Healthcare after employer coverage ends in Dayton

A care path built around your needs

SakeOf is a healthcare membership designed to make the next step clearer: identify the care you need, review the options available through your membership, and choose a provider or service that fits. That can mean an initial conversation about a new symptom, ongoing primary-care support, a prescription, an in-person test, or help understanding a bill.

Membership includes two primary programs, Full Service and Major Medical Only. Your program, selected features, effective dates, and applicable responsibilities determine what is available. Use the calculator to explore membership options, then read the Savings Guide to understand how the model works. Contact Jordan if you want help thinking through your membership choices.

Use selected everyday-care options

For an initial conversation when you feel unwell, Zero Copay Telemedicine may be available if selected and active. Virtual Primary Care may offer another route for primary-care support when that feature is selected and active. Check your membership details for access instructions and the services each option can address. If an in-person examination, test, or specialist is needed, you can choose a provider and confirm the appointment and charges directly.

If you need medication, review whether Rx and Prescription Benefits are active and check the current terms for the medication and pharmacy arrangement. Confirm the price before filling a prescription; the benefit terms determine what applies to a particular medication or pharmacy.

Mental Health and Counseling may provide counseling support when selected and active. Psychiatry, medication costs, inpatient behavioral health, and other services are separate unless another active benefit or program expressly includes them. For any feature, check its effective date and terms before relying on it; a feature added later does not make an earlier service or expense eligible.

Choose local in-person care when it fits

You can choose an in-person provider for an examination, lab work, imaging, specialist care, or hospital services. Kettering Health Dayton is located at 405 West Grand Avenue, and its location page lists emergency care, laboratory, imaging, and pharmacy services. ^{www.summahealth.org} Contact the facility to confirm current service availability and expected charges. A hospital service listing is not an individualized price estimate.

For emergency symptoms, seek emergency care. For non-emergency care, ask the provider what service is appropriate, whether an appointment is available, and what you may be expected to pay. Provider participation, prices, and patient responsibility depend on the service and provider, so confirm details before care.

At the county level, Public Health – Dayton & Montgomery County lists community health centers and describes sliding-scale fees at listed centers. ^{my.clevelandclinic.org} Ask a center directly whether it offers the care you need, whether you qualify for its fee arrangements, and what charges or payment options apply. The county public-health clinic has limited, appointment-based services; call 937-225-4550 to confirm current services and scheduling. ^{my.clevelandclinic.org}

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 confirm current availability and eligibility. ^{www.summahealth.org} These are city and county resources, not confirmation of a particular appointment, provider arrangement, or price for an individual.

Get help when a bill needs a closer look

Full Service offers advocacy, bill verification, fair-price review, and negotiation support under program rules. If a bill is confusing or seems out of line with the service, contact SakeOf with the bill and relevant details. The team can review the charge and explain next steps. Fair-price review and advocacy help you examine a bill; they do not promise a particular result.

An itemized bill is required for submissions and should include service dates, provider information, and CPT or HCPCS codes when available. SakeOf may also request medical records, clinical notes, billing records, or other documentation. Submit complete documents within six months of the service date. Submit a balance bill, denial, or payment demand within 10 days of receiving it.

Know how larger eligible expenses are handled

For larger medical events, Full Service combines advocacy and fair-price review with voluntary member-to-member community funding for eligible expenses. The applicable member commitment, active membership, documentation, and program rules matter. Community funding is voluntary and is not guaranteed. Keep your membership current and contact SakeOf in advance about planned higher-cost care when reasonably possible.

Eligibility can depend on the event, timing, documentation, and program terms. Symptoms can be considered during pre-existing-condition review even without a formal diagnosis. Review your membership details and ask SakeOf how the rules apply before planning care. Turning on a feature later does not create retroactive eligibility for an earlier condition, service, or course of treatment.

Explore other selected options and take a next step

Depending on your household’s needs, membership options may include maternity, dental and vision discounts, chiropractic or acupuncture, PT/OT, and durable medical equipment. Each option has its own selection and eligibility terms. For dental and vision discounts, members pay participating providers directly; actual discounts vary. Routine dental and vision bills are not community-shared unless another written program term expressly states otherwise.

• Explore options: Use the calculator and Savings Guide to compare membership choices and understand the model.
• Find care: Use provider search where helpful, then confirm services, appointments, participation, and expected charges with the provider.
• Ask a question: Contact Jordan about your situation or membership choices.
• Ask about Medicaid applications: Montgomery County lists County Shared Services at 844-640-6446 for program and application information. Contact the county about application routes; this does not determine individual eligibility. ^{my.clevelandclinic.org}