Healthcare before Medicare in Cincinnati

Put your care needs at the center

SakeOf is a healthcare membership designed to make arranging care more member-directed. Members can use selected everyday-care services, choose a provider for in-person care, and ask for help reviewing medical bills. For a larger eligible medical event, SakeOf combines advocacy and bill review with an applicable member commitment and voluntary community funding.

Begin with the care you need: a routine concern, an ongoing primary-care relationship, a prescription question, counseling, a clinic visit, or help with a bill. Check which membership features you selected and have active. Then choose a practical route and confirm details with the provider or SakeOf as appropriate.

Use everyday care features that fit

When selected and active, Zero Copay Telemedicine offers virtual visits for suitable concerns. Rx and Prescription Benefits may help with prescription needs under their program terms. Check the applicable feature for details about the medication, eligibility, and any related costs.

Mental Health and Counseling, when active with its required features, includes unlimited on-demand telephonic counseling at $0 and 24/7 access to master's-level counseling professionals for members and eligible enrolled dependents. Up to three face-to-face counseling consultations per incident may be arranged when available through the program. Counseling may also help with referrals to appropriate behavioral-health plans or local community resources when additional care is needed.

Virtual Primary Care offers a dedicated physician relationship, ongoing virtual follow-up, an annual virtual wellness visit, and chronic-care or medication-management support when clinically appropriate for virtual care. It has a $15 monthly adjustment and requires Rx and Prescription Benefits, Zero Copay Telemedicine, and Mental Health and Counseling to remain active. Compare the feature with your needs in the calculator or ask Jordan how to explore membership options.

Choose a Cincinnati in-person starting point

If you need an examination, test, or other in-person service, you can choose a provider and contact the office directly. Cincinnati Health Department’s City of Cincinnati Primary Care lists six community health centers offering medical care and gives 513-357-7320 for appointment calls. Ask which center offers the service you need and what arrangements are available. The department also lists dental services and separate contacts. ^{www.summahealth.org}

Hamilton County Public Health lists clinical services including STI/HIV testing and treatment, tuberculosis services, and support for eligible families through the Children with Medical Handicaps program. Its clinic is at 5050 Section Avenue, Cincinnati, OH 45212; call 513-946-7610 to confirm current services, arrangements, and fees before visiting. ^{www.summahealth.org}

UC Health and TriHealth list Cincinnati-area care locations. For a planned service, ask the provider for an estimate and confirm current participation and expected charges with the provider and any applicable payment or benefit source. A directory listing is a place to start, not confirmation of availability or an individual price. UC Health provides a route to request estimates, and TriHealth describes financial-assistance and financial-counseling options; contact each health system to confirm current details. ^{www.summahealth.org}

Get help understanding a bill

SakeOf Full Service advocacy can help with bill verification, fair-price review, and negotiation support. If a charge is unclear or seems high, contact SakeOf to ask about the review process. Support follows program rules and does not promise a particular bill outcome.

Start with an itemized bill showing service dates, provider information, and CPT or HCPCS codes when available. SakeOf may also request medical records, clinical notes, diagnosis or procedure details, billing records, or a signed release to review eligibility, medical necessity, and fair pricing. Submit complete documents within six months of the service date. Submit a balance bill, denial, or payment demand within 10 days of receiving it.

Plan ahead for a larger eligible medical event

For planned higher-cost care, contact SakeOf in advance when reasonably possible. That gives you a chance to ask about the advocacy process, documents to prepare, and the applicable member commitment. Larger eligible needs involve review under program rules and voluntary community funding; eligibility and the applicable commitment depend on the situation and documentation.

Eligibility review may consider whether an illness, injury, symptom, diagnosis, or treatment existed, was known, or had medical advice or care recommended or received during the 24 months before membership began. A symptom may count even without a formal diagnosis. Ask Jordan or contact SakeOf about how the process applies to your circumstances.

Match optional features to your needs

Optional features include maternity care, dental and vision discounts, chiropractic and acupuncture, physical and occupational therapy, and durable medical equipment. Each is subject to its feature terms, including selection, active status, and eligibility. With dental and vision discounts, members pay participating providers directly at the applicable discounted rate; discounts vary and are not guaranteed at every provider. Routine dental and vision bills are not community-funded under the described program terms.

If you turn off a feature, services or eligibility tied to that feature end under the applicable change rules. Turning it back on later does not make an inactive period retroactively eligible. Review your membership options and confirm feature-specific details before arranging care.

Choose your next step

• For a routine concern: Check whether Zero Copay Telemedicine is active and suitable for the care you need.
• For ongoing care: Review Virtual Primary Care’s requirements and monthly adjustment, or call City of Cincinnati Primary Care at 513-357-7320 to ask about local center services and appointments. ^{www.summahealth.org}
• For a prescription: Check whether Rx and Prescription Benefits are active and review the terms for the medication you need.
• For in-person or planned higher-cost care: Contact the provider about services, availability, and an estimate; contact SakeOf in advance when reasonably possible.
• For a bill question: Gather the itemized bill and requested records. Send balance bills, denials, or payment demands to SakeOf within 10 days of receipt.

Use the calculator to explore membership options, the Savings Guide to understand the model, provider search to identify care options, or Jordan to help choose a next step.