For Self-Pay Members

Optimal Care

Everything needed for you and your loved ones
to have access to quality healthcare and control over the costs.

It takes an average of

3 Weeks

to schedule a doctor’s appointment.
You’ll wait an average of

4 Hours

in the emergency room.
It costs an average of

$155

for a visit to Urgent Care.
And an average of

$1,318

for a visit to the Emergency Room.

Your complete healthcare solution

Medical services can be broken into two categories, Primary Care & Major Medical Care. Optimal Care combines all the services of the Optimal telehealth Primary Care membership with the financial protection of medical cost sharing for major medical events to deliver a healthcare package that’s better than insurance.

Primary Care

  • Dedicated 1:1 Doctor Relationship
  • 24/365 Access to Urgent Care
  • 24/365 “Virtual First” Triage
  • Email a Medical Specialist
  • Health Risk Assessment
  • Annual Lab Blood Panel
  • Shared Electronic Medical Records
  • Chronic Illnesses Treatment
  • Caregiver Support Tools
  • Dedicated Care Team
  • *Dermatology Consultations
  • Patient Advocacy Services
  • Behavioral Health Counseling
  • **Access to Psychology & Psychiatry Counseling

*Includes 3 Dermatology consultations per year. Additional consultations at $60 each.

**Psychology & Psychiatry Consultations are
Fee-Per-Call

Optimal Care

  • Reduce monthly price by removing the inflated cost created by the insurance industry.
  • Reduce out-of-pocket by eliminating annual deductible and co-insurance.
  • No provider networks, you chose your own doctors.
  • Free second opinion service to assure your diagnosis and treatment plan are correct.
  • No annual renewals or open enrollment
  • No annual price increases
  • No in-network/out-of-network providers

Take control of your own healthcare

Optimal Care reduces medical expenses by taking the insurance industry out of your healthcare and connecting you directly with providers, but you’re not alone, you’ll have all the support you need to navigate this new way of managing your health. It’s not difficult, it’s different, like changing from iPhone to Android.

It’s a Membership, Not Insurance

Medical Cost Sharing gives you control over the costs of your care

Get the exact same quality of healthcare as you would with traditional health insurance but at a lower cost.
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Proven solution

Medical Cost Sharing has been used by people just like you for more than 25 years.

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No more surprises

You can actually know what the costs of your care are going to be. Get the care you need without fearing the bill.

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Huge savings

Save 40-50% over the costs of traditional health insurance and say goodbye to deductibles and co-pays.

It’s a Membership, Not Insurance

community

The power of community makes quality healthcare accessible

Medical Cost Sharing means exactly what the name implies. Rather than depending on an insurance company, a community of like-minded people pool their financial resources to help each other pay for healthcare.

Need-based approach

Discover a truly need-based approach

Your understanding of how Medical Cost Sharing works begins with the concept of the “Need.” A Need is one or more medical expenses related to a SINGLE, eligible accident or illness. You agree to pay an “Initial Unshareable Amount (IUA)” for each Need. After that, the community covers the rest!

Here’s what you pay in Medical Cost Sharing

There are two kinds of payments for which you’ll be responsible for…

Monthly
Contributions

You make monthly contributions to the community fund. This amount varies depending on how many people are included in the membership, age of the oldest member and the IUA of the membership plan chosen

Initial
Unshareable Amounts (IUA)

As mentioned above, you only pay this once for each eligible medical Need. You decide this amount! IUA’s start as low as $500, and you never pay more than 3 IUA’s per year per family.

It’s a Membership, Not Insurance

Here’s how you pay in Medical Cost Sharing

Step One

Cash Pay Patient

Instead of presenting an insurance card, you present yourself to a healthcare provider as a Self-Pay or Cash-Pay patient. (Cash-Pay rates are lower than insurance rates!). Have the provider bill you or use Savvor Marketplace for funding.

Step Two

Get reimbursed

Any amount that’s above your IUA for the eligible Need that’s being treated will be reimbursed! There are no co-pays or annual deductibles. Beyond your monthly contribution, your IUA is all you’re responsible for.

Step Three

Control your costs

Your costs are always based on your Monthly Contribution and your chosen Initial Unshareable Amount for each eligible medical Need. There are no endless co-pays or hidden costs, and you’ll know what to expect.

You also gain control over who you see for healthcare. In Medical Cost Sharing, there are no “out-of-network” doctors!

Savvos – Another way to pay

Connecting Patients with the Largest Cash Pay Marketplace.

A smarter way to find a great price, schedule care, and simplify payment

We get it, cash pay medical services, shopping medical providers for the best price, it’s all new to you and you’re not sure if you’re going to like it. Sedera understands how you feel and they have always had dedicated care navigators to guide members through this unfamiliar territory. But now Sedera has taken one more step toward making you comfortable with cash pay medical services.

Sedera is now affiliated with Savvos Marketplace, the nations largest source for cash-pay medical services. Savvos not only gives you a platform to select your provider and price, they even pay the bill for you immediately. And here’s the best part, it doesn’t cost you anything! Sedera is so impressed with Savvos, they will reduce your IUA when you use their service.

