of your cholesterol-lowering, blood pressure, or COPD medications. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

About 9% of men and 11% of women in the U.S. have faced fertility issues. These challenges may feel overwhelming, but there are a variety of treatment options for both male and female infertility to support your family building journey.

Here’s an overview of the causes and symptoms of male and female infertility and common fertility treatments.

Infertility, Explained

About 9% of men and 11% of women in the U.S. have faced fertility issues. These challenges may feel overwhelming, but there are a variety of treatment options for both male and female infertility to support your family building journey.

Here’s an overview of the causes and symptoms of male and female infertility and common fertility treatments.

Infertility, defined as the inability to get pregnant after twelve months or more of unprotected sex, is a health condition that affects both men and women. Approximately one-third of infertility cases stem from a female reproductive factor, one-third stem from a male reproductive factor, and one-third stem from a combination of both or unknown causes.

These are some common causes of female infertility.

The majority of female infertility cases are caused by problems with ovulation, the release of a mature egg from the ovaries. There are several causes of ovulation disorders, including the following.

Polycystic ovary syndrome (PCOS), a condition characterized by a hormone imbalance that impacts ovulation. It is the leading cause of female infertility.

Excessive exercise, eating disorders, or stress, each of which can result in hormonal imbalances

Primary ovarian insufficiency, sometimes referred to as premature ovarian failure

Fallopian tube damage or blockage can prevent sperm from reaching an egg, or fertilized eggs from attaching to the uterus. Common causes of fallopian tube damage or blockage include pelvic inflammatory disease — an infection of the uterus and fallopian tubes from chlamydia, gonorrhea, or other sexually transmitted infections — or a prior surgery in the abdomen or pelvis, including surgery for ectopic pregnancy.

Uterine or cervical issues such as the following can disrupt the implantation of an egg into the uterus or increase a woman’s risk for miscarriage.

Benign polyps or fibroids may block fallopian tubes or interfere with the implantation of an embryo. However, many women with these growths are able to conceive.

Structural issues with the uterus that are present at birth

Cervical stenosis, a narrowing of the cervix

Endometriosis is a condition in which tissue that should only grow in the uterus implants and grows elsewhere. The abnormal tissue growth — as well as surgical procedures to remove it — can block the fallopian tubes, preventing the fertilization of an egg. In some cases, endometriosis may interfere with implantation of the fertilized egg, or embryo.

Male infertility is most often an issue of sperm production — including the quantity and quality of sperm produced — or of sperm mobility, which affects the sperm’s ability to find and fertilize an egg. A blockage in the testicle or damage to the reproductive organs can also contribute to male infertility.

Age is a factor in both male and female fertility issues. The quality and quantity of a woman’s eggs begin to decline as she enters her mid-thirties, and age factors into the success rates of in vitro fertilization (IVF).

Many individuals and couples first learn of a fertility issue after trying to conceive without success, and the primary symptom of infertility is the inability to get pregnant. There aren’t always noticeable symptoms, but the following may indicate an underlying fertility problem.

A menstrual cycle that’s irregular, absent, longer than 35 days, or less than 21 days

Unusually light or heavy bleeding during menstrual cycles

Erectile dysfunction or low sex drive in men

The timeline for seeking fertility treatment depends on your age. If you are under the age of 35, most health experts suggest consulting a reproductive specialist after a year of trying to conceive. If you are between 35 and 40, you may want to pursue testing or treatment after six months of trying to become pregnant. And if you are over 40, you may want to pursue testing or treatment before you start trying to conceive.

An evaluation for fertility issues and potential treatment begins with a conversation about your health history. Several tests may be used during the diagnostic process, including the following.

An hysterosalpingogram (HSG), an x-ray taken to examine issues within the uterus and fallopian tubes

Blood tests to measure hormone levels related to fertility and reproduction

Ovarian reserve testing, which evaluates the number of viable eggs in your ovarian reserve. These are typically used for women over 35 or those at risk of a low egg count for other reasons.

A semen test is used to diagnose most cases of male infertility. This identifies how many sperm you produce and whether the sperm are normal in shape and movement — healthy sperm have an oval head and long tail. In some cases, additional blood tests and/or genital ultrasounds may be used to rule out other health conditions.

Fertility problems do not mean that you won’t be able to have children biologically. There are many treatment options that can help increase your chances of conception. The most effective course of treatment depends on the underlying cause of your or your partner’s fertility issues. These are among the most common fertility treatments.

Forms of assisted reproductive technology (ART) including in vitro fertilization (IVF), a process in which eggs and sperm are fertilized in a laboratory and then placed into the uterus with the potential outcome of a pregnancy. In addition to treating female infertility, IVF can also be used when male infertility is a factor.

Intrauterine insemination (IUI), a type of artificial insemination in which sperm that have been washed and concentrated are placed directly into a woman’s uterus during ovulation.

Injectable fertility medications including gonadotropins and oral fertility medications such as Clomid® and Femara® can treat fertility-related hormonal imbalances.

Your doctor may also recommend lifestyle changes or treating a related health condition.

