Sedera Creates a Community of Health Care Cost Sharing
Feb 26, 2021 08:30AM ● By Sheila Julson
Leslie Allen
After a career in advertising, Leslie Allen struck out on her own in the employee/individual benefit field offering health care plans and supplemental benefits for consumers. After seeing many changes during the nearly two decades in the business, she realizes that one size does not fit all.
Allen watched clients struggle with the traditional healthcare model where monthly premiums can be prohibitive; the cost to use the product was excessive due to high initial out-of-pocket costs or surprise bills; and confining restrictions of networks. She came to embrace the medical cost sharing (MCS) model of health care which has been around since the early 20th century, based on a community of like-minded individuals coming together to share in each other’s medical needs.
Sedera, headquartered in Austin, was founded in 2014 by Dr. Tony Dale, of Great Britain, is led by president and CEO Jamie Lagarde and operates nationwide. “More than 1 million members have shared billions of dollars in medical expenses across the various sharing ministries,” Allen says. Typically, MCS ministries require members to make a statement of belief or faith, but Sedera has removed the barriers to entry by building on a set of ethical beliefs, creating an inclusive community regardless of personal belief or faith. “The market is changing, and we’re on the precipice of huge changes in health care,” she says. “Sedera is a terrific fit for what I see for the future.”
The company sees 250,000 medical fundraising campaigns per year started by individuals (gofundme.com/start/medical-fundraising). Allen also cites a study published in the American Journal of Medicine that found 60 percent of U.S. bankruptcies result from medical bills, and that 77 percent of those people had major medical insurance at the time.
Sedera brings together a powerful community of individuals and families to be active and engaged participants in their healthcare decision-making. “The concept is simple and incredibly powerful,” Allen says. “There are no networks, and members can seek treatment where they wish. There are no insurance cards; Sedera members are cash pay patients.”
She explains that the member selects an Initial Unshareable Amount (IUA) that suits them. It could be $500, $1,000, $1,500 or $2,500. This is the initial amount a member pays on their own prior to any amount that may be eligible for sharing. Once the IUA is met, expenses are submitted to Sedera headquarters, reviewed and negotiated. The funds are then delivered to the member for payment to their providers, which typically takes 30 days. Allen says bills are reduced by up to 50 percent. A dedicated member advisor helps the member navigate the situation the entire time.
She cites an example. “Dad develops pneumonia, which requires hospitalization for three days at a total cost of $12,000. His IUA is $500, leaving the remaining $11,500 eligible for sharing. Or Mom is diagnosed with skin cancer requiring lab work and surgical removal on an outpatient basis at a total cost of $3,500. Her IUA is $500, leaving the remaining $3,000 eligible for sharing.”
Allen emphasizes that Sedera promotes freedom of choice and supports members’ ability to choose their own doctors and healthcare facilities, as well as allowing the freedom to choose their personal strategy for dealing with medical issues.
“The Sedera model and corporate culture is one that is truly committed to lifting up one another’s burdens,” Allen advises. “Members have access to a partner throughout the entire process. There’s a robust prescription program in the Rx marketplace with access to international pharmacies, bulk home delivery service, discount cards and prescription assistance directly with the manufactures. There’s a telemed service and the Doctor’s Second Opinion feature to give members even more choices. They become their own best advocate and are actively involved in taking care of their own health. Health care can be complicated and expensive. We believe it should be affordable, efficient and transparent.”
For more information about Sedera, contact Leslie Allen at 972.284.0709, email [email protected] or visit Sedera.Community/LeslieAllen.
Allen watched clients struggle with the traditional healthcare model where monthly premiums can be prohibitive; the cost to use the product was excessive due to high initial out-of-pocket costs or surprise bills; and confining restrictions of networks. She came to embrace the medical cost sharing (MCS) model of health care which has been around since the early 20th century, based on a community of like-minded individuals coming together to share in each other’s medical needs.
Sedera, headquartered in Austin, was founded in 2014 by Dr. Tony Dale, of Great Britain, is led by president and CEO Jamie Lagarde and operates nationwide. “More than 1 million members have shared billions of dollars in medical expenses across the various sharing ministries,” Allen says. Typically, MCS ministries require members to make a statement of belief or faith, but Sedera has removed the barriers to entry by building on a set of ethical beliefs, creating an inclusive community regardless of personal belief or faith. “The market is changing, and we’re on the precipice of huge changes in health care,” she says. “Sedera is a terrific fit for what I see for the future.”
The company sees 250,000 medical fundraising campaigns per year started by individuals (gofundme.com/start/medical-fundraising). Allen also cites a study published in the American Journal of Medicine that found 60 percent of U.S. bankruptcies result from medical bills, and that 77 percent of those people had major medical insurance at the time.
Sedera brings together a powerful community of individuals and families to be active and engaged participants in their healthcare decision-making. “The concept is simple and incredibly powerful,” Allen says. “There are no networks, and members can seek treatment where they wish. There are no insurance cards; Sedera members are cash pay patients.”
She explains that the member selects an Initial Unshareable Amount (IUA) that suits them. It could be $500, $1,000, $1,500 or $2,500. This is the initial amount a member pays on their own prior to any amount that may be eligible for sharing. Once the IUA is met, expenses are submitted to Sedera headquarters, reviewed and negotiated. The funds are then delivered to the member for payment to their providers, which typically takes 30 days. Allen says bills are reduced by up to 50 percent. A dedicated member advisor helps the member navigate the situation the entire time.
She cites an example. “Dad develops pneumonia, which requires hospitalization for three days at a total cost of $12,000. His IUA is $500, leaving the remaining $11,500 eligible for sharing. Or Mom is diagnosed with skin cancer requiring lab work and surgical removal on an outpatient basis at a total cost of $3,500. Her IUA is $500, leaving the remaining $3,000 eligible for sharing.”
Allen emphasizes that Sedera promotes freedom of choice and supports members’ ability to choose their own doctors and healthcare facilities, as well as allowing the freedom to choose their personal strategy for dealing with medical issues.
“The Sedera model and corporate culture is one that is truly committed to lifting up one another’s burdens,” Allen advises. “Members have access to a partner throughout the entire process. There’s a robust prescription program in the Rx marketplace with access to international pharmacies, bulk home delivery service, discount cards and prescription assistance directly with the manufactures. There’s a telemed service and the Doctor’s Second Opinion feature to give members even more choices. They become their own best advocate and are actively involved in taking care of their own health. Health care can be complicated and expensive. We believe it should be affordable, efficient and transparent.”
For more information about Sedera, contact Leslie Allen at 972.284.0709, email [email protected] or visit Sedera.Community/LeslieAllen.
