A Total Healthcare Solution
Sedera Health is a proven insurance alternative for Direct Primary Care members who want a low-cost way to limit out-of-pocket expenses for unexpected medical needs—like surgeries or hospitalizations—that are not included in the cost of their DPC memberships. Our medical cost sharing community provides an extra layer of support just when it is needed most.
Why You’ll Love Sedera
Monthly costs start at just $99 per member—typically way less than insurance.
Always know your out-of-pocket costs before you receive care.
There’s no such thing as “out-of-network” with Sedera. We go where you go.
Need-related costs are capped after 3 medical needs for an individual (5 for a family) in a 12-month period.
Our expert advisors will help you navigate the complex world of medical care.
Get 2nd opinions on surgeries and new diagnoses from some of the world’s top doctors.
The Sedera Story
The answer to skyrocketing healthcare costs
Together with our members, we’re building a new kind of community, one centered on healthy living and sharing the cost of medical care. In doing so, we are able to provide a high-end healthcare experience, delivering tremendous value for members and their families.
A sharing economy take on healthcare
Our unique model allows members to share medical expenses at a fraction of the overhead without ever compromising quality of care. When a member has a significant need that exceeds their Initial Unshareable Amount (their committed portion), like a broken leg or MRI, they submit that need to Sedera and the community steps in to share the cost.
Your care, your choice
With Sedera, no healthcare providers are out of network, so our members have access to more options. As self-pay patients they often get better rates for care than with insurance. And because they commit to leading a healthy lifestyle, membership costs stay low as well.
30 years in the making
Sedera Health was founded by Dr. Tony Dale. A former physician from Great Britain, Dr. Dale’s interest in the American medical system began in the mid 1990s when he had to have surgery in the U.S. Through this experience, Dr. Dale saw the tremendous inconsistencies and staggering costs built into the American health insurance system. He knew there had to be a better way.
Today, Sedera has members in 45 states who share funds toward medical costs.
How medical cost sharing works
When you join Sedera, you’re joining a medical cost sharing community—not an insurance plan. Every month, you chip in a Monthly Contribution to help pay for the medical needs of other members.
When you’re the one with a medical need, you first pay your fixed Initial Unshareable Amount (IUA), and then the Sedera community steps in to share the rest.
Just people helping people.
Pricing & Membership Guidelines
Frequently Asked Questions
Does Sedera use deductibles and co-insurance?
Sedera’s process differs significantly from insurance practices in this regard; to our member’s advantage. Traditional healthcare deductibles are cumulative over the course of a plan year. Co-insurance is the portion of the medical expense owed by the patient. These insurance cost-sharing measures can amount to thousands of dollars in out-of-pocket costs to insurance policyholders annually. Conversely, when Sedera Members incur an eligible medical expense that exceeds their Initial Unshareable Amount (IUA), any amount above the IUA is then eligible for sharing, effectively reducing the member’s burden to the selected IUA for any single need.
What is the process for paying my medical bills when I have a need?
Every member of Sedera is a“self-pay” patient and should present themselves that way to their medical providers (doctors, laboratories, clinics, hospitals, etc.). The providers will, in turn, bill the Member directly. The Member then organizes their bills, fills out a Need Processing Form and submits that form, along with copies of all relative medical bills and any proof of payments. Our team of medical bill negotiators may contact the providers to discuss the appropriate payment for the services that were performed and determine if negotiations are necessary or available for the billed amounts. Members will receive the appropriate number of shares from Sedera, which they then use to pay their medical providers.
What kinds of needs do Sedera Health Members share?
In general, needs for illnesses or injuries resulting in visits to licensed medical providers, emergency rooms, diagnostic testing facilities, laboratory fees or hospitals are shared on a per person, per incident basis. See Sections 6-9 of the Member Guidelines for details.
How can I know if my need qualifies for sharing?
The types of needs that qualify for sharing can be found in the Member Guidelines. Consult Section 10 to familiarize yourself with the general procedures for submitting your need and Sections 6-9 for the specific requirements for sharing certain types of needs. If you have any questions, do not hesitate to call your Sedera Member Advisor at 1-855-973-3372.
How does Sedera handle medical claims?
Because there is no “transfer of risk” in Sedera’s health care sharing program, no “claim” is ever owed. When Members incur medical expenses we call that a medical “Need”. Sedera Members send proof of their “Need” along with their medical expenses to Sedera where they are evaluated and processed according to the Guidelines and the amount of shares collected from the Member each month. Each member’s monthly share is voluntary, but it is also a requirement to remain an active member.
Contact your direct primary care doctor to join the Sedera community.
Still have questions? Call us at 1-855-374-7791.