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SakeOf

Program Guidelines

Concise overview of how SakeOf works. This is not traditional insurance. Final terms are in the full Program Guide.

What’s included (examples)

  • Provider visits and hospital services (medically necessary)
  • Urgent and emergency care
  • Diagnostics, labs, and imaging
  • Ambulance transport
  • Prescription medications (plan limits may apply)
  • Maternity on eligible plans (waiting period may apply)
  • Therapies when prescribed (PT, OT, Speech, Respiratory)
  • Telemedicine and online submissions
  • Repricing and negotiation support

Eligibility and maximums vary by plan and options selected.

How benefits pay

SakeOf is a limited indemnity program: benefits pay fixed cash amounts when covered events occur. You may assign benefits to your provider or receive payment directly, per your scenario.

  • Office visit — e.g., $150–$250 per visit depending on plan
  • Urgent care — e.g., $300–$750 per visit
  • Imaging — e.g., $250–$1,200 per study based on modality
  • Inpatient daily benefit — e.g., $300–$1,000 per day
  • Maternity — available on select plans with a waiting period
If the final bill is lower than your benefit plus your contribution, the savings are yours to keep.

Plans and options (at a glance)

  • Base plan for an individual or household (Essential, Standard, Plus, Premium).
  • Visit bundle — number of office/virtual visits included per year.
  • MRA (Member Responsibility Amount) paid before benefits apply.
  • Labs option and other configurable categories.
  • Maternity on eligible plans (waiting period may apply).
  • Add-ons such as counseling, Rx savings, vision, dental (as available).
  • Annual pricing discount may apply when selected.
Included perks: BasicCare+ discounts for common services, and on Plus/Premium plans, Vitality testing credits. See plan details.

Not included

  • Cosmetic or elective procedures
  • Services not medically necessary
  • Items outside published limits or maximums
  • Pre-existing conditions during waiting periods
  • Fraudulent, illegal, or non-covered items

Waiting periods and limits

  • General eligibility begins after your initial waiting period.
  • Maternity is available on select plans after the waiting period.
  • Some categories include annual or per-incident caps.
  • Availability and rules may vary by state.

Member responsibilities

  • Pay your plan’s MRA/initial responsibility as applicable.
  • Provide complete, accurate documents for review.
  • Submit bills promptly after receiving care.
  • Use benefits in good faith; report changes that affect eligibility.

How your plan works

  1. 1Choose a plan and options; pay your monthly price.
  2. 2Bring your membership card to any licensed provider (no networks).
  3. 3By default, providers bill using your membership details; if they offer a discounted immediate payment, you can pay on the spot with your SakeOf Visa debit.
  4. 4Upload bills/receipts as needed — we review for eligibility and process payment or reimbursement per your plan.
Final eligibility, limits, and any waiting periods are defined in the full Program Guide.

Tools and perks

  • Repricing and navigation — we help request cash pricing and negotiate fair bills.
  • SakeOf Visa debit — pay at time of service where accepted to secure discounts.
  • BasicCare+ — bundled discounts for common services.
  • Vitality — testing credits and health tracking (included on Plus/Premium; available as add-on on other plans).
  • Digital support — telemedicine, online submissions, and fast review.
Get a quote / Enroll Read FAQs

SakeOf is not insurance. Benefits pay fixed amounts per covered event and are subject to plan limits, waiting periods, and state availability.