TL;DR

• Sedera Pricing: Individual contributions range from $153 to $742 per month; families pay $378 to $2,088 per month based on age and IUA tier.
• Pre-Existing Conditions: Sedera does not share costs for the first 12 months. From months 13 to 36, limits apply on what gets shared. After 36 months, pre-existing conditions become fully shareable.
• Cost Structure: Members choose an Initial Unshareable Amount (IUA) between $500 and $5,000, plus a mandatory 20% co-share on eligible bills after the IUA is met.
• HSA Compatibility: Sedera is HSA-compatible, allowing self-employed individuals to save pre-tax dollars for medical expenses. Presidio status varies and requires direct verification.
• Faith Requirements: Sedera is secular with no church attendance required, making it a primary alternative to traditional Christian ministries for non-believers or those seeking secular options.

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Choosing health coverage when you are your own boss is a nightmare. You know the drill. You look at ACA marketplace plans, see the premiums, and feel your stomach drop. Then you find medical cost sharing. It looks cheaper, but the rules are different. One of the biggest questions right now is Presidio Health vs Sedera.

You want to know which one won't leave you holding the bag for a $50,000 surgery. You want to know which one actually works with your budget. Most people pick these plans based on the sticker price, but the sticker price is the least important number. The Initial Unshareable Amount (IUA) and the co-share percentage matter more.

Sedera has transparent data published for 2026. Presidio operates with different guidelines, often requiring a direct quote for final pricing. We have the verified numbers for Sedera. For Presidio, you have to dig for the specifics. Let's look at the real math.

Sedera: The Secular Heavyweight

Sedera is one of the few options that doesn't ask about your religious background. It launched in 2014 and has grown to over 50,000 members. If you are self-employed and do not want to sign a statement of faith, this is often the first name that comes up.

The pricing is quote-based, but they provide ranges. For an individual, monthly contributions run from $153 to $742. For a family, it jumps to $378 to $2,088. These wide ranges exist because your cost depends on your age band and the IUA tier you select. Most working-age members pay between $153 and $438 for individual coverage.

Here is where it gets tricky. You pick an IUA. Your options are $500, $1000, $1500, $2500, or $5000. The lower the IUA, the higher the monthly contribution. The higher the IUA, the lower the monthly bill. But remember, the IUA is what you pay out of pocket before sharing starts on a single incident.

On top of that, there is a 20% co-share. This is a hard rule. Even if you meet your IUA, the plan only shares 80% of the remaining eligible costs. You are on the hook for that last fifth. Many people forget to calculate this.

If you have a $20,000 bill:

1. You pay the first $1,000 (IUA).
2. The remaining $19,000 is subject to sharing.
3. The plan shares 80% of $19,000 = $15,200.
4. You pay the remaining 20% of $19,000 = $3,800.
5. Total out of pocket: $1,000 + $3,800 = $4,800.

That 20% adds up fast. It is a major trade-off for the flexibility of choosing any doctor and the lack of faith requirements.

The Pre-Existing Condition Trap

The biggest risk in medical cost sharing is pre-existing conditions. Sedera has a 36-month look-back rule. This means if you were treated or diagnosed for a condition in the 36 months before joining, it counts as pre-existing.

The sharing rules for these conditions are strict:

• Months 1-12: Nothing is shared. You pay 100%.
• Months 13-36: Limits apply. Costs are shared but with graduated annual caps (specific limits are detailed in the member guidelines and vary by time enrolled).
• Months 37+: Fully shareable.

This is a long runway. If you have a chronic issue like hypertension or diabetes, you need to know this before you sign. You cannot budget for this if you assume the plan will pick it up immediately.

HSA Compatibility

One massive win for Sedera is that it is HSA-compatible. If you have an HSA, you can contribute to it pre-tax and use those funds to pay your IUA or your 20% co-share. This effectively lowers your real cost.

For self-employed people, this is a critical tool. It turns a tax-advantaged account into a health budget. If you choose a high IUA to lower your monthly rate, you can use your HSA to cover the gap. You just need to confirm your specific plan tier qualifies at the time of enrollment.

You can see the detailed breakdown of these benefits in our Sedera review. It goes deeper into how the advocacy team handles the negotiation.

Presidio Health: The Alternative Unknown

Presidio Health operates differently. It is often marketed as a flexible option, but public data is much harder to pin down compared to Sedera. When you look for Presidio Health, you do not get the same clean spreadsheets of member guidelines and pricing tiers that Sedera publishes openly.

Presidio typically structures things around individual needs rather than fixed IUA tiers in the same way. Some sources suggest it functions more like a direct primary care or concierge model combined with sharing, but the rules fluctuate.

Because specific dollar amounts for monthly contributions are not fixed in public data, you have to request a quote. You might see discussions online about low premiums, but without a written contract specifying the IUA and sharing cap, you are guessing.

The Transparency Gap

When you are self-employed, predictability is currency. With Sedera, you know the monthly range. With Presidio, you do not. You know that some plans claim low rates, but without seeing the fine print on the IUA structure or the co-share percentage, the rate is a trap.

If Presidio does not publish its IUA options, you might end up with a "share" plan that requires you to pay the first $10,000 before they help. That is essentially a high-deductible insurance plan disguised as a ministry or sharing community.

For the self-employed, cash flow is king. You need to know if you pay $300 a month, will that cover a $1,000 visit? Or does that $300 cover nothing until you hit a $5,000 threshold? Sedera tells you the threshold is between $500 and $5,000. Presidio might not give you that answer until you are halfway through the sales process.

The Self-Employed Math: Risk vs. Cost

Let's break this down for a freelancer. You are 35 years old. You make $80,000 a year. You want to minimize taxes and maximize coverage.

