Healthcare after employer coverage ends in Cincinnati

Start with the care you need

SakeOf is a healthcare membership designed to make care decisions more direct and supported. Start with the need in front of you: timely guidance for a common concern, an ongoing primary-care relationship, help with prescriptions or counseling, an in-person appointment, or a bill that needs review. Your options depend on the features you select and keep active.

For a practical first step, use the calculator or Savings Guide to explore membership options. Provider search can help you look for care, and Jordan can help you think through where to start. For local appointments, Cincinnati Health Department’s City of Cincinnati Primary Care operates community health centers offering medical care and lists 513-357-7320 for appointment information. ^{www.summahealth.org} Call to ask which center offers the service you need and whether appointments are available.

Use everyday-care services that fit

Zero Copay Telemedicine, when selected and active, provides access to telemedicine under the program’s terms. It can be a convenient starting point for a concern appropriate for a virtual visit. Rx and Prescription Benefits, when selected and active, support prescription needs under program rules; medication costs may remain separate. Check the details of your active options and ask about the cost of a prescription before filling it.

Mental Health and Counseling is an optional direct service. When active with its required features, it includes unlimited on-demand telephonic counseling at no member cost and 24/7 access to master’s-level counseling professionals for the member and eligible enrolled dependents. Up to three face-to-face counseling consultations per incident may be arranged when available. Psychiatry, inpatient behavioral health, emergency psychiatric care, and medication costs are not included simply because counseling is active.

Virtual Primary Care offers zero-dollar virtual primary-care access through the current service partner, a dedicated physician relationship, ongoing virtual follow-up, and an annual virtual wellness visit with health-risk assessment and stratification. Chronic-care follow-up and medication-management support may be available when appropriate for virtual care. This option requires Rx and Prescription Benefits, Zero Copay Telemedicine, and Mental Health and Counseling to remain active for the current bundled service tier. The feature has a monthly adjustment of $15.

Choose a provider for in-person care

An examination, test, procedure, or specialist visit may call for in-person care. SakeOf supports provider choice: identify a provider, ask about the service and expected charges, and decide how to proceed. City health centers are one Cincinnati starting point; the city lists six community health centers and provides the appointment number above. ^{www.summahealth.org} The city also lists dental services and contacts. ^{www.summahealth.org} Confirm current services and arrangements directly.

Hamilton County Public Health lists 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, fees, and eligibility. ^{www.summahealth.org} This is a county resource located in Cincinnati, not a guarantee of appointment access for every ZIP code.

For hospital care, UC Health provides patient pricing information and a route to request an estimate. Ask its estimate team about the specific service. TriHealth also describes financial assistance and financial-counseling contacts; contact TriHealth to confirm current requirements and eligibility. ^{my.clevelandclinic.org} Before scheduled care, ask the provider what the estimate includes and whether other clinicians or facilities may bill separately.

Ask for help with a confusing bill

Full Service advocacy can support bill verification, fair-price review, and negotiation under program rules. The goal is to help members understand what was billed and what steps may be available; review and eligibility depend on the event, documentation, and applicable requirements. Keep the itemized bill and related paperwork together so the review can begin with the details of the service.

An itemized bill is required 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, other billing records, or a signed medical-record release. Submit complete documents within six months of the service date. Submit a balance bill, denial, or payment demand within 10 days of receiving it.

Understand support for larger eligible needs

For a larger eligible medical event, SakeOf’s process can include bill verification, fair-price review, negotiation support, and voluntary community funding, subject to program rules. The applicable member commitment is part of handling an eligible event. Check your membership materials for the amount and requirements that apply to you. Keep your membership current, submit requested documents promptly, and contact SakeOf in advance for planned higher-cost care when reasonably possible.

For planned care, request an estimate and ask what services and clinicians it includes. Save bills and records from each provider involved. These practical steps give advocacy the information it may need if you request a review; they do not determine the outcome or eligibility of a particular event.

Review other options and choose a next step

Depending on what you select and keep active, membership options may include maternity care, chiropractic and acupuncture, physical and occupational therapy, and durable medical equipment. Dental and vision discounts are optional: members pay participating providers directly at the applicable discounted rate, and discounts vary by provider, location, service, and product. Ask a provider whether it participates and what you will pay before receiving care.

• Need timely guidance? Check whether Zero Copay Telemedicine is active and whether your concern is appropriate for a virtual visit.
• Want ongoing primary care? Review Virtual Primary Care and its required active bundled features.
• Need local care? Call Cincinnati Health Department primary care at 513-357-7320, or contact your chosen provider to ask about appointments and expected charges. ^{www.summahealth.org}
• Have a bill to review? Gather the itemized bill and related documents, then check the SakeOf submission requirements and timelines.
• Planning or comparing options? Use the calculator or Savings Guide, explore provider search, or ask Jordan for help deciding what to do next.