A fertility pharmacy partner you can rely on

Since 2016, Alto has supported more than 50,000 fertility journeys. We understand that fertility treatment is a significant investment — physically, emotionally, and financially — and we see ourselves as a partner in your health.

We offer free, same-day delivery seven days a week and temperature controlled packaging to ensure that your fertility medications always arrive in the right condition. And our fertility-trained pharmacists are available until 9 pm PST (12 midnight EST) on weeknights to offer any support you need.

Resources for Affording HIV Medication

The HIV treatment and prevention landscape continues to evolve, with many effective medications. Antiretroviral therapy (ART), the frontline treatment for HIV since 1997, is a combination of medications that lower the amount of HIV in your bloodstream. When taken as prescribed every day, ART can help individuals with HIV achieve and maintain an undetectable viral load. As a result, more than half of all those living with HIV in the U.S. are not at risk of transmitting the virus to others.

On the prevention front, PrEP, or pre-exposure prophylaxis, can lower risk of sexual transmission of HIV by 99% when taken daily and reduces the risk of getting HIV from intravenous drug use by about 74%.

For many individuals, cost is a barrier to both starting and continuing to take ART and PrEP as prescribed. Fortunately, HIV prevention medication and treatment continue to become more accessible, with generic PrEP options and expanded health insurance coverage of PrEP and ART. In addition, the following resources, including patient assistance programs and copay savings cards from medication manufacturers, can help reduce the cost of HIV treatment and prevention medication.

Read on to learn more about eligibility for these programs, and revisit our previous post on state-funded PrEP drug assistance programs.

Many pharmaceutical companies have patient assistance programs (PAPs) to offset the cost of prescription medications for individuals without insurance or with insufficient insurance coverage. If Alto is your pharmacy partner for HIV treatment or prevention, your medication protocol may include medications manufactured by Gilead, which offers the PAP outlined below.

If your medications are manufactured by a different company, contact them directly to learn about any available financial assistance including PAPs.

Gilead's Advancing Access® Patient Assistance Program

Gilead's Advancing Access Patient Assistance Program provides medication free of charge to individuals without insurance who meet program eligibility criteria. There are several ways to learn if you are eligible:

Call 1-800-226-2056 (Monday-Friday, 9 am to 8 pm EST)

Print the enrollment form and submit it via fax

Copay savings cards from pharmaceutical manufacturers can help offset the cost of prescription medications for individuals with insurance. If Alto is your pharmacy partner for HIV treatment or prevention, your medication protocol may include medications manufactured by Gilead or ViiV Healthcare, which offer the copay savings cards below.

If your medications are manufactured by a different company, contact them directly to learn about any available financial assistance including copay savings cards.

Gilead’s Advancing Access copay savings card

Gilead also offers a copay savings card for individuals with insurance to reduce the cost of copays. Those who are enrolled in any state or federally funded prescription medication program such as Medicare Part D and Medicaid, or who are in the Medicare Part D prescription coverage gap, are not eligible.

Learn more about program eligibility and terms and conditions.

The ViiVConnect Savings Card Program helps eligible individuals with commercial insurance save on copay costs for select ViiV Healthcare medications. Those who are enrolled in any state or federally funded prescription medication program such as Medicare Part D and Medicaid, or who are in the Medicare Part D prescription coverage gap, are not eligible.

If you do not have insurance coverage of prescription medications, contact 1-844-588-3288 to learn about additional financial assistance opportunities from ViiV.

Created to help individuals living with chronic health conditions access the treatment they need, the PAN Foundation offers financial assistance for medication costs, copays, and insurance premiums.

Learn what financial assistance you are eligible for.

The Ready, Set, PrEP program provides PrEP at no cost to eligible individuals without insurance coverage of prescription medications.

Learn more about program eligibility and the application process.

Your financial well-being is our priority

At Alto, we understand how stressful it can be to navigate insurance coverage benefits and savings opportunities. We prioritize your financial wellness, working with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to make ART or PrEP as affordable as possible. In addition to automatically applying coupon savings, we’ll connect you with any outside programs that require you to apply directly.

We also offer free, same-day delivery to make it as easy as possible to stay on track with treatment, and our dedicated HIV support team is here to answer any questions you may have about ART or PrEP. Reach out any time via phone at 1-800-874-5881, or in-app messaging.

It’s understandable to feel overwhelmed after receiving a diagnosis of chronic obstructive pulmonary disease (COPD) — living with a chronic lung disease brings changes to many aspects of life. Many people don’t realize that the condition is highly treatable, and that there are things you can do to slow the progression of COPD. To help you better understand and manage your COPD, let’s take a look at five common misconceptions surrounding this lung disease.

Blog

The Medicare Donut Hole, Explained

A Guide to Traveling With Asthma

Navigating Pregnancy With Type 1 or Type 2 Diabetes

Pulmonary Hypertension, Explained

Infertility, Explained

Resources for Affording HIV Medication

5 Misconceptions About COPD

Atherosclerosis, Explained

The Science of Habit-Forming

Understanding Heart Valve Disease

Traveling With Diabetes: How to Prepare

Cardiomyopathy, Explained

Switch to a better pharmacy.