Health care cost sharing ministries left some members to pay high childbirth bills
Health care sharing ministries offer reimbursements for members’ medical bills. But they are largely unregulated, and most restrict maternity coverage. Four families said they struggled to get reimbursed for childbirth costs.
ARDEN, N.C. — Rachel Kaplan was uninsured when she became pregnant last year. So her doctor suggested an alternative: a nonprofit called Sedera, which bills itself as a medical cost-sharing service.
Sedera members pay monthly fees that get pooled together, and the organization can use the collected funds to reimburse members for medical bills. The model is somewhat akin to health insurance, but Sedera isn’t subject to the same regulations.
“It seemed simple enough that we were like, ‘OK, this makes sense,’ only to find out when I tried to submit the bill from the hospital, we were denied,” Kaplan said.
She and her husband, Andrew Sheffield, reached out to Sedera for reimbursement after their son, Lucas, was born in August 2023. The delivery had involved an induction, 40 hours of labor and ultimately a cesarean section — the kinds of complications that can send hospital bills skyrocketing. But to the couple’s shock, they said, Sedera told them they were ineligible, citing a policy near the end of the group’s member guidelines: Within the first year of membership, medical bills for childbirth “are not shareable.”
“We basically gave Sedera our money and received nothing in return,” Kaplan said. “The rug was pulled out from underneath us.”
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