Healthcare when you work for yourself in Boca Raton

Start with the care you need

SakeOf is a healthcare membership designed to make navigating care more member-directed. Start with the need in front of you: a new symptom, a prescription, ongoing primary care, or an in-person service. Then check which SakeOf services you selected and have active, and choose a local provider when hands-on care is needed.

This approach can make the next step clearer: everyday-care services may help with routine needs, while provider choice lets you seek local examinations, tests, specialist care, or hospital services. For questions about your membership, check your details or ask Jordan before arranging an expense you expect to submit for review.

Use everyday services when they fit

For a new, non-emergency concern, Zero Copay Telemedicine offers 24/7 urgent-care consultations with the current service partner when selected and active. The partner describes unlimited medically appropriate consultations. A clinician can assess the concern and advise on an appropriate next step.

Rx and Prescription Benefits, when selected and active, include approximately 70 acute medications at $0 through participating pharmacy locations. Confirm that the prescription is on the available list and that a participating pharmacy can fill it. A medication outside the benefit may remain your responsibility.

Mental Health and Counseling, when selected and active, provides on-demand telephone counseling, including immediate problem assessment, supportive counseling, follow-up, and crisis support. Up to three face-to-face counseling consultations per incident may be available when arranged. Counseling may also refer members to behavioral-health plans or community resources for additional care. Psychiatry, inpatient behavioral-health care, emergency psychiatric care, and medication costs are not automatically included by activating counseling.

Virtual Primary Care is an optional direct service with a $15 monthly adjustment. In the current service tier, it provides $0 virtual primary-care access, a dedicated physician relationship, an annual virtual wellness visit, health-risk assessment, and chronic-care follow-up and medication-management support when clinically appropriate. Rx, telemedicine, and Mental Health and Counseling must remain active for this bundled tier.

Choose a local provider for in-person care

SakeOf members choose providers for in-person care based on the service they need and their preferences. Boca Raton has hospital-based care, independent primary-care offices, and a Health Care District community health center. These are city-level options, not confirmation that a provider is available or accessible to every resident of ZIP 33428. Call the location to check appointments, services, charges, payment arrangements, and accepted plans.

The West Boca Community Health Center lists adult primary care, mental health, and adult and pediatric optometry at its Boca Raton location. Its listing gives weekday hours of 8 a.m. to 5 p.m. and 561-642-1000 as the main phone number; verify details before visiting. The Health Care District describes a sliding fee scale and payment-plan options, so ask the center about eligibility and current fees.

Other Boca Raton primary-care listings include Baptist Health Primary Care | Boca Raton (BRiC) at 4930 Conference Way North, Suite 100, and Florida Atlantic University Medicine Primary Care at 880 NW 13th Street. Contact each practice to confirm current services, availability, charges, and accepted plans. Boca Raton Regional Hospital, at 800 Meadows Road, is a 24-hour hospital listing emergency care and diagnostic imaging; call 911 for emergencies.

Plan for costs and ask for estimates

Before scheduled care, ask the facility and any separately billing clinicians for a personalized estimate. A visit may involve separate bills for a clinician, laboratory work, imaging, or facility services. Baptist Health publishes hospital price information and offers estimates through its pricing office, but an estimate may differ from the final bill, including when other providers bill separately.

FloridaHealthFinder supports facility searches and selected quality comparisons; use it to research facilities, not to assume a particular provider is available to you. ^{quality.healthfinder.fl.gov} FloridaHealthPriceFinder compares listed service bundles using statewide claims data. Its comparisons are not individual quotes or ZIP-specific prices. ^{price.healthfinder.fl.gov}

Get advocacy when a bill needs review

With Full Service, members can seek help understanding medical bills, verifying billing information, reviewing fair pricing, and pursuing negotiation support. If a charge is unclear or seems unusually high, gather the itemized bill and related records and submit them through the SakeOf process for review under program rules.

An itemized bill is required for submissions and should show service dates, provider information, and CPT or HCPCS codes when available. SakeOf may request clinical notes, medical records, billing records, or other documentation to assess 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.

Understand support for larger events and optional features

For larger eligible medical events, Full Service combines the applicable member commitment with bill review and advocacy. Voluntary community funding may also be considered under program rules. The commitment and whether an expense is eligible depend on the program and event; outcomes and amounts are not guaranteed. Keep estimates, referrals, bills, and clinical documents together, and check your membership details before making decisions based on an assumed amount.

If maternity care is relevant, review the feature before pregnancy: a pregnancy must begin after the continuous 12-month maternity waiting period is completed. Eligible expenses may include prenatal care and delivery-related services, subject to program limits and rules. Adding or restoring the feature after conception does not make that pregnancy eligible.

The PT/OT feature may apply to medically necessary care from an appropriately licensed therapist. It has a shared limit of 12 visits and $780 annually across the enrolled membership. Eligible visits use a $35 feature-specific member responsibility in place of the standard $500 event commitment. A physician order, referral, or plan of care may be required when clinically appropriate or required by state law.

Choose your next step

• For a new symptom, check whether Zero Copay Telemedicine is active and appropriate for the situation.
• For ongoing care, compare Virtual Primary Care with an in-person appointment and confirm which services are active.
• For a local visit or planned procedure, call the provider about availability, charges, and separate bills; request an estimate where possible.
• For a bill review or larger eligible expense, gather records and ask Jordan about Full Service and applicable program rules.
• Use the calculator and Savings Guide to explore membership choices, and provider search to research care options.