Is Sedera Insurance?
No. Sedera is not health insurance. Its own guidelines state that Sedera “is not an insurance company nor is it insurance.” Sedera is a medical cost sharing community: members' monthly contributions are used to share each other's eligible medical bills under written guidelines, with no legal guarantee of payment.
Written and reviewed by Graham Kerswell, Founder of Beacon Health Benefits.
What “Not Insurance” Means in Practice
| Feature | Sedera (Medical Cost Sharing) | Traditional Health Insurance |
|---|---|---|
| Can you compel payment? | No. Sharing is voluntary; you stay responsible for bills | Yes. Enforceable under the insurance policy contract |
| What you pay first | An IUA per Need (max 3 per year) | An annual deductible per calendar year |
| Monthly price | Set by household size, age of oldest, IUA, and tobacco status | Set by age and plan; tax credits may subsidize premiums |
| Pre-existing conditions | Phased in over 3 years ($0 shared in Year 1) | Covered from day one under ACA mandates |
| Provider network | None; see any doctor or hospital nationwide | Restricted HMO/PPO networks with out-of-network penalties |
| Minimum essential coverage? | No | Yes |
| Regulatory oversight | Not regulated as insurance | Regulated by state insurance commissioners |
Why Isn't Sedera Insurance?
In insurance, a customer pays a premium to transfer financial risk to an underwriter that legally promises to pay claims. In Sedera, members do not transfer risk; they agree to voluntarily share each other's eligible medical Needs according to published guidelines.
If in any given month the total eligible Needs submitted exceed the total funds available from member shares, sharing can be prorated. While Sedera negotiates bills, offers an appeals process, and maintains high transparency, there is no legal mechanism to force payment.
Does Sedera Count for State Mandates?
No. Sedera is not minimum essential coverage. While there is no longer a federal tax penalty for going without insurance, Massachusetts, New Jersey, Rhode Island, and Washington, DC enforce their own individual tax mandates. Health sharing does not exempt residents in those states.
When is Insurance the Better Choice?
- • You qualify for substantial income-based tax credits on HealthCare.gov
- • You have an active ongoing condition requiring immediate treatment this year
- • You are pregnant or planning to give birth within the next ~9 months
- • You want contractually guaranteed reimbursement and consumer appeal protections
Then Why Do People Choose Sedera?
Primarily for cost savings and clinical freedom: no provider network locks, no lifetime maximums, the ability to join any month of the year, and a flat monthly amount that doesn't penalize households with higher incomes. Paired with Direct Primary Care for everyday visits, it provides a practical alternative for self-employed and healthy families.
Is Sedera a scam?
No. It is an established program with 10+ years of operation, an appeals process, and published guidelines.
Will it pay my hospital bill?
Eligible bills above your IUA are shareable under written rules, though payments are not legally guaranteed.
Can I use an HSA?
Sedera is not an HDHP, so it does not make you eligible to contribute new funds to an HSA on its own.
Not sure if health sharing fits your situation?
Call (704) 255-4580 or request an online analysis. We will tell you if insurance is the better fit.
Statutory Legal Notices:
Health care sharing ministries and medical cost-sharing communities are not insurance and are not regulated as insurance. Sharing of medical expenses is voluntary and not guaranteed.
Beacon Health Benefits is not an insurance agency and does not sell insurance. We help individuals explore non-insurance alternatives.