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Join the Association and be part of our group.
What is Medical Cost Sharing?
Our Healthy Care Strategy uses
Medical Cost Sharing to
Eliminates the chance of financial catastrophe from bad health.
Healthcare Expenses
Sedera Health (Sedera) is a group healthcare
solutions and benevolence organization. It’s
modeled after a number of proven and highly
successful medical sharing ministries that have
facilitated the sharing of their member’s
healthcare expenses for more than two decades
within the confines of the Christian community.
For the benefit of the shareholders that own the
Insurance Company
For the benefit of the members that share in the
Community Funds
Medical Cost Sharing – a Fast Growing Health Solution
Medical Cost Sharing – a Better Way
Health Care through
Community vs Health
Care through Insurance
Industry Wide Estimate:
1 Billion in Sharing
1 Million Members
Freedom from
Networks
Big Savings Over
Health Insurance
Sharing begins at $500, $1000,
$1500, $2500 or $5000 per
need you decide
Promotes a Healthy
Lifestyle
Medical cost sharing by Sedera Health is not insurance and is specific to the Sedera Health membership community.
“Industry-wide statistic source: www.healthcaresharing.org
Medical Cost Sharing is “Need” Based
Defining a “Need” and how it works
A “Need” is one or more medical expenses
caused by a SINGLE accident or illness
Initial Unshared Amount (IUA)
What members pay before Sharing begins for the Need
Needs over the IUA ($500, $1000, $1500,
$2500 or $5000)
Limiting your out-of-pocket costs
Fully Shared with the Community
Three (3) for Individual and five (5) when there are
family members participating. Everything is fully
shareable after that point.
Medical Cost Sharing in Real Life
Comparing $5000/Family Member Insurance Deductible vs a $500 Initial Unshareable Amount
For Example, a family’s two year old
daughter had a persistent ear infection.
Their deductible was $5,000/per family
member threshold
Care for the child required:
1. A series of antibiotics and booster
injections
2. Visit with an ENT specialist who
inserted tubes in the child’s ear at
a local hospital
Cost of an average family insurance policy with a primary of 45 and a $5000
deductible is $1450.00 per month, a $500 IUA healthy care strategy is $783.00/mn
Medical Cost Sharing in Real Life (continued)
Members pay for visits and treatments up to the IUA, costs are fully shared thereafter.
Pre-Existing Conditions
Pre-existing Conditions:
When well controlled, these conditions DO NOT
have sharing restrictions
• High Blood Pressure
• High Cholesterol
• Sleep Apnea
• Non-Insulin Dependent Diabetes
Pre-existing Conditions:
Sharing Restrictions*
A condition is considered pre-existing if a member
had symptoms or treatment in the last 36 months
at the time of joining the community.
• Year 1: No Sharing for the Condition
• Year 2: $15,000 sharing limit
• Year 3: $30,000 sharing limit
• Year 4: Fully Shareable
* Standard sharing restrictions apply when joining the community for genetic defects and/or hereditary disease. There are also restrictions on
existing pregnancies when joining the community. Please see the Sedera Member Access Membership Guidelines for more information..
Prescription Drug Coverage
Medications:
Cure
Examples: Antibiotics, pain medications related
to a car accident or post pregnancy, chemotherapy
drugs
+ Same sharing rules apply
Maintenance
Examples: Blood pressure medication, cholesterol
medications
+ Sharing eligible for first 120 days following a new
diagnosis
+ After 120 days on a new diagnosis (or for an existing
diagnosis): Our Pharmacy Consultant has good
resources for securing discounted prices for
maintenance medications (paid from pre-tax HSA or
Health Matching Account HMA)
In addition to sharing medical expenses, Sedera provides
access to:
• Counseling – Marital, Emotional and Spiritual
• Medical Bill Negotiation
• Telemedicine
• Expert Second Opinion
• Personal Member Advisor

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What is medical cost sharing?

  • 1. Join the Association and be part of our group. What is Medical Cost Sharing?
  • 2. Our Healthy Care Strategy uses Medical Cost Sharing to Eliminates the chance of financial catastrophe from bad health. Healthcare Expenses
  • 3. Sedera Health (Sedera) is a group healthcare solutions and benevolence organization. It’s modeled after a number of proven and highly successful medical sharing ministries that have facilitated the sharing of their member’s healthcare expenses for more than two decades within the confines of the Christian community.
  • 4. For the benefit of the shareholders that own the Insurance Company
  • 5. For the benefit of the members that share in the Community Funds
  • 6. Medical Cost Sharing – a Fast Growing Health Solution
  • 7. Medical Cost Sharing – a Better Way Health Care through Community vs Health Care through Insurance Industry Wide Estimate: 1 Billion in Sharing 1 Million Members Freedom from Networks Big Savings Over Health Insurance Sharing begins at $500, $1000, $1500, $2500 or $5000 per need you decide Promotes a Healthy Lifestyle Medical cost sharing by Sedera Health is not insurance and is specific to the Sedera Health membership community. “Industry-wide statistic source: www.healthcaresharing.org
  • 8. Medical Cost Sharing is “Need” Based Defining a “Need” and how it works A “Need” is one or more medical expenses caused by a SINGLE accident or illness Initial Unshared Amount (IUA) What members pay before Sharing begins for the Need Needs over the IUA ($500, $1000, $1500, $2500 or $5000) Limiting your out-of-pocket costs Fully Shared with the Community Three (3) for Individual and five (5) when there are family members participating. Everything is fully shareable after that point.
  • 9. Medical Cost Sharing in Real Life Comparing $5000/Family Member Insurance Deductible vs a $500 Initial Unshareable Amount For Example, a family’s two year old daughter had a persistent ear infection. Their deductible was $5,000/per family member threshold Care for the child required: 1. A series of antibiotics and booster injections 2. Visit with an ENT specialist who inserted tubes in the child’s ear at a local hospital Cost of an average family insurance policy with a primary of 45 and a $5000 deductible is $1450.00 per month, a $500 IUA healthy care strategy is $783.00/mn
  • 10. Medical Cost Sharing in Real Life (continued) Members pay for visits and treatments up to the IUA, costs are fully shared thereafter.
  • 11. Pre-Existing Conditions Pre-existing Conditions: When well controlled, these conditions DO NOT have sharing restrictions • High Blood Pressure • High Cholesterol • Sleep Apnea • Non-Insulin Dependent Diabetes Pre-existing Conditions: Sharing Restrictions* A condition is considered pre-existing if a member had symptoms or treatment in the last 36 months at the time of joining the community. • Year 1: No Sharing for the Condition • Year 2: $15,000 sharing limit • Year 3: $30,000 sharing limit • Year 4: Fully Shareable * Standard sharing restrictions apply when joining the community for genetic defects and/or hereditary disease. There are also restrictions on existing pregnancies when joining the community. Please see the Sedera Member Access Membership Guidelines for more information..
  • 12. Prescription Drug Coverage Medications: Cure Examples: Antibiotics, pain medications related to a car accident or post pregnancy, chemotherapy drugs + Same sharing rules apply Maintenance Examples: Blood pressure medication, cholesterol medications + Sharing eligible for first 120 days following a new diagnosis + After 120 days on a new diagnosis (or for an existing diagnosis): Our Pharmacy Consultant has good resources for securing discounted prices for maintenance medications (paid from pre-tax HSA or Health Matching Account HMA)
  • 13. In addition to sharing medical expenses, Sedera provides access to: • Counseling – Marital, Emotional and Spiritual • Medical Bill Negotiation • Telemedicine • Expert Second Opinion • Personal Member Advisor