Sedera Health Medical Cost Sharing

An Overview of What Sedera Health Offers

For Sedera SELECT members, IUAs range from $500, $1,000, or $1,500 per medical need.

For both Sedera SELECT and ACCESS, there isn’t a maximum share amount. However, while the dollar amount is not capped, available funds or membership guidelines may limit sharing.

Preventive care screenings, such as colonoscopies and pap smears, are shareable prior to meeting the IUA. Childhood immunizations, before age 18, are also shareable. Telemedicine is available with a $0 consult fee and is an unlimited service. 

Maintenance medications are not shareable for existing medications. Medications for new conditions, on the other hand, are shareable for the first 120 days. Curative medications are shareable as part of a need.

After the IUA, the following are eligible for sharing:

Surgery (in- and out-patient)

Laboratory work (out-patient)

Any pre-existing condition that has been active or needed treatment within 36 months prior to membership is subject to sharing limitations.

Pre-existing conditions will be eligible for sharing based on how long the member has held membership. For the first year (12 months), costs are not eligible for sharing. For the second year (13 to 24 months), costs are shareable up to $25,000. For the third year (25 to 36 months), costs are shareable up to $50,000. Starting the fourth year (37 months), costs are eligible for sharing.

To make the most of this platform, you’ll want to be sure to take advantage of your Sedera Advisor whenever you have a medical need. They can help you find the right healthcare professionals, negotiate for the best prices, and even save money on surgeries.

How to Take Advantage of Group Pricing Discounts

While Sedera is designed for businesses of five or more, Sedera can make exceptions down to three if there is an expectation of growth.

How to Set Up an HSA-qualified Plan

Through the Sedera Benefits program, you can also enroll in an HSA-qualified minimum essential coverage (MEC) plan, which meets the Employer Mandate of the ACA.

An HSA, or health savings account, allows you to deposit pre-tax money in a tax-advantaged HSA, which can then be used to pay future medical expenses. 

The tax savings can be substantial. More information is on our HSA Info page.

Quotes and Application

Start your instant quote by selecting your State at the top or bottom of this page.

This will show you your estimated monthly share amount and take you to the Sedera Health Benefits Enrollment page.

The first step is to agree to complete the Sedera Benefits Enrollment and Lifestyle Profile.

In the second step, in the Referring Source, choose “Wiley Long.” (If you do not choose us, we will not be able to help if you ever need assistance.)

When you complete your payment information, there will also be a one-time $125 set-up fee to join the Sedera Benefits platform. In years two and beyond, there is a $50 annual membership renewal fee.

The final step will take you to the Sedera website to complete that portion of the application.

If you apply no later than the 20th of the month, your membership can be effective starting the first of the following month.