Sedera Health Medical Cost Sharing

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Sedera Health Medical Cost Sharing
By Christine Corsini – Updated Nov 23, 2022
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

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

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:

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)

*(only if member doesn’t have access to maternity care through other means)
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 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.

Available for Individuals, Families, and Small Groups

Sedera Access+ is available to individuals and families, up through age 64. Sedera Select+ is designed for businesses of five or more, but Sedera can make exceptions down to three if there is an expectation of growth.

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.

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.


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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3.9
Rated 3.9 out of 5
3.9 out of 5 stars (based on 13 reviews)
5 star31%
4 star46%
3 star8%
2 star15%
1 star0%

Not the cheapest plans but worth it

Rated 4 out of 5
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

Rated 4 out of 5
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

Rated 2 out of 5
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

Rated 5 out of 5
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

Rated 4 out of 5
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!

Rated 5 out of 5
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

Rated 4 out of 5
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

Rated 4 out of 5
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

Rated 3 out of 5
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

Rated 2 out of 5
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

Rated 4 out of 5
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!

Rated 5 out of 5
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

Rated 5 out of 5
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
 

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