Healthcare after employer coverage ends in Cincinnati

Start with your care need, not a directory

SakeOf is a healthcare membership for people who want a more active, organized way to approach care. You can select everyday-care services, choose providers when you need in-person care, and turn to Full Service advocacy for help understanding medical bills. For larger eligible medical events, the process can include fair-price review and voluntary community funding under program rules.

The practical advantage is having clear next steps for different situations: use an active direct service when it fits, contact a provider about an in-person service, or prepare bills and records for review. Services and support depend on the options selected and active, eligibility, and applicable program rules. Use the calculator or Savings Guide to compare membership options, search for a provider, or ask Jordan how a feature works.

Use everyday services that match your needs

Zero Copay Telemedicine is an optional direct service. When selected and active, it provides access through the current service partner for appropriate virtual care. A virtual visit can be a convenient first conversation for a concern suited to that setting; whether care can be handled virtually depends on clinical needs.

Rx and Prescription Benefits is an optional feature. When selected and active, it can be part of your everyday-care setup. Check the applicable program terms for a particular medication or pharmacy expense before relying on it, and consider whether a prescription could involve separate costs or require an in-person follow-up.

Mental Health and Counseling, when selected and active with its required features, includes unlimited on-demand telephonic counseling at $0 for included access 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. The feature does not automatically include psychiatry, inpatient behavioral healthcare, emergency psychiatric care, testing, residential substance-use treatment, or medication costs.

Virtual Primary Care provides 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 for the current bundled tier. If your care calls for a lab, imaging, specialist, or in-person exam, contact the provider about the next step and its expected charges.

Choose a local provider when care needs to be in person

When you need an exam, test, imaging, specialist, dental service, or hospital care, you can choose a provider and ask directly about the service, appointment access, and charges. Cincinnati Health Department City of Cincinnati Primary Care lists six community health centers offering medical care. Call 513-357-7320 to ask about appointments and which center may fit your need. The department also lists dental services; confirm service details and arrangements when calling.

For specific county clinical services, 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 ask about current services, fees, eligibility, and arrangements. These are county resources, not a guarantee of an appointment for a particular ZIP code.

UC Health provides patient pricing information and a route to request an estimate for a specific service. TriHealth lists financial-assistance and financial-counseling information, including Bethesda North Hospital among its regional locations. For scheduled care, ask the facility about an estimate and any available assistance. Charges and patient responsibility depend on the service, provider, and applicable arrangements.

For public behavioral-health access, Central Connection is a countywide phone entry point available 24/7/365. People using Ohio Medicaid can consult the state’s benefit and provider-directory resources; Medicare Care Compare is a federal tool for finding and comparing Medicare-approved providers. These broader resources are starting points: contact the relevant provider or program to confirm current services and access.

Get support with bills and fair-price review

If a medical bill is difficult to understand, gather the itemized bill and check the service dates, provider information, and CPT or HCPCS codes when available. SakeOf Full Service advocacy can help verify bills, review fair pricing, and support negotiation. It is a support process, not a promise of a particular price or outcome.

An itemized bill is required for submissions. 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. Submit complete documents within six months of the service date. Submit balance bills, denials, or payment demands within 10 days of receiving them.

To make a request easier to review, collect the documents you have before submitting and respond promptly if additional information is requested. Use the Savings Guide or ask Jordan how to begin; keep the relevant deadlines in mind.

Understand the process for a larger eligible medical event

For a larger eligible event, the membership process can include bill verification, fair-price review, negotiation support, and voluntary community funding under program rules. Review the applicable member commitment so you understand your responsibility and how required asks are handled. Contact SakeOf in advance for planned higher-cost care when reasonably possible.

Keeping membership active, maintaining a valid payment method, funding required asks, and submitting requested documents are member responsibilities. Eligibility depends on documentation and program terms. Symptoms may count in the 24-month pre-existing-condition review even without a formal diagnosis; final determinations depend on documentation, clinical review, and the Program Guide.

Choose optional features around the care you expect

Other optional features include Maternity Care, chiropractic and acupuncture, Physical and Occupational Therapy, and Durable Medical Equipment. Each has a monthly price adjustment. Services or eligibility tied to a feature apply only when it is selected and active and otherwise follow program rules.

Dental and Vision Discounts provide access to participating providers at applicable discounted rates. Rates vary by provider, location, service, and vendor terms. Members pay participating providers directly at the applicable discounted rate; routine dental and vision expenses are not community-sharing expenses under the stated program rules. Confirm the provider and price for a specific service before arranging care.

For a useful next step, compare membership options with the calculator, review the Savings Guide, search for a provider, or ask Jordan which active features relate to the care you expect to use.