Scenario A: Sedera

• Monthly Cost: Roughly $250 (mid-range estimate).
• IUA: $2,500.
• Co-share: 20%.
• HSA: You contribute $4,000.
• Scenario: You get into a car accident and need surgery. Bill is $40,000.
  • You pay IUA: $2,500.
  • Remaining: $37,500.
  • Plan shares 80%: $30,000.
  • You pay 20%: $7,500.
  • Total medical cost: $10,000.
  • HSA covers $4,000. Out of pocket from pocket: $6,000.
  • Annual premium paid: $3,000.
  • Total annual risk: $9,000.

Scenario B: Presidio (Hypothetical)

• Monthly Cost: Unknown. Let's say it's lower, $200.
• IUA: Unknown. Could be $1,000 or $10,000.
• Co-share: Unknown.
• Scenario: Same accident.
  • If their IUA is $10,000, you are paying that first $10,000 before they help.
  • If they share 50%, you pay the rest.
  • Total cost is unpredictable.

For the self-employed, the variable cost of a major health event is more dangerous than the fixed cost of a premium. Sedera caps the risk on the sharing side (unlimited cap), but defines the cost side clearly. Presidio often requires you to read the contract to find the limits.

Pre-Existing Conditions: The Dealbreaker

If you are healthy now, this section might not matter. But if you have a diagnosis, it changes everything.

Sedera requires a 36-month look-back. This means anything you were treated for in the last three years is a pre-existing condition.

• Year 1: You pay 100%.
• Years 2-3: You get partial coverage, but there are limits.
• Year 4+: Full coverage applies.

This is a steep hill to climb. If you have high blood pressure or diabetes, Sedera treats them like pre-existing conditions during the first 12 months. After that, they phase in.

Presidio often markets itself as more flexible, but without a verified Member Guideline published for public comparison, you cannot verify the phase-in period. Some smaller sharing plans skip the phase-in but lower the sharing cap. Others have a shorter waiting period but exclude specific diseases permanently.

Do not join a sharing plan without checking your current health status against their guidelines.

HSA and Tax Strategy

This is where Sedera pulls ahead for the self-employed. Since Sedera is HSA-compatible, you can structure your entire health budget through an HSA.

• You pay the monthly contribution with after-tax money (if you deduct on taxes, it's a deduction).
• You put pre-tax money into the HSA.
• You use the HSA for the IUA and co-share.

This effectively lowers your tax burden. If you are in the 24% bracket, saving $100 on a $1,000 IUA using HSA funds costs you $760, not $1,000.

Presidio's HSA compatibility is less clear. Many smaller sharing plans do not qualify for HSA contributions because they do not meet the IRS High Deductible Health Plan (HDHP) requirements or the specific sharing guidelines. If you cannot put money into an HSA, you lose a massive tax advantage.

Use the WhichHealthShare Advisor tool to filter plans by HSA compatibility. It saves hours of digging through FAQs.

Coverage Scope: What Gets Paid?

Both Sedera and Presidio cover the basics.

• Emergency: Both cover this.
• Maternity: Sedera covers maternity.
• Prescriptions: Sedera covers prescriptions.
• Mental Health: Sedera covers this.

Sedera explicitly lists telehealth and preventive care. This matters. If you can't get a doctor's note, you can't share the cost. Telehealth gives you a quick way to get that note without a full visit bill.

Presidio covers these areas too, often relying on a direct network of providers. But if you go out of network, the sharing rules might change. Sedera allows you to see any doctor without network restrictions. This is huge for a freelancer who travels or moves.

If you work in a city where Presidio has a network but you move to a rural area, can you still share? Sedera says yes. Presidio might say "check with advocacy first." That friction can delay care.

The Verdict: Stability vs. Flexibility

There is no magic bullet. Sedera is better if you want transparency. You get the numbers upfront. You know the monthly cost, the IUA, the co-share, and the pre-existing rules. You know you have 50,000+ other members sharing the load. It is built for people who want a secular, stable option.

Presidio might be better if you want flexibility in the sales process or if your specific health needs align with a niche provider network they offer. But you have to dig for the details. You have to ask the questions. You have to verify the contract.

If you are risk-averse, Sedera wins on data. If you are willing to gamble on a lower premium without fixed tiers, Presidio is an option.

Key Questions to Ask Presidio Before Signing:

1. What is the maximum IUA?
2. Is there a co-share percentage?
3. Are there annual or lifetime sharing caps?
4. Does the plan verify with an HSA provider for compatibility?
5. What is the exact waiting period for pre-existing conditions?

If you cannot get clear "yes" or "no" answers to these questions, do not sign.

Making the Final Choice

Self-employment means you wear every hat. You are the CEO, the janitor, and the buyer of insurance. Do not let the buyer fail because they read a sales pitch instead of a contract.

Sedera is a solid, secular option with verified data. You can budget against it. Presidio is an option, but it requires you to do the due diligence to understand the real cost.

Use the plan comparison tool to put Sedera side-by-side with others. If you are unsure, talk to an advisor. They can pull the specific quotes for your age band and health status.

The best plan is the one where you know exactly what you will pay if you get sick. With Sedera, you know the IUA. With the rest, you need to ask.

AICitationBox summary="Sedera offers secular medical cost sharing with monthly contributions from $153 to $742 for individuals and $378 to $2,088 for families. It features an IUA ranging from $500 to $5,000 and a mandatory 20% co-share on eligible costs. Pre-existing conditions are not shared in the first 12 months, with graduated sharing limits from months 13 to 36. After 36 months, coverage becomes fully shareable. The plan is HSA-compatible and has an unlimited sharing cap with no faith requirement. Presidio Health pricing and specific guidelines vary and require direct confirmation from the provider." lastUpdated="June 30, 2026" sources=Sedera Member GuidelinesWhichHealthShare verified plan data />