Healthcare after employer coverage ends in Shawnee

Start with the care you need

SakeOf is a healthcare membership and a smarter alternative to the traditional insurance-first way of paying for and navigating healthcare. The practical starting point is simple: identify the care you need, choose an appropriate route, and understand how the relevant SakeOf options work before moving forward.

For a common, non-emergency concern, an active telemedicine option may offer a convenient place to start. For ongoing needs, Virtual Primary Care can provide a dedicated physician relationship with virtual follow-up, an annual virtual wellness visit, a health-risk assessment, and chronic-care or medication-management support when clinically appropriate for virtual care. It is a direct service with a monthly adjustment, and requires Rx and Prescription Benefits, Zero Copay Telemedicine, and Mental Health and Counseling to remain active for the current bundled tier.

Urgent or emergency symptoms call for appropriate urgent or emergency care; a routine virtual-care workflow is not an emergency response.

Build an everyday-care routine

Zero Copay Telemedicine, Rx and Prescription Benefits, and Mental Health and Counseling are distinct membership options. They apply only when selected, active, eligible, and otherwise subject to program rules. Counseling being active does not by itself include psychiatry, inpatient behavioral health, emergency psychiatric care, neuropsychological testing, residential substance-use treatment, or medication costs.

For prescription needs, check the active Rx benefit and its current terms. If you also use another healthcare arrangement, check the terms that apply before combining benefits; participation in one service does not establish that another vendor benefit can be combined with an insurance claim.

Virtual Primary Care can support ongoing virtual follow-up when that care is clinically appropriate. Labs, imaging, in-person exams, procedures, specialist visits, and medications are separate expenses and follow their applicable program rules. If your care needs one of those services, plan for that next step rather than assuming it is part of the virtual visit.

Use local care when an in-person visit makes sense

Genesis Primary Care lists a primary-care office at 118 W. Main St. in Shawnee, with phone number 740-394-6205. Its directory lists Tuesday through Friday, 7:00 a.m. to 3:30 p.m.; it also notes that the office closes at 3 p.m. for lab draws and walk-in appointments. Call to confirm current services, appointment options, hours, participation, and expected charges before arranging care.

If you need county public-health services, Perry County Health Department in New Lexington lists nursing services including immunizations, disease control, clinics, and community health services, as well as environmental health and health education. Call 740-342-5179 to ask about current services, scheduling, and fees. A county resource guide also lists Perry County Family Practice at 1625 Airport Road SE in New Lexington; confirm its current location, services, appointment availability, participation, and charges directly.

These are local options to investigate, not guarantees of a particular service or appointment. Keep provider choice central: ask the provider about the specific care you need and its expected price, then check the applicable SakeOf program rules before higher-cost care when reasonably possible. Statewide directories can help with Medicaid provider and application information, but they do not establish local availability or individual costs.

Get help making sense of a medical bill

When a bill is unclear or seems unusually high, SakeOf’s Full Service advocacy can help with bill verification, fair-price review, and negotiation support, subject to program rules. The applicable member commitment and the details of the event matter; SakeOf does not promise a particular price or outcome.

Keep the itemized bill and supporting documents. Submissions require an itemized bill with service dates, provider information, and CPT or HCPCS codes when available. SakeOf may request records or other documentation to review eligibility, medical necessity, and fair pricing. Submit complete documents within six months of the service date; send balance bills, denials, or payment demands within 10 days of receiving them.

For planned higher-cost care, contact SakeOf in advance when reasonably possible. That gives you an opportunity to understand the review process and applicable member responsibility before care. Keep your membership active, maintain a valid payment method, and fund required asks.

Understand support for larger eligible events

For a larger eligible medical event, the applicable member commitment is part of how the event is handled. Voluntary community funding may also be involved for larger eligible events, subject to program rules. Eligibility, documentation, and the specific program terms matter, so review the applicable details rather than assuming an event or expense will qualify.

Maternity is one option with specific conditions: pregnancy must begin after the continuous 12-month maternity waiting period is completed. When eligible and subject to program rules, the maternity feature may include certain routine prenatal care, medically necessary pregnancy-related care, delivery charges, and postpartum care through six weeks. The feature has a sharing limit. If you are considering maternity, review its current rules before relying on it, and add a newborn to membership within 30 days of birth.

Take a useful next step

• For a quick care question: Check whether your selected, active telemedicine option fits the need.
• For ongoing virtual care: Review the Virtual Primary Care prerequisites and monthly adjustment.
• For a Shawnee office visit: Call Genesis Primary Care at 740-394-6205 to confirm current availability, participation, services, and charges.
• For a bill or planned major expense: Use the Savings Guide or contact SakeOf at 800-212-5920 to understand the process and applicable rules.
• To explore membership: Use the calculator, provider search, or Jordan to compare next steps and available options.