ARDEN, North Carolina. When Rachel Kaplan became pregnant last year, she had no insurance. As a result, her physician recommended Sedera, a nonprofit organization that markets itself as a medical cost-sharing program.
Members of Sedera pay monthly dues that are combined and used by the organization to pay for members’ medical expenses. Although Sedera is not governed by the same laws as health insurance, the model is fairly similar.
According to Kaplan, it appeared straightforward enough that we thought, “Okay, this makes sense,” but when I attempted to submit the hospital bill, we were turned down.
Following the birth of their baby, Lucas, in August 2023, she and her husband, Andrew Sheffield, contacted Sedera to request payment. An inducement, forty hours of labor, and a cesarean section were all part of the birth process—the kind of problems that often cause hospital expenditures to soar. To the couple’s surprise, however, Sedera informed them that they were not qualified, citing a rule at the end of the group’s member standards that states that medical expenditures related to childbirth are not shareable during the first year of membership.
According to Kaplan, we essentially gave Sedera our money and got nothing in return. They yanked the rug out from under us.
Several inquiries for comment from Sedera were not answered.
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