Sedera Health Medical Cost Sharing

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Sedera Health Medical Cost Sharing
By Christine Corsini – Updated Mar 6, 2024
Reviewed by Mike Montes – Fact checked by Leslie Jablonski

About Sedera Health

Sedera Health is a non-religious membership-based Medical Cost Sharing community for the purpose of sharing healthcare costs between members. It is not an insurance company, but it provides an excellent alternative to traditional insurance.

The concept behind Sedera is to get like-minded people together to share medical expenses. All members must express a belief in a healthy lifestyle, and Sedera focuses on helping all members minimize their medical expenses. Members pay a monthly contribution, which is applied to legitimate healthcare bills as needed. 

(If you want to compare this program to another secular healthshare program, check out the HSA Secure).

An Overview of What Sedera Health Offers

Sedera offers two primary types of membership: ACCESS+ which is designed for individuals and families up through age 64, and SELECT+, for small businesses and groups with five or more members. 

For Sedera ACCESS and SELECT members, initial unshareable amounts (IUA) range from $500, $1,000, $1,500, $2,500, or $5,000 per medical need. 

There is no specific annual maximum dollar amount or lifetime maximum limits per member. But large sharing needs may be limited by the total available funds. For example, no single Need may consume more than one-third of the total number of shares available in the Sedera’s Excess Needs Account (“ENA”) in order to assure ample shares for all members.    
Additionally, certain dollar amounts and/or visit limits apply to specific types of medical care and therapies. 

Members are responsible for preventative care costs4, other than larger, high-cost routine diagnostic procedures of:

  • Screening colonoscopy age 45+ 
  • Childhood immunizations to age 18
  • Screening mammogram age 40+ 

As an optional add-on benefit, Sedera also offers unlimited telemedicine visits with a zero copay via Teladoc, for an additional monthly contribution. 

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

Hospital-administered medications are also fully shareable as part of an eligible need.

After the IUA, the following are eligible for sharing:

sedera primary

Primary care

sedera overall health

Specialty care

sedera emergency

Emergency room visits

sedera hospitalization

Hospitalization (in- and out-patient)

sedera surgery

Surgery (in- and out-patient)

sedera maternity

Maternity care* 

sedera diagnostics

Diagnostics Imaging (MRI, CT, PET scans)

sedera xray

X-rays

sedera laboratory

Laboratory work (out-patient)

*Pregnancies must begin after the membership effective date to be shareable. 

Maternity Specific Initial Unshareable Amount applies: 

  • Normal vaginal and emergency C-Section – $5,000
  • Elective C-Section – $7,500

Newborn Members must be added to a household no later than 30 days after birth to be eligible for shared funds. 

Please refer to the Sedera Membership Guidelines to see the fine print on how needs are shared and what limitations there are.

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 related to pre-existing conditions are not eligible for sharing. 
  • For the 2nd year (13 to 24 months), costs are shareable up to $25,000.
  •  For the third year (months 25 to 36), costs are shareable up to $50,000.
  • For fourth year, costs to treat pre-existing conditions are fully shareable.

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.

FAQs About Sedera

Q: What is Sedera Health?

Sedera Health is a not-for-profit Medical Cost Sharing community. They facilitate sharing of medical costs among members, but they are not an insurance company.

Q: How does Sedera Health work?

When a member receives medical bills, they submit the information to Sedera. Sedera’s medical bill negotiators may contact the provider to negotiate the payment amount. Sedera will review the need and administer sharing of funds with the Member (less the member’s initial unshared amount (IUA)). The member can then use this money to pay the medical provider.

Q: What does Sedera cover?

Sedera is not health insurance, so it does not “cover” medical expenses. Instead, it facilitates sharing of expenses among members. Most medical expenses are eligible for sharing, but not all. You can read more details in the Membership Guidelines.

Q: Does Sedera use Networks?

No, you are free to use the medical providers of your choice.

Q: How much does Sedera cost?

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.

Optimize Your Sedera Membership with HSA MEC

Enhance your Sedera Health membership by adding HSA MEC from HSA for America. This preventive-only, HSA-qualified plan is specifically designed to complement Sedera’s medical cost sharing approach, providing you with exceptional tax savings and investment opportunities.

Why Combine Sedera with HSA MEC?

  • Tax Benefits: Secure substantial tax deductions and enjoy your savings’ tax-free growth.
  • Investment Potential: Leverage HSAs for unparalleled tax-favored investments.
  • Healthcare Freedom: Utilize your funds tax-free for global medical expenses.

Enhance your Sedera experience with the comprehensive benefits of HSA MEC.

About Us

Since 2004, HSA for America has led the way in affordable healthcare, crafting innovative cost-saving strategies and providing strong alternatives to expensive traditional health insurance for individuals, families, and small businesses. Read more about us.

Questions about Sedera Health?

Partially self-directed healthcare plans are becoming more popular as the cost of health insurance rises. Going with an HSA-healthshare plan could be the best move for you and your family’s health and well-being.

