HealthShare Works

What is an IUA? (Initial Unshareable Amount)

Thank you for your intrest in our services, however we are unable to serve your

 

state at the present time.

Thank you for your interest in joining Sedera Health. If you have questions or concerns regarding this form, please call Sedera Health toll-free at 1-855-973-3372. We are happy to help you with anything you need.

 
The following requirements benefit all members by assuming honor and integrity. Through adherence to these principles, members minimize medical risks and ensure proper accountability while encouraging good health practices. All Sedera members must agree with and attest to the following principles. If at any time a member no longer meets all of these membership requirements, they must notify Sedera immediately and their membership and all privileges will cease. unless otherwise indicated.

 

A. I believe that a community of moral, ethical and health-conscious people can most efficiently and effectively encourage and care for one another by sharing each other’s medical needs directly.

 

B. I understand that Sedera, Inc is a benevolence organization that facilitates the Sedera Medical Cost Sharing Community, not an insurance entity, and that while Sedera, Inc. will make every effort to facilitate the sharing of a Sedera member’s medical needs, Sedera, Inc., in and of itself, cannot and does not guarantee the payment of any medical expenses.

C. I agree to practice good health measures and strive for a balanced lifestyle.

 

D. I agree to refrain from the usage of any form of illegal substances.

 

E. I understand that medical needs caused by, or due to, the act of performing any illegal or unlawful activity will not be shareable.

 

F. I agree to submit to mediation followed by subsequent binding arbitration, if needed, for any instance of a dispute with Sedera, Inc. or its affiliates.

 

G. I am an employee, member, or participant of a sponsoring entity that is providing access to the Sedera Medical Cost Sharing Community and am eligible for membership with the Sedera Medical Cost Sharing Community through that relationship. I understand that Sedera, Inc., Version: Select 20190901 19 Sedera Medical Cost Sharing - Select Membership Guidelines by and of itself, does not make any representation that the Sedera Medical Cost Sharing Community satisfies any federal or state law requirements for healthcare coverage or insurance.

 

H. I agree to sign and submit a membership continuation agreement each renewal year confirming my commitment to adhere to these principles.

 

I. I have read an understand all of the above, as well as the Sedera Membership Guidelines (including the Disclaimers and Section 12 Disputes and Reconciliation) and am certifying that all of my answers are true and accurate and indicate my agreement to abide by the Membership Guidelines as well as the Member Principles and Responsibilities.

 

The Primary Member (applicant) accepts the responsibility to notify, educate and inform all persons listed on their application for membership of the above Member Principles and Responsibilities as well as the Sedera Membership Guidelines and accepts the responsibility to assure their adherence to, and cooperation with, the requirements of membership. All members who have joined within a primary member’s account will have access to information for any other members within the same account. This information includes all pending and past medical needs and other personal information. Any applicant (or their eligible dependents) who is not comfortable with the Sedera Membership Guidelines is free to decline the offer to participate in the Sedera membership.

 

Disclaimers WARNING: : SEDERA, INC. IS NOT AN INSURANCE COMPANY AND THE SEDERA MEDICAL COST SHARING MEMBERSHIP IS NOT ISSUED OR OFFERED BY AN INSURANCE COMPANY. WHETHER A SPONSORING ENTITY CHOOSES TO SEND MONETARY ASSISTANCE TO YOU AND/OR YOUR FAMILY TO HELP WITH YOUR MEDICAL EXPENSES WILL BE TOTALLY VOLUNTARY AND NEITHER YOU NOR SEDERA, INC. HAS ANY RIGHT TO COMPEL PAYMENT OF MEDICAL COST SHARING COSTS FROM ANY MEMBER. THE SEDERA MEMBERSHIP IS NOT AND SHOULD NEVER BE CONSIDERED TO BE OR TO BE LIKE A GROUP INSURANCE POLICY OR AN INDIVIDUAL INSURANCE POLICY. WHETHER YOU RECEIVE ANY MONEY FOR MEDICAL EXPENSES, OR WHETHER OR NOT THIS MEMBERSHIP CONTINUES TO OPERATE, YOU AS THE MEMBER WILL ALWAYS REMAIN LIABLE FOR YOUR UNPAID MEDICAL EXPENSES AND DO NOT HAVE ANY LEGAL RIGHT TO SEEK REIMBURSEMENT OR INDEMNIFICATION FOR ANY SUCH EXPENSES FROM SEDERA, INC. OR ANY OTHER MEMBER OR SPONSORING ENTITY. THIS IS NOT A LEGALLY BINDING AGREEMENT TO REIMBURSE OR INDEMNIFY YOU FOR THE MEDICAL EXPENSES YOU INCUR, BUT IS AN OPPORTUNITY FOR YOU TO ASSIST OTHER MEMBERS IN NEED, AND WHEN YOU ARE IN NEED, TO PRESENT YOUR MEDICAL BILLS TO OTHER MEMBERS AND SPONSORING ENTITIES AS OUTLINED IN THESE GUIDELINES. THE FINANCIAL ASSISTANCE YOU MAY RECEIVE WILL COME FROM OTHER MEMBERS AND/OR SPONSORING ENTITIES, AND NOT FROM SEDERA, INC.

Payment Authorization Terms & Conditions

I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify SHMI Inc. in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. For ACH debits to my checking/savings account, I understand that because these are electronic transactions, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates. In the case of an ACH transaction being rejected for Non Sufficient Funds (NSF) I understand that SHMI Inc. may at its discretion attempt to process the charge again within 30 days, and agree to an additional charge for each attempt returned NSF which will be initiated as a separate transaction from the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I certify that I am an authorized user of this credit card/bank account and will not dispute these scheduled transactions with my bank or credit card company; so long as the transactions correspond to the terms indicated in this authorization form.

While member health status has no effect on eligibility for membership, there are limitations on the sharing of needs for certain conditions that existed prior to the membership effective date. Needs that do not qualify for medical sharing may still be met in part or in whole through Special Needs Sharing. (See Sedera Guidelines, Section 5.A. See Sections 6-9 of the Guidelines for a detailed list of shareable and non-shareable needs.)

In general, needs that result from a medical condition that existed prior to membership (known or producing observable symptoms) are only shareable if the condition appears to be fully cured and thirty-six (36) months have passed without any observable symptoms (either benign or deleterious), treatment, or medication, even if the cause of the symptoms is unknown or misdiagnosed. Additional limitations apply for specific medical conditions as indicated below. See Sedera Guidelines, Sections 7 – 8 and Appendix.

Medications prescribed for chronic, long-term conditions and taken on a regular, recurring basis (i.e. maintenancemedications) are not shareable unless associated with a new diagnosis and then only for 120 days. Examples of common maintenance medications are insulin, blood pressure medicine, cholesterol medicine, etc.

Please be advised:

Medical expenses for child birth that have an expected delivery date within the first 12 months of membership are not shareable.

Medical Condition(s)

In the past 36 months (9 months for pregnancy) have you or any family member applying for membership;