No credit check, no finance contracts! As long as you have a valid Sedera membership, you’re in.
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220090+

Available Providers

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160500+

Listed Prices

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50

States

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Connect with affordable providers, approve the cost before receiving care, and pay less out of your pocket.

What We Do

Largest Cash Pay Marketplace

Savvos created the nation’s largest marketplace of affordable cash prices for shoppable medical care, including imaging, outpatient surgery, labs, and more.

The exploding demand for affordable cash prices from alternative payors includes health sharing ministries, self-funded employer groups, creative insurance products, self-pay patients, and more.

Simplifying the Healthcare Experience

Savvos Connect™ redefines the healthcare experience of patients, payors, and providers by connecting all participants in the healthcare decision to create bundled pricing in real time, simplify scheduling, secure payor approval, and guarantee Immediate Cash Payment™.

Savvos eliminates the need to develop networks or direct contracts with the alternative payor market by making cash pay pricing the future of mainstream healthcare.

For Patients

Savvos helps you save money and hassle

It’s Time for a Better Healthcare Experience

It used to be difficult to “shop” for medical care, but not anymore! Now you can compare prices and connect with affordable providers in just minutes.

  • Know the Price Before Receiving Care
  • Simplify Scheduling and Communication
  • Eliminate Surprise Billing
  • Pay Less for Medical Care

Savvos Health Pricing – No PEPM Fees!

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  • No monthly fees
  • No per user fees
  • Pay when you save
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  • Largest Cash Pay Marketplace
  • Concierge Services
  • Providers paid quickly
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  • Free for Patients
  • Free for Medical Providers
  • Lower costs & savings for Payors

Our Cash Pay Marketplace is Making Healthcare Affordable for Everyone

Our members, payors, and providers save everyday by using Savvos to connect with affordable medical care. Here are just a few examples:

ACL
Repair

Savvos Price: $6,000
Savings: $20,133

74% of Medicare Price
Reference Price: $26,133

Gallbladder Removal

Savvos Price: $4,278
Savings: $49,086

61% of Medicare Price
Reference Price: $53,364

Tonsillectomy & Adenoidectomy

Savvos Price: $2,000
Savings: $19,556

32% of Medicare Price
Reference Price: $21,556

MRI
Cervical Spine

Savvos Price: $2,000
Savings: $9,550

94% of Medicare Price
Reference Price: $10,000

Medical Cost Sharing services in Optimal Care are powered through our partnership with Sedera

Sedara is one of the premier Medical Cost Sharing organizations in the United States, which is why Optimal TeleHealth trusts them to provide excellent service to clients. Take a deeper dive into Medical Cost Sharing in this video.

Sedera Logo

It’s a Membership, Not Insurance

Examples of Medical Cost Sharing

In these examples, the Medical Cost Sharing member has chosen an IUA (Initial Unshareable Amount) of $1,500.

Remember, with Optimal Care you also have Primary Care, which gives you access to Urgent care and virtual primary care services, which means you don’t have to go to a healthcare provider in person every time you have an illness or injury. Regular interaction with your primary care physician will reduce frequency of major medical events.

Broken arm

Member breaks arm falling off a step stool at home and goes to local emergency room facility.

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Heart attack

Member has a heart attack and is home and is taken to the ER by ambulance. The patient spends 5 days in the hospital and receives an EKG, surgery, and post-surgery physical therapy. Doctor prescribes prescriptions for maintenance.

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It’s a Membership, Not Insurance

Current Group Pricing for
Optimal Care

Primary Care

Comprehensive telehealth services to compliment medical cost sharing

care

  • Everything in Essential Care
  • + 1:1 Doctor Relationship
  • Everything else you’d need in a virtual healthcare membership

Optimal Care

Add medical cost sharing to primary care and you have all you need to replace traditional medical insurance

  • Financial protection for major medical events
  • No provider networks
  • No annual price increases

Optimal Care Self-Pay Monthly Membership Contribution

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It’s a Membership, Not Insurance

Find more health benefit options for employees

Available Memberships at Optimal TeleHealth

Here’s how Access + Control come together to create healthcare benefits your employees will use
Optimal Care

It’s Not Insurance, It’s Better

Optimal Care

Optimal Care is an excellent alternative to traditional medical insurance. In addition to being 40% to 50% less expense each month, Optimal Care provides financial protection for major medical events in a way more consistent with how medical services are utilized, thereby significantly reducing out-of-pocket expenses.

  • Optimal Care includes all the services contained in Primary Care, plus medical cost sharing.
  • Medical cost sharing delivers financial protection for major medical events for as little as $500 out-of-pocket, depending upon the membership selected.
  • Optimal Care reduces medical expenses by taking the insurance industry out of your healthcare and connecting you directly with providers, but you’re not alone, you’ll have all the support you need to navigate this new way of managing your health. It’s not difficult, it’s different, like changing from iPhone to Android.

Too many people feel like they’re out of options for affordable, quality healthcare, so we created a new one. Our two-part strategy uses new technology and the power of community to control your costs and give you greater access to care than ever before.

Optimal TeleHealth

When you remove the insurance industry from your healthcare, monthly costs are reduced by 40% to 50% and your out-of-pocket expense for any major medical event drops dramatically.
© 2023 Optimal TeleHealth. All rights reserved.