To see what plans are available for you right now, call one of our Personal Benefits Managers at 800-913-0172.


The process of how everything went through the process and with Leslie (Personal Benefits Manager) was great! Things went smoothly and promptly, and all the information I needed was construed concisely.

Ted Chiero
WI

Misty Berryman (Personal Benefits Manager) was fantastic to work with! I explained our situation/needs to her and she went through a number of options very thoroughly. We (Misty and I) worked through each of our options and determined the best path forward for my family. She is the best and any time we are in need for insurance, she will be our first call!

Travis Lawler
TX

Mike Montes (Personal Benefits Manager) is my go-to referral for my clients.

Daniel DuBois
TN

Whitney Kline (Personal Benefits Manager) was amazing and went far above my expectations in customer service. She answered every question and so far everything has been just like she said it would be!!! thank you

Wendy Skeesick
LA

Lou (Personal Benefits Manager) made me feel comfortable with the new concept of Health Sharing by being himself, honest, and sharing his own experiences.

Neil DeFrancisco
MD

WARNING: SEDERA, INC. IS NOT AN INSURANCE COMPANY AND THE SEDERA MEDICAL COST SHARING MEMBERSHIP IS NOT ISSUED OR OFFERED BY AN INSURANCE COMPANY. WHILE EVERY EFFORT IS MADE TO MEET MEMBER’S MEDICAL NEEDS, SEDERA, INC. AND THE SEDERA MEDICAL COST SHARING COMMUNITY DO NOT GUARANTEE PAYMENT OF ANY MEDICAL EXPENSE.

Sedera Health Reviews Section

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3.7
3.7 out of 5 stars (based on 20 reviews)
5 star20%
4 star55%
3 star5%
2 star10%
1 star10%

You won't regret choosing Sedera

March 13, 2024

The plan has been a blessing for our family. The emphasis on a holistic approach to health, combined with the cost-sharing model, sets Sedera apart. The comprehensive coverage and the ability to share medical expenses with a community of like-minded individuals make healthcare more accessible. We appreciate the transparency and integrity that Sedera upholds.

Wyatt MI

Simple and transparent

January 16, 2024

The simplicity and transparency of the plan make it stand out. The cost-sharing aspect has made healthcare affordable, and the freedom to choose our providers is invaluable. Our claims have been processed smoothly, and the reimbursement process is efficient. The wellness resources provided by Sedera have been an added bonus, helping us stay proactive about our health.

Charles K MN

Sedera rocks

November 5, 2023

First, it’s way cheaper than regular insurance. I save about half off my old premiums from my former plan.

I can pick my doctor. There’s no network I have to worry about.

I’ve had a couple of medical events and got reimbursed within two weeks both times.

Preventive care is covered.

Great customer support.

I get big discounts because providers think of me as a cash customer. Which I am.

Sedera’s not for everyone. But for self-employed creatives who don’t get a break from an Obamacare subsidy (like me!) it’s a great option.

Sandy R

There system gave us an error and they denied it and screwed us

August 15, 2023

We submitted our new baby to the portal within the 30 day window that we were instructed. This update is not auto-approved, though. It is delayed. This put us in a position where our baby was not approved in their 30 day window so they rejected all of her claims. They told us that we were supposed to call to have it approved sooner, but they never communicated that in their initial emails. My partner submitted the addition within 2 weeks of having the baby, but we did not get a confirmation email which we should have received from the system. Instead, we got an email several weeks later, on august 1st, saying that the changes made on august 2nd (???) would be approved august 3rd. However, I went through my partners browsering history and she was not on the Sedera account page on the 1st or the 2nd. This means that we did not get the email confirmation at the right time and were unable to have them change the time that our baby was added to fit in the 30 day window. They said they couldn’t accept our browsing history as proof, and we didn’t have any confirmation otherwise because the email was not sent when she completed the account change. I tried to test the email confirmation by adding a new account, and we got an email right away, but that did not happen the first time. I found it strange that the wording of the email confirmation was different the first time than the test time, but the rep I spoke to claimed that was due to a time discrepancy with a tech company they contract. This is not to mention that they are tirelessly picking apart every claim that we submit saying that we don’t have the right information. It feels like they are picking us apart over every dollar, and that we got screwed on a tech issue when we tried our best to follow the policy. There is no element of basic human decency or trust. I would not recommend this company at all.

Cole B.
Verified

So far so good

July 9, 2023

Had a small issue but they got it fixed. Member Services and Needs Coordinators are SO easy to contact and communicate with! Pretty happy with our plan so far.

Rachel J
Verified

There are Pros & Cons

March 2, 2023

WHAT I LIKE: Sedera saves me almost half what I was paying for my family health insurance plan from Blue Cross. We earn just over the threshold for an ACA subsidy, so that’s a big deal for us.

Reimbursement is pretty quick. We had some shareable expenses and they sent what they were supposed to send within a week of us submitting all the bills.

