A different way to healthcare in Anaheim

Plan care around what you need

SakeOf is a healthcare membership designed to make it easier to take an active role in care: consider everyday-care options, choose a provider for in-person services, get help understanding a bill, and explore community help for larger eligible medical expenses. Rather than starting with paperwork, start with the need in front of you—a quick health question, ongoing care, a prescription, an appointment, or a substantial bill.

Membership features depend on what is offered and selected. The calculator and Savings Guide can help you review membership options; provider search can help you investigate a clinician or service. If you are unsure where to begin, ask Jordan to help organize the next step. Each feature and any community sharing is handled under the applicable program terms.

Use everyday-care options when they fit

For a routine health question, Zero Copay Telemedicine may provide a convenient way to connect with care when the feature is selected and active. Virtual Primary Care may offer another option for primary-care needs when it is available through your active membership. These choices can make it easier to begin with a remote visit when appropriate; an in-person exam or follow-up may still be needed depending on the situation.

For prescriptions, review the Rx and Prescription Benefits available with your membership and check whether the benefit applies to the medication and pharmacy you plan to use. Confirm the price before filling it. A prescription benefit does not by itself tell you that every medication or pharmacy expense applies, and a separate clinician visit, lab, imaging service, or other care may have a separate cost.

Mental Health and Counseling may include immediate problem assessment, supportive counseling and follow-up, crisis support, and referrals to appropriate behavioral-health plans or local community resources when more care is needed. Psychiatry, inpatient behavioral health, emergency psychiatric care, neuropsychological testing, residential substance-use treatment, and medication costs are not automatically included just because counseling is active. Check which options are currently offered and active for your membership.

Choose a provider and verify the service

When you need an in-person appointment, test, specialist, or hospital service, identify the service and location you need, then search for a provider. Confirm participation and availability for that exact service with both the provider and your applicable plan. Ask about your expected cost before care; a directory listing alone does not establish current participation, an appointment, or a service price.

For Medi-Cal provider searches serving Anaheim and Orange County, the California Department of Health Care Services Provider Information Network supports searches by ZIP code, county, or address, with filters for provider type, language, and services. ^{www.dhcs.ca.gov} DHCS also maintains a managed care plan directory organized by county; check Orange County options and verify specific provider participation directly. ^{www.dhcs.ca.gov} These are statewide search tools, not a guarantee that a particular provider or service is available.

For hospital price research, California’s HCAI publishes cost-transparency resources, including hospital chargemaster information. ^hcai.ca.gov Listed charges are not necessarily your individual cost. Ask the facility for a patient-specific estimate for the planned service and whether separately billing clinicians are included. Also ask the facility about its own financial-assistance process and eligibility requirements.

Bring confusing bills to advocacy

If a bill is unclear or seems unusually high, gather the itemized bill and any denial, balance bill, or payment demand. Full Service advocacy can include bill verification, fair-price review, and negotiation support when applicable. SakeOf reviews submitted information and may review or negotiate a price for fairness; the process does not guarantee a particular price or result.

An itemized bill is required for submissions and should include service dates, provider information, and CPT or HCPCS codes when available. SakeOf may also request medical records, clinical notes, diagnosis or procedure details, provider documentation, billing records, or a signed medical-record release to review eligibility, medical necessity, and fair pricing. Complete documents are due within six months of the service date. Submit balance bills, denials, or payment demands within 10 days of receiving them.

Under the program terms, the applicable standard-event commitment or feature-specific member responsibility is applied. Remaining eligible amounts may be matched to voluntary community funds, subject to program limits and available funds. Approved amounts may be paid through the member wallet or card, or directly to a provider, depending on the process used. For a hospital bill, facility financial assistance is a separate process worth asking about.

Understand community help for larger eligible needs

For a larger medical event, the general process is to receive or plan care, submit requested documentation, have SakeOf review eligibility and documentation, and have the price reviewed or negotiated for fairness when applicable. The applicable member commitment is then applied. Remaining eligible amounts may be matched to voluntary community funds within program limits and available funds. The membership’s current terms determine how a particular event is handled.

Maternity is a specific community-sharing feature when offered and selected. It requires continuous active membership with maternity selected and current for at least 12 months before conception. The member responsibility is $5,000 per eligible pregnancy, with community sharing up to $25,000 after that responsibility, subject to program rules and available funds. Potentially eligible care includes routine prenatal visits and tests, pregnancy-related specialist care, delivery, medically necessary complications, and routine pregnancy-related postpartum care through six weeks. Adding or restoring maternity after conception does not make that pregnancy eligible.

Choose options for the care you expect

Depending on what is offered, selected, and active, membership options may also include dental and vision discounts, chiropractic or acupuncture, PT/OT, and durable medical equipment. Review the applicable option before arranging a service, and ask the provider about price and any separate bills. These options complement the broader membership approach: everyday-care choices, freedom to investigate providers, advocacy when bills need review, and possible voluntary community help for eligible larger expenses.

• Comparing membership options? Start with the calculator or Savings Guide.
• Looking for care? Use provider search for the service and location, then confirm participation and cost.
• Sorting out a bill? Keep the itemized statement and submit documents within the applicable timeframes.
• Unsure what to do next? Ask Jordan to help identify a useful next step.