Sedera Health Medical Cost Sharing
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By Christine Corsini – Updated Feb 18, 2023
Reviewed by Mike Montes – Fact checked by Leslie Jablonski
About Sedera Health
Sedera Health is a 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.
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:
Emergency room visits
Hospitalization (in- and out-patient)
Surgery (in- and out-patient)
Diagnostics Imaging (MRI, CT, PET scans)
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.
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 $15,000.
- For the third year (months 25 to 36), costs are shareable up to $30,000.
- After 36 months, 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?
Q: How does Sedera Health work?
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?
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.
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.
Sedera Health Reviews Section
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There are Pros & Cons
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.
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.
Not the cheapest plans but worth it
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.
Better than Trinity for our business
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.
Took 3 weeks to get paid
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.
Best customer service yet
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!
Cost sharing took almost a month
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.
Great customer service!
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.
Affordable way to give my employees healthcare
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.
Sedera sharing is working well for our small business
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.
Sedera has done a pretty good job
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.
Our of pocket was More than Expected
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.
Sedera offers a good alternative to expense health insurance
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.
Sedera came through for me!
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.
Works great for my small business
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.
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