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Healthcare 3.0   – healthcare NOT health insurance

Virtual or Direct Primary Care with Medical Cost Sharing

ACB – Affordable Care Benefits

Access to Care

Connect to a physician on your time, as often as needed in-person or through our secure, HIPAA – compliant text first platform

Continuity of  Care

When further services are required, your care logistics team will locate, negotiate price and set appointment.

Control Care Costs

Pay/Share large expenses i.e. Hospital, Surgeries, Specialist, MRI etc. with a Medical Cost Sharing Community

Key Elements and Features of the MPB Virtual Care Solution

  • Direct Doctor access 8am and 10pm – 7 days a week. Communicate with a dedicated physician within 60 seconds from phone or web with an easy, intuitive chat interface. Need to share photos, or prefer to use phone or video to connect? No problem – MPB supports these functions, too. $0 co-pay

  • Members can breathe easy knowing they can chat with doctors as long as they’d like, whenever it fits in day day. The conversation doesn’t end until they get the answers – and peace of mind – they need. Then the medical records are added to member’s PMR Vault for access by they circle of care team.
  • Care Logistic Team – for situations where an in-person visit is necessary, they provide fair price navigation, negotiation, and appointment setting for convenience and ease.

Wellness programs are out. Wellbeing strategies are in.

It’s time for a new approach that goes beyond wellness to help individuals excel in every facet of their lives: physically, emotionally, socially, and financially.

White Paper of Capbilities

 

Large Preventive services are shared at $0 co-pay in Medical Cost Sharing (colonoscopies, mammograms and child immunizations). Most other preventive services are handled by text, phone or video with the assistance of images and our Wellbeing Program.

We create ONE cohesive team of providers and develop ONE game plan for our members. Our providers coordinate with ONE point of contact to navigate YOU through the complex healthcare system. This reduces the burden on you and your family by creating an easy to understand process to follow.

A better way to manage prescriptions

We aren’t just an app that gives you some coupons or rebates to take to your local pharmacy and “save” on your prescriptions.

MPB Pharmacy Benefit gives you the real prices (aka we skip the “markups and fees” part) on your prescriptions, and tells you the pharmacy where you can get them. From there it’s entirely up to you, but most people get pretty excited to save more money. Getting ripped off feels pretty horrible. Let’s cut that out.

The “PMRVault” patient-centric healthcare platform was created on the premise that the patient’s electronic health records must be accessible throughout the care continuum, no matter the level, source or time of day. This level of integration and access drives clinical quality, positive provider – patient experience and lower costs in a value-based world.

Create a “Circle of Care” that gets access to all your medical records and notification of qualified changes. That communication increases your physicians knowledge of your condition enhancing your experience and speed to recovery.*

Key Elements and Features of the DPC Direct Primary Care Solution

  • Although each DPC Doctor has their own features list, generally they all provide same day direct access to their members during business hours and virtual all other times for most preventive, primary and some urgent care.

  • You can breathe easy knowing you as often as you like at no additional charge, you can continue to meet with your Primary Care doctor until your condition is resolved to your satisfaction.
  • For care beyond the scope of services provide by Primary Care, they provide fair price navigation and referral to like minded – cash based Physicians.

Large Preventive services are shared at $0 co-pay in Medical Cost Sharing (colonoscopies, mammograms and child immunizations). All other preventive services are handled under the scope of services offered by your Direct Primary Care Physician

Sourced by your DPC Doctor.

Features of the Sedera Medical Cost Sharing Community

Benevolence Cost Sharing Community – for Large Curative Treatments (including Specialist, Hospitalization, Surgeries, ER Visits, MRI’s, etc.) that are caused by an accident or illness above the selected Initial Unshareable Amount.

No Network Concerns – select the best Specialist or Service Provider when large medical bills arise, without concern whether they are in or out of network.

The Community is Open to All – who are health-focused, however, certain conditions that have had symptoms, diagnosis or treatment in the past three years have a waiting period.

Dedicated Member Services Team guides members in navigating each of a full suite of innovative cost containment services.

A look-back period of 36 months applies to all prior medical conditions for Sedera Health applicants. A prior medical condition is a condition for which the applicant has either received medical treatment, taken medication or exhibited observable symptoms. Any prior medical condition that has not exhibited symptoms during the 36 continuous months prior to the membership effective date is considered cured and will have no sharing restrictions. Prior medical conditions will become eligible for sharing based on the Member’s tenure with Sedera, as indicated by the Community Guidelines.

Sharing restrictions do not apply for high blood pressure, cholesterol, type two diabetes or sleep apnea as long as the member has not been hospitalized in the 36 months prior to membership and the condition is controlled through medication or diet.

Maintenance Medications for treatment of chronic conditions will not be shared.

Sedera’s Medical Cost Sharing program is “Needs” based. A “NEED” is your request for the Costs caused by an accident or illness to be Shared with the Sedera Community.

Small medical expenses are managed via your Direct Primary Care membership.

When you enroll in the Medical Cost Sharing Community, you select the amount that you can comfortably afford to pay, called the I.U.A – Initial Unshareable Amount. Then, should a Large Medical Need occur, it is shared at 100% by the Community above that amount.

The Initial Unshareable Amount (I.U.A.) $1500 is more similar to a deductible in Auto Insurance than the annual deductible in Health Insurance. Should an accident or illness occur, you pay the first $1500 and the community pays 100% of the balance until your health is restored to its previous condition or better. There are no constraints of time or money – the need remains active until you no longer show signs or symptoms relating to that accident or illness for twelve months.

An Individual Member has a maximum of 3 Needs per calendar year. For all other membership types the maximum is 5 Needs per year.

Navigating the complex world of healthcare can be difficult. Healthcare 3.0 makes it easy with our mobile app. Access all components of care from one location.

Whether engaging in “Self-Care” finding a recipe, setting an appointment with a Doctor  or  submitting a bill to Sedera Medical Cost Sharing, Healthcare 3.0  removes the confusion and eliminates the fear of leaving health insurance.

Member Units pays a $100 setup fee and a $25 annual membership fee.

For more information, call the Healthcare Advisor that sent you here or (800) 519-2969