Healthcare after employer coverage ends in Dayton

Start with the care need, not the bill

SakeOf is a healthcare membership designed to make the next step easier to navigate. Members can use selected practical-care and discount features, choose providers for in-person services, and get advocacy and fair-price review when medical bills are difficult to understand. For larger eligible medical expenses, Full Service may also involve voluntary member-to-member community funding under program rules.

Your membership program, selected features, effective dates, responsibilities, and eligibility rules determine what applies. Start with the calculator and Savings Guide to explore membership options. Then check your enrollment details or ask Jordan about the feature that fits your question.

Use everyday-care features when they fit

For a straightforward care question, Zero Copay Telemedicine may be available when selected and active. Virtual Primary Care may be an option for ongoing primary-care needs when that feature is selected and active. These services can offer a practical first step; check your membership details for current access and terms.

For prescriptions, review the Rx and Prescription Benefits active in your membership and confirm current terms for the specific medication and pharmacy. A benefit does not mean every medication is included, and medication costs or prescriptions outside the active benefit may remain separate.

Mental Health and Counseling may be available when selected and active. Psychiatry, inpatient or emergency behavioral-health care, neuropsychological testing, residential substance-use treatment, and medication costs are separate unless another active benefit or program expressly includes them.

Choose local care for in-person needs

For an exam, lab, imaging, specialist visit, or hospital service, members can choose a provider and confirm details directly. Kettering Health Dayton, at 405 West Grand Avenue, lists emergency care and on-site laboratory, imaging, and pharmacy services. The facility’s listing is not an individual price estimate; ask about current availability and expected charges before non-emergency care.

Public Health – Dayton & Montgomery County lists area community health centers and says listed federally funded centers adjust fees on a sliding scale. Contact a center directly to ask about its services, eligibility, appointment availability, and fees. The county public-health clinic has limited, appointment-based services; call 937-225-4550 to confirm current services and scheduling.

Dayton Community Paramedicine describes scheduled home visits and connections to healthcare and community resources. The city lists 937-333-4509 and 937-333-4535; contact the program to confirm current availability and eligibility. These are city-level resources, so listings alone do not establish appointment access or charges for an individual member.

Before arranging non-emergency care, ask what service is being scheduled, whether lab or imaging charges may be separate, and what you may be expected to pay. Confirm provider participation and charges with the provider and any applicable coverage source.

Get help with bills and fair pricing

Full Service advocacy can help verify a medical bill, review fair pricing, and provide negotiation support. For planned higher-cost care, contact SakeOf in advance when reasonably possible. Asking the provider for an itemized estimate can help clarify the planned service and expected charges before care.

Keep the itemized bill, including service dates, provider information, and CPT or HCPCS codes when available. SakeOf may also request medical records, clinical notes, billing records, or a signed release to review eligibility 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.

Understand support for larger eligible needs

For larger eligible medical expenses, Full Service combines advocacy and fair-price review with voluntary member-to-member community funding. An applicable member commitment or feature-specific responsibility may apply. Eligibility, documentation, program rules, fair-price review, and available community funds all matter; funding, savings, or a particular outcome is not guaranteed.

Keep your membership active, maintain a valid payment method, meet applicable member responsibilities, and submit requested documents promptly. For planned major care, contact SakeOf ahead of time when reasonably possible. For maternity support, pregnancy must begin after the continuous 12-month maternity waiting period is completed; adding the feature after conception does not make that pregnancy eligible.

Check other membership features and take action

Participating-provider dental and vision discounts may be available when included in your membership. Members pay the provider directly at the applicable discounted rate; discounts vary, and routine dental and vision bills are not community-funded. Chiropractic or acupuncture, PT/OT, and durable medical equipment options depend on the selected program and features, so check your enrollment details before arranging services.

• Compare membership options: Use the calculator and Savings Guide to review available programs and features.
• Find care: Use provider search, then confirm services, appointments, participation, and expected charges directly with the provider.
• Ask a question: Contact Jordan with a specific care need or membership-feature question.
• Explore county application help: Montgomery County lists online, phone, and in-person Medicaid application routes. County Shared Services is 844-640-6446; individual eligibility depends on the application.