Frequently Asked Questions

The Sedera Medical Cost Sharing Community is a membership-based non-insurance community of like-minded individuals established for the purpose of sharing legitimate healthcare expenses between members.

Instead of paying monthly premiums to an insurance company, Members share a given amount on a monthly basis and draw from Community funds as medical Needs arise. Monthly shares are generally lower than typical insurance premiums. Through Sedera’s Medical Cost Sharing model, Members save between 30 – 50% of the costs that are typically incurred with health insurance plans.

When members join, they select their Initial Unshareable Amount ($500, $1500, $2500, or $5000) which determines how much they contribute in shares each month. The monthly contribution goes into the community fund for the sharing of member medical Needs. The IUA comes into play when we have an unexpected illness or injury, it’s the amount that members are responsible to bear prior to any sharing.

For example: Let’s say a member picked the $500 Initial Unsharable Amount (IUA) and the monthly contribution that goes along with it. Each month, this member contributes their monthly share, which goes into the Community funds. Then say for example that this member has an accident and needs surgery to repair a broken arm. The estimated costs associated with this injury total $7,500. Let’s take a look at how the process would be broken down:

1. As these costs were due to an unexpected injury, this member would ‘open a Needs case’ and submit their bills to Sedera to be shared.
2. If needed, the billss will first go through bill negotiation, reducing the total cost from $7,500 to about $3,500 (we average right around a 53% reduction costs through negotiation).
3. The member would be responsible to pay their chosen IUA ($500 in this example).
4. The member receives a check for the difference, in this case $3,000 from the Community to cover the remaining medical bills from their Need.

The medical Need is resolved with the member paying a total of $500 vs the original 7,500 estimated cost. Great, right?

It’s not – the concept of medical cost sharing has been in practice for over 30 years. It started in faith-based communities and we model our medical cost sharing community after those successes, we’ve simply removed the religious rules and restrictions. Today there are over a million members participating in medical cost sharing which represents over a billion dollars shared.

To date, there have been over $28M in medical bills processed through the community and an average of 53% in cost savings through negotiations.

First things first, members typically save 30-60% when compared to traditional health insurance. And when a large medical need does arise, you have a large community of people there to support you.

On top of that, members are back in the drivers seat of their own healthcare decisions. There’s no network restrictions so members are free to seek out the care that they need from whoever they think is best.

We combine all of this with a high-quality membership experience – what’s not to love?

In general, Needs for unexpected illnesses or injuries resulting in visits to licensed medical providers, emergency rooms, testing facilities, or hospitals are sharable on a per person, per incident basis.

* Some limitations may apply, refer to the membership guidelines for more specifics.

Routine medical care such as general wellness, preventative care, and maintenance meds are generally not shared.

There are a couple exceptions to this: Colonoscopies and mammograms. These two items are sharable without the IUA if the screening is performed as a well-patient procedure (i.e. not to evaluate signs/symptoms of a potential new illness). The third exception is for routine childhood immunizations which are also sharable.

When operating as a self-pay patient for routine medical care, you’d likely be surprised to see how affordable health care really can be. In addition to in-person visits with your primary care doctor, there are a number of virtual resources you can utilize as well. Take a look at all of the resources on our Member Resources page and see how easy it is to save money on your health care.

There is no specific annual maximum dollar amount or lifetime maximum limits per member, though certain dollar amounts and/or visit limits apply to specific types of medical care and therapies. Sharing is only limited to the cumulative contributions received from participating members in any given month. There is, however, no limit on the number of Needs that an individual member or household may have.

Our commitment to complete transparency is something we strongly pride ourselves on. We highly recommend that everyone read through the membership guidelines prior to becoming a member. You can view the Sedera membership guidelines here to get a more in-depth look at how and what we share as a community.