Sedera, headquartered in Austin, Texas, has been serving its members since 2014. The company was founded by Dr. Tony Dale, and, while based on the HealthShare ministry model, has no religious requirement for membership. Instead, members commit to a healthy lifestyle, moral behavior, and certain ethical beliefs.
Recently, founder Dr. Dale once again took the role as Sedera’s CEO, with former CEO Jamie Lagarde taking the role of Chief Growth Officer, in charge of sales of business development.
How does a Sedera membership work?
Sedera does not have religious requirements for entry, and is instead focused on providing a medical cost sharing community centered around a set of core ethical beliefs that anyone is welcome to commit to.
The cost of monthly contributions depends on a member’s chosen Initial Unshareable Amount (IUA), of which there are multiple options to choose from, the prices, and the prices for them can be found on Sedera’s website: the lower a member’s IUA, the higher their monthly contribution.
Members are encouraged to contact Sedera for assistance with the needs process. Sedera member advisors assist members with submitting a need, and will advocate on their behalf to keep healthcare costs low for them and the HealthShare community. After negotiations, Sedera will transfer the funds for the need to bank account they have with Sedera, which they will then use to pay for any related medical expenses. The Expert Second Opinion (ESO) program rewards members who seek out a second opinion on any diagnosis, treatment plan related to non-emergency or elective surgeries by reducing their related IUA by $250 and a higher portion of related expenses being shared. Conversely, any member who has non-emergency or elective surgery without utilizing the ESO program will have their sharing for that need capped at 50% of related medical costs.
Sedera and pre-existing conditions
Sedera, like other HealthShares, is mainly designed to handle larger medical expenses, especially those that result from unexpected or unpredictable medical emergencies. While they do not initially share members’ pre-existing conditions in the first year of membership, depending on a member’s longevity they may share a portion, or even the totality, of related, eligible expenses. After 12 months, they will share a limited amount of medical expenses related to pre-existing conditions (initially $15k, and then $30k after 24 months), and after 37 months, those expenses will be completely shareable.
These numbers are a bit different for Team memberships. After one year of membership, a member enrolled with a team may initially share $25k, and then $50k after 24 months, and after 37 months there are no sharing restrictions.
For prospective members with long-term concerns about sharing expenses related to pre-existing conditions, this may be a key consideration.
Here is some of the top information we believe potential members might want to know about this HealthShare.
- Sharing turnaround time between 14–60 days
- Tobacco use allowed with additional monthly contribution*
- Sedera member advisors assist members through non-emergency needs
- Separate bank account required
- Sharing unavailable in some states (Illinois, New York, Pennsylvania, Vermont, and Washington)
- Members must agree to the Ethical Beliefs and Principles set forth in the guidelines
- Be under 65 years old for individual membership
- No yearly or lifetime sharing cap
- Maximum of 3 IUAs per calendar year
- 5 flexible IUA levels
- 90% of monthly contributions dedicated to member needs
- Pre-existing conditions fully shareable after 37 months of uninterrupted membership
- Expert Second Opinion program can reduce the IUA for elective and non-emergency surgeries
- Excellent member reviews
- Sharing reduction (50%) for not using the Expert Second Opinion program
- No single need may consume more than 1/3 of the total number of shares available in a given month
- Adoption expenses not shareable
- Maternity IUA $5,000–$7,500 for individual memberships
- Desire to join a HealthShare but do not meet the religious requirements of other sharing programs
- Want a family membership with a legally married, domestic parents
- Have a single parent household
- Want an alternative healthcare strategy for a team