Healthcare after employer coverage ends in New Madison

Start with the care you need

SakeOf is a healthcare membership built around a practical question: what kind of help do you need now? It combines membership services, advocacy, fair-price review, voluntary community sharing, and optional direct-service or discount features selected during enrollment. You choose the provider for in-person care; SakeOf can help you understand available membership services and review bills.

The current handbook base membership fee is $50 per member per month. Your final monthly amount depends on your program, household, community ask, selected features, and any applicable Full Service commitment adjustment. Use the calculator to explore your likely setup, then review membership options or ask Jordan a question if you want help comparing features.

Use selected services for everyday care

Common illnesses and symptoms

When Zero Copay Telemedicine and Rx and Prescription Benefits are both active, eligible urgent-care telemedicine consultations cost $0 through the current service partner. Access is available 24/7 by phone or video where licensing and service-partner availability permit. The service is intended for common non-emergency concerns appropriate for telemedicine. If the clinician recommends an exam, lab, imaging, specialty care, a procedure, or in-person follow-up, arrange that care separately with a provider.

Prescriptions and counseling

When Rx and Prescription Benefits are active, check the current pharmacy tool before filling a prescription. A listed formulary medication can be $0 when the participating-pharmacy process and prescribing and dispensing requirements are met. Non-formulary medications may have a negotiated or discount price; they are not automatically $0. The current formulary and pharmacy rules determine whether a specific medication is included.

Mental Health and Counseling is available when selected and active, with its required companion features active. It includes unlimited telephonic counseling through the current service partner and, when arranged and available, up to three face-to-face consultations per incident. Check your membership details for current access and arrangement terms. Virtual Primary Care may also be an option in the membership choices available to you; review those details rather than assuming it is active.

Choose a local provider when you need in-person care

Family Health Services lists its New Madison clinic at 101 Anderson Street, New Madison, OH 45346, with weekday hours of 8:00 a.m. to 5:00 p.m. The listed phone number is (937) 996-0023. Call to confirm current hours, appointments, whether the service you need is offered at this location, and expected charges. ^{www.summahealth.org}

The clinic lists behavioral health, dental, eyecare, family medicine, home health, internal medicine, pediatrics, pharmacy, specialty care, and women’s care at its New Madison location. It also lists patient resources on insurance assistance and a sliding discount scale. Ask the clinic about current eligibility and terms, and whether the particular service you need is available there. ^{www.summahealth.org}

For county public-health services, the Darke County General Health District lists nursing, immunization, Help Me Grow, environmental health, and vital-record services. These are county public-health resources, distinct from a clinic or hospital visit. Check the district for current service details, hours, and fees. ^{www.summahealth.org}

For any in-person service, use provider search to identify an option, then contact the provider to confirm availability and expected charges. The provider you choose remains central to arranging care; SakeOf can help you understand your membership services and, when applicable, review bills.

Get support understanding a bill

Full Service includes advocacy and fair-price review. If a bill is unclear or seems high, gather the itemized bill and contact SakeOf to discuss a review and possible next steps. Negotiation support may be available as part of the process, but the amount owed and any result depend on the bill, review, and program rules.

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

Plan ahead for larger eligible needs

In Full Service, larger eligible events involve an applicable member commitment and voluntary community funding, subject to program rules and review. The commitment and event eligibility depend on the specific program terms. Community funding is voluntary, so it is not a guaranteed payment. Keep your membership active and current, and contact SakeOf in advance for planned higher-cost care when reasonably possible.

Before scheduling planned care, request an itemized estimate from the provider and ask what services it includes. Contact SakeOf about the information needed for the event, and confirm provider availability and charges directly. This can help you understand the expected bill and the review process before care begins.

Compare features and take your next step

Some memberships offer optional features for specific needs. Maternity is a Full Service community-sharing feature when offered and selected. It has an $18 monthly adjustment, requires continuous active selection for at least 12 months before conception, and has a $5,000 member responsibility per eligible pregnancy before community sharing, subject to program rules.

Ask about current options if dental or vision discounts, chiropractic or acupuncture, PT or OT, or durable medical equipment matter to your household. Availability depends on the options offered and selected, so review the current membership details before planning care or spending.

• Use the calculator to explore membership and household costs.
• Call Family Health Services at (937) 996-0023 about New Madison appointments, the service you need, expected charges, and its sliding discount scale. ^{www.summahealth.org}
• Use provider search for other in-person care, then confirm availability and charges with the provider.
• Read the Savings Guide, ask Jordan a question, or review membership options to decide what to do next.