Healthcare before Medicare in Dayton

Start with the care you need—not a directory

SakeOf is a healthcare membership designed to make common care decisions more manageable. Depending on your program and selected, active features, you can explore everyday-care services, choose a provider for in-person care, use advocacy and fair-price review for bills, and—through Full Service—request consideration for voluntary member-to-member community funding for eligible medical expenses.

For your next step, identify the care you need, check your enrollment summary for active features and effective dates, and use SakeOf’s provider search or ask Jordan for help. The calculator and Savings Guide can help you explore membership options. Your selected program, feature terms, eligibility, member responsibilities, documentation, and available community funds determine how support applies.

Find an appropriate first step for everyday care

For a non-emergency concern, check whether Zero Copay Telemedicine or Virtual Primary Care is selected and active. Mental Health and Counseling is another feature to check for counseling services; psychiatry and other specialized behavioral-health services are separate unless another active benefit or program expressly includes them. If symptoms are severe or may be an emergency, seek emergency care.

If you need a continuing primary-care relationship, search for a provider or ask Jordan to help identify a next step. Contact the office to ask whether it accepts new patients, provides the service you need, and how it handles payment. In Montgomery County, Public Health – Dayton & Montgomery County distinguishes its limited, appointment-based clinic services from routine primary care and lists area health centers. Its directory describes sliding-scale fees at listed federally funded health centers; ask a center directly about services, eligibility, appointments, and charges.

Check prescriptions and other selected features

Rx and Prescription Benefits may be available when selected and active. Check the current feature terms and confirm that both the medication and pharmacy qualify. A prescription feature does not establish that every medicine is included, and medication costs may remain separate. Do not assume a vendor prescription or telehealth benefit can be combined with another arrangement unless current vendor terms confirm it.

Depending on your selections and program terms, you may also want to check maternity, dental and vision discounts, chiropractic or acupuncture, physical or occupational therapy, or durable medical equipment features. For maternity, pregnancy must begin after the continuous 12-month waiting period is complete; adding or restoring the feature after conception does not make that pregnancy eligible. Dental and vision discounts are paid directly to participating providers at the applicable rate. Actual discounts vary, and routine dental and vision bills are not community-sharing expenses under the stated rules.

Choose local in-person care when you need it

You choose your provider for in-person services. Match the setting to the need—such as routine care, lab work, imaging, specialty care, or hospital care—and confirm the specific service and expected patient charges before non-emergency care.

Kettering Health Dayton is at 405 West Grand Avenue; its location information lists emergency care, laboratory, imaging, and pharmacy services. Call the hospital to confirm current availability and ask about expected charges. A hospital service listing can help you identify a place to contact, but it does not provide an individualized price estimate.

For community-based support, the City of Dayton describes Community Paramedicine as offering scheduled home visits and connections to healthcare and community resources. The city lists 937-333-4509 and 937-333-4535; contact the program to ask about current availability and eligibility. This is a Dayton city resource, not confirmation of access based on ZIP code alone.

Get help sorting out a bill or price

With Full Service, SakeOf provides advocacy, bill verification, fair-price review, and negotiation support under program terms. For planned care, ask the provider for an expected charge and contact SakeOf in advance about higher-cost services when reasonably possible. If a bill is unclear, an itemized statement gives SakeOf information to review, including service dates, provider details, and CPT or HCPCS codes when available.

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 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. Keep copies and follow the submission instructions for your membership.

Fair-price review and negotiation support do not guarantee a price reduction or payment outcome. Your program terms, applicable member commitment, eligibility, documentation, and available community funds all matter.

Understand support for larger eligible medical needs

Full Service combines advocacy and fair-price review with voluntary member-to-member community funding for eligible expenses. The applicable member commitment is part of the process. Funding is voluntary, and neither a particular contribution nor a payment outcome is guaranteed. Eligibility and available funds depend on program rules and review.

Keep your membership active, meet member responsibilities, and submit complete documentation promptly. During pre-existing condition review, a symptom can matter even without a formal diagnosis. The review may consider an illness, injury, symptom, diagnosis, or treatment that existed, was known, or was the subject of recommended or received care during the 24 months before membership began. Documentation, clinical review, and the Program Guide determine final eligibility. Contact SakeOf about planned care before the event when possible.

Make a local next-step plan

• For everyday care: Check whether telemedicine, Virtual Primary Care, or Mental Health and Counseling is active for you.
• For ongoing or in-person care: Use provider search or ask Jordan for help, then call the provider to confirm services, appointments, participation in any applicable arrangement, and expected charges.
• For community health centers: Use the county public-health directory as a starting point and ask an individual center about sliding-scale eligibility, services, appointments, and fees.
• For a bill: Gather the itemized bill and follow your membership’s documentation and submission timelines.
• For Medicaid application information: Montgomery County lists online, phone, and in-person application routes and County Shared Services at 844-640-6446. Contact the county about current application help; the county does not determine an individual’s eligibility through the listing.