Healthcare when you work for yourself in Troy

A healthcare membership built around practical choices

SakeOf gives members a way to organize everyday care, choose providers, and get help making sense of medical bills. You can start with the kind of care you need, then explore which active membership options fit that situation. For a common, non-emergency concern, that might mean telemedicine. For ongoing primary care, it may mean reviewing Virtual Primary Care. When you need in-person services, you choose a provider and can ask about expected charges before care.

For higher-cost care, Full Service can support bill verification, fair-price review, and negotiation. Eligible larger events may also involve voluntary community funding under program rules. Your next step can be simple: compare options with the calculator or Savings Guide, search for providers, or ask Jordan to help you understand a feature.

Use everyday care options when they fit

Zero Copay Telemedicine is designed for common non-emergency illnesses and symptoms appropriate for a virtual visit. The current service partner does not impose a program limit on consultation frequency or duration. Provider availability, technology, state law, clinical appropriateness, and prescribing rules still apply. A clinician may issue a prescription when appropriate and legally permitted; its cost depends on the active Rx program.

A virtual visit can be a convenient starting point for an everyday concern. If the clinician recommends an examination, tests, imaging, specialist care, or in-person follow-up, you can choose a provider for that next step. Emergency symptoms call for emergency services.

When Rx and Prescription Benefits is active, listed formulary medications may be available at $0 through the participating-pharmacy process when prescribing and dispensing requirements are met. Check the current pharmacy tool before filling: formulary content, participating pharmacies, and vendor rules can change. Non-formulary medications are not automatically $0; separate active programs may be needed for chronic-maintenance or other medication categories.

Build a routine for ongoing care and counseling

Virtual Primary Care is a separate option with a $15 monthly adjustment. When it is active alongside its required bundled options—Rx and Prescription Benefits, Zero Copay Telemedicine, and Mental Health and Counseling—it provides virtual primary-care access through the current service partner, a dedicated physician relationship, an annual virtual wellness visit and health-risk assessment, and ongoing virtual follow-up. Chronic-care follow-up or medication-management support is available when clinically appropriate for virtual care.

Mental Health and Counseling may include problem assessment, supportive counseling, follow-up when available, crisis support, and referrals when more care is needed. Psychiatry, inpatient behavioral health, emergency psychiatric care, neuropsychological testing, residential substance-use treatment, and medication costs are separate unless another active benefit or program expressly includes them. Review your active options to see what applies to your household.

Choose local care in Troy when an in-person visit is needed

Troy has two identified hospital campuses. Upper Valley Medical Center is at 3130 N. County Road 25-A and lists emergency, heart, cancer, behavioral-health, and other services. [[cite:]] Kettering Health Troy is at 600 W. Main St. and lists inpatient and outpatient services, emergency and cancer care, lab, and imaging. [[cite:]] These city-level listings are useful starting points; call the facility to ask about the service you need, appointments, and expected charges.

Miami County Public Health is located at 510 W. Water St., Suite 130, Troy, and lists clinic, immunization, community-health, and family-and-children services. Its phone number is 937-573-3500. [[cite:]] Contact the department about current services, appointments, eligibility, and fees. Public-health clinics, urgent care, and hospitals are different care settings, so ask which services are available where you plan to go.

Use SakeOf provider search to begin exploring care options. Before scheduled care, contact the provider to ask about availability, participation in any applicable arrangement, payment options, and expected charges. A provider listing can help you find a place to start; direct confirmation helps you plan the next step.

Get support reviewing a medical bill

Full Service advocacy can help members with bill verification, fair-price review, and negotiation support. If a bill is unclear or higher than expected, gather the itemized bill and related records and contact SakeOf about submitting them. The itemized bill should include service dates, provider information, and CPT or HCPCS codes when available.

SakeOf may request clinical notes, medical records, diagnosis or procedure details, billing records, or a signed release to review eligibility, medical necessity, and fair pricing. Submit complete documents within six months of the service date. Send a balance bill, denial, or payment demand within 10 days of receiving it. Members also need to keep their membership current, fund required asks, and pay the applicable member commitment or feature-specific responsibility.

Plan ahead for larger eligible needs

For planned higher-cost care, contact SakeOf in advance when reasonably possible. That gives you a chance to ask what information is needed, how the event will be reviewed, and what member commitment or feature-specific responsibility applies. Voluntary community funding may be part of the process for eligible larger events under program rules. Plan with SakeOf rather than assuming a particular event or amount will be funded.

If maternity planning is relevant, check the feature timing early: 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. Ask SakeOf about current terms and applicable limits as you consider your options.

Explore options for your household

Depending on available options and program terms, membership may also include dental and vision discounts, chiropractic or acupuncture, PT/OT, and durable medical equipment. Check the Savings Guide or ask Jordan which options are currently available and how to check a specific service.

• Everyday concern: Check whether Zero Copay Telemedicine is active and appropriate for your situation.
• Ongoing virtual care: Review Virtual Primary Care’s prerequisites and $15 monthly adjustment.
• Prescription: Check the current formulary and participating-pharmacy process before filling.
• Troy-area in-person care: Use provider search, then contact the provider about services, access, and expected charges.
• Bill or planned major event: Contact SakeOf about records, timing, and the applicable member commitment.
• Compare membership choices: Start with the calculator or Savings Guide, ask Jordan, or review membership options.