facilitates healthcost sharing for:
* Recognized Sedera Associations
*Is Not Religiously Affiliated
Individuals are able to enroll in Sedera through a
Sedera Certified Association
that I work with to best serve you
*No Enrollment Costs
*No Yearly Renewal Costs
*Low Monthly Costs
- As low as $124 monthly
*No Yearly Commitment
With Sedera, your relationship is with your provider-
Not an insurance company!
As a "Cash Pay" patient,
you are not limited
by networks - or even borders.
SEDERA'S GOALS = YOUR GOALS
*Low monthly membership costs
*Sedera puts HealthCare
back in your hands!
Standard and Preferred Pricing Available
and Supporting Health
Sedera Member Advisors help with..
+ Health Cost Estimates
+ Medical Bill Negotiation
* Mammography over age 40
* Colonoscopy over age 50
* Childhood immunizations
A 2nd.MD video consultation is appropriate for any member who has
* A chronic condition,
*Has a new diagnosis
*Has a condition requiring surgery**
Unlimited use of 24/7/365
state licensed physicians
available via phone or online.
Doctors are able to assess the situation and when appropriate prescribe medications.
Included in the cost of the
"Need" for the first 120 days of a new diagnosis. Alternative Medications
with Prior Approval
Not eligible for sharing but our resources greatly reduce costs
3 free counseling sessions through Head to Heart per need.
If further assistance is needed, Sedera Member Services assists members in finding additional affordable and accessible solutions.
Sharing Guidelines include sharing in eligible psychiatric hospitalizations
You choose the initial unsharable amount from $500-$5,000. Once the total costs for any new “Need” exceeds that amount, the Sedera Medical Cost Sharing program will share in those expenses.
A "NEED" is defined as ALL of the expenses experienced surrounding a new diagnosis, accident or illness.
The initial Unshared Amount (IUA)
is met only once for the "Need"
A "Need" may include an ambulance, emergency services, curative prescriptions, medical supplies and rental of durable medical equipment, x rays, imaging, hospitalizations, specialists, rehabilitation...
the list is quite exhaustive and comprehensive.
IUA stands for The initial Unshared Amount
When a medical expense is experienced
If /when the total of expenses surrounding a "Need"
goes over the member's chosen IUA
it is then fully shared thereafter.
"The Need" stays open, and all related expenses will be group shared, until 1the issue has resolved itself or 12 months has past without further expenses.
Let's say you fall of a ladder and you break your leg. You require emergency transport to an Urgent Care of ER, there you have the expenses of the physician, x-rays, etc and require crutches and incidentals.
Then, once home, you go to an Orthopedic Dr, go for a second opinion and let's say that you require surgery. The surgery, and all associated costs, post surgical physician visits, and rehabilitation therapy are all part of the one "Need"
To further protect members:
If any individual has met 3 IUA's within a given year,
Or a couple, single parent or family, more than 5 IUA's
Any further expenses would be then shared at dollar one
When a members can quickly and easily add the expense into their online Sedera Member's App where it will be stored until if /or when the total of the expenses surrounding the "need" exceeds the chosen IUA.
Once an IUA is meet and a new "Needs Case" is opened, the member can view their account and how their expenses are being shared, quickly and easily.
Any Medical condition that existed prior to membership
(diagnosed, suspected or producing observable signs or symptoms)
is considered a Pre-Existing Medical Condition.
Pre-Existing Medical Conditions that have not exhibited symptoms
during the 36 continuous months prior to membership effective date
is considered cured and will have no sharing restrictions.
Pre-Existing Medical Conditions become eligible for sharing
based on the member’s tenure with Sedera,
First 12 months: Not Sharable
Months 12-24: Eligible up to $15,000
Months 24-36: Eligible up to $30,000
Month 37 and thereafter: Fully Eligible
Sharing restrictions do not apply for high blood pressure, or high cholesterol as long as the member has not been hospitalized for either condition within 36 months prior to membership and the condition is controlled through medication and/or diet.
Additionally, expenses related to medical treatment for conditions related to hemorrhoids and/or sleep apnea, in the 36 months prior to membership, are not subject to the restrictions.
All births are eligible for sharing with an expected due date 12 months after commencement of membership
Individual via Sedera Access:
Vaginal births: Shared dollar one after a $5,000 IUA
Planned C-Section: Shared after a $7,500 IUA
Home Births - The member’s IUA will be reduced to $500 for home births as as
they significantly reduce overall maternity costs.
Birthing Center - The member’s maternity IUA will be reduced
by 50% for utilizing a birthing center
The member’s maternity IUA will be reduced by 50%
for a vaginal birth after cesarean (VBAC).
Your Member Services Representative
can additionally assist you in locating quality birthing centers.
PLEASE SEE SEDERA ACCESS (FOR INDIVIDUALS)
OR SEDERA SELECT (EMPLOYER GROUPS)
FOR MORE DETAILS