When we do have an issue, customer service has been great. They’re easy to contact and very responsive.

WHAT I DON’T LIKE: Sedera doesn’t share costs for naturopathic, homeopathic or other alternative forms of care.

Jim B
Verified

Disappointed!

December 2, 2022

I’m very disappointed in my maternity experience with Sedera. There is already a high unshareable amount ($5,000) which we agreed to pay. I gave birth to my daughter in November 2021 and was told I needed to add her within 30 days to have her covered by Sedera. I tried to add her online 4 days after her birth and thought I added her successfully, only to realize too late that it didn’t work. I told them what happened and even sent my internet history showing I was on the Sedera website 4 days after her birth, but my request was denied. We now have to pay an additional 4k+ for her birth because of this mistake.

Andrea W
Verified

Not the cheapest plans but worth it

October 20, 2022

Terrific! I had to have minor surgery two weeks ago. I submitted the final bill to Sedera and they wired me the full shareable amount within a week! I didn’t even have to make a phone call.

It wasn’t the cheapest healthshare plan on the market, but I’d definitely recommend them.

Colleen O
Verified

Better than Trinity for our business

August 11, 2022

Our last healthshare company went out of business last year so we had to find a new one. Only went with Altrua because of a recommendation from another business owner. We’re pretty happy with them so far. The plans are bit more expensive but not by much. We dealt with our first cost sharing requests this week and everything went smoothly.

Markus L.
Verified

Took 3 weeks to get paid

June 23, 2022

My ER bill was waiting to be paid for almost 3 weeks. The cost sharing came through, but I had to hold of on paying some bills. Just be ready for the wait if you get sick or injured.

Tremayne B.
Verified

Best customer service yet

April 29, 2022

We got a needs coordinator when my wife was sick with COVID late last year. He was so nice and attentive, and was calling to check on our needs all the time. We felt really taken care of, and it was during such a hard time. Thanks to the whole team!

Dean C.
Verified

Cost sharing took almost a month

February 10, 2022

I was in the E.R. really briefly, and it was covered by my Sedera program. But It took a few weeks for the sharing payment to come through. I was hoping it would be a little quicker. But it worked just like they said it would.

Layla J
Verified

Great customer service!

January 15, 2022

Hands down, these guys have the best customer service team in the business. If you’ve ever had to drive your kid to the hospital, then you know how much it means to have someone who truly cares handling the bill. I’ll never forget the love and care we received from the Sedera community in our time of need. Members for life.

Dan K
Verified

Affordable way to give my employees healthcare

December 19, 2021

Everyone was telling me that I needed to offer a health plan if I wanted my company to grow. I don’t need to offer anything because I only have about 20 employees. But Sedera lets me choose how much to contribute. I can pay a little towards their plans, and that’s much better than nothing.

Keith D.
Verified

Sedera sharing is working well for our small business

December 3, 2021

Our small company transitioned to health sharing this year with Sedera. This was our first time offering an employee health benefit, and we weren’t sure how it would go. Last week we submitted our first needs claim, and the process was just as smooth as they said it would be. The employee got their check within weeks, which is even faster than they predicted.

Julie W
Verified

Sedera has done a pretty good job

November 30, 2021

The costs from my ER visit took about 30 days to process. I’ve heard other members getting their cost sharing handled in as fast as two weeks, so that was kind of a bummer. But other than that, Sedera has done a pretty good job. They’re team is super nice, and that’s always a big deal.

Sheila M
Verified

Our of pocket was More than Expected

November 15, 2021

Loving the monthly price of the plan. But I went to the ER last week and had to pay almost the whole bill myself, just because I hadn’t met my member commitment yet. It was a hard bill to cover.

Nathan F
Verified

Sedera offers a good alternative to expense health insurance

October 2, 2021

I’d love to give my employees a good health insurance plan, but since we’re so small, there’s just no way we can afford it yet. Sedera healthshare isn’t as comprehensive as some of the group plans that we looked at, but it’s a lot more affordable. Now, we at least have something in place for a benefits package. For now, it gets the job done.

James W
Verified

Sedera came through for me!

September 9, 2021

I was diagnosed with an immune disorder in 2019. I was already signed up with Sedera, but I was terrified that it wasn’t going to be enough to pay for what was about to come. Once I was admitted to the ICU, I thought that I’d be paying a fortune. But Sedera connected me with my needs coordinator, they handled everything. The community came together and paid for my hospital costs, just like they said they would.

Billy S.
Verified

Works great for my small business

August 14, 2021

I got my small business signed up with Sedera last year, after the pandemic made it clear that I needed to offer some kind of health benefit. I was losing employees to other jobs that could offer health insurance. The Sedera Select plus plan lets me contribute however much I want, giving my workers an option that’s affordable. I think it’s working … We’re pretty happy with the program so far.

Leah B.
Verified
 

1001-A E. Harmony Rd #519 Fort Collins, CO 80525
Telephone: 800-913-0172
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