Healthcare when you work for yourself in Dayton

Build a care path around what you need

SakeOf brings everyday-care options, provider choice, bill support, and help with eligible larger medical needs into one healthcare membership. Members can compare Full Service and Major Medical Only, then select any optional features that fit their needs. Your enrollment summary, effective dates, active features, and program terms determine which services and processes apply.

Start with the question in front of you: do you need a first step for a new concern, ongoing care, a local in-person service, or help understanding a bill? Matching the need to the right path can make the next step clearer. Use the SakeOf calculator or Savings Guide to compare options, search for a provider, or ask Jordan to help you understand membership features.

Use everyday care options when they fit

When Zero Copay Telemedicine is selected and active, it can be a convenient starting point for appropriate virtual care. If the clinician recommends an exam, test, or in-person follow-up, you can choose a provider for that care and ask what services and charges will be involved.

Prescription benefits may be available when selected and active. Check the current feature terms for the medication and pharmacy you plan to use. Medication or pharmacy charges may be separate, and a third-party prescription benefit may have coordination rules of its own.

Mental Health and Counseling may provide access to counseling when active. Psychiatry, inpatient behavioral health, and medication costs are separate unless another active benefit or program expressly includes them. Virtual Primary Care may be another option when selected and active; compare its service terms with the kind of ongoing care you are looking for.

Choose local in-person care in Dayton

For an in-person evaluation, test, or hospital service, you can choose a provider and confirm the details directly. Kettering Health Dayton is at 405 West Grand Avenue, and its location page lists emergency care and on-site laboratory, imaging, and pharmacy services. Confirm current services, appointment access, and expected charges with the facility before non-emergency care. [[cite:]]

Public Health – Dayton & Montgomery County lists area community health centers and describes sliding-scale fees at listed federally funded centers. Contact a center directly to ask about services, eligibility, appointments, and payment options. The department describes its own clinic as offering limited appointment-based services rather than primary or urgent care; call 937-225-4550 to confirm current clinic services and scheduling. [[cite:]]

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. [[cite:]]

For emergencies, use emergency services. For planned or non-emergency care, asking about the service, access, and expected charges in advance can help you choose your next step.

Get help reviewing a bill or price

Full Service includes advocacy, bill verification, fair-price review, and negotiation support. If a bill is confusing or a price needs a closer look, gather the itemized bill and contact SakeOf to start the review process. An itemized bill should show service dates and provider information, with CPT or HCPCS codes when available. SakeOf may request clinical notes, medical or billing records, provider documentation, or a signed release.

Submit complete documents within six months of the service date. Send balance bills, denials, or payment demands within 10 days of receiving them. Keeping your membership current, responding to document requests, and following the applicable member responsibilities helps move the review forward.

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. The applicable member commitment, documentation, eligibility requirements, and available community funds all matter. Contact SakeOf in advance for planned higher-cost care when reasonably possible, so you can understand the process and your responsibilities before care begins.

For pre-existing condition review, an illness, injury, symptom, diagnosis, or treatment that existed or was known—or for which advice, diagnosis, or care was recommended or received—during the 24 months before membership began may be treated as pre-existing. Final decisions depend on documentation, clinical review, and the Program Guide.

Plan ahead for household features

If maternity is relevant to your plans, pregnancy must begin after the continuous 12-month maternity waiting period is complete. Adding or restoring the maternity feature after conception does not make that pregnancy eligible. Review the timing and newborn enrollment requirements before planning care.

Dental and vision discounts are a separate kind of benefit: members pay participating providers directly at the applicable discounted rate. Discounts vary and are not guaranteed at every provider; routine dental and vision expenses are not community-shared. Depending on selected and active features, chiropractic or acupuncture, PT/OT, and durable medical equipment may also be worth checking in your enrollment details.

Choose your next step

• For a new concern: Check whether telemedicine is selected and active, and ask whether any recommended in-person care is separate.
• For ongoing care: Compare Virtual Primary Care, if active, with local health-center services and appointment options.
• For a prescription: Check the active prescription feature’s terms for your medication and pharmacy.
• For local care in Dayton: Contact a provider or community health center directly to confirm services, access, and expected charges.
• For a bill or planned major expense: Ask SakeOf about Full Service advocacy, fair-price review, documentation, and applicable member responsibilities.
• To compare memberships: Use the calculator or Savings Guide, search for a provider, or ask Jordan about your options.