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@RoKhanna #UnitedHealthCare doesn't have any Occupational Therapists or Speech Therapists in network in San Jose for my autistic son. I pay out of pocket and then get reimbursed eventually by UHC sometimes over a month later (Full payment is usually just under $4K/month). 1/
@RoKhanna I have applied for GAP in the past where it's covered at in network rates ($30 copay). But lately (past couple of years) they've been denying this and appeals. So in out of network I pay full price to the provider and then get reimbursed after $700 deductible 2/
@RoKhanna (reimbursement) 30% co-insurance (on their estimate of fair market value) and the uncovered portion. So for a $200 speech visit (my son is autistic and goes 100 times per year), I pay $200 and am reimbursed $122.50. $25 is not covered and 30% co-insurance is $52.50 3/
@RoKhanna Out of pocket maximum is $5750 per year so I start getting reimbursed $175 per visit eventually. But $25 will always be a cost to me even though our provider is paying to live and do business in Los Gatos. Similar with OT. I spend countless hours fighting with UHC 4/
@RoKhanna and it just gets worse each year. My out of pocket for my son out of network will be will be $5750+$2500 (uncovered), plus his $2750 out of pocket for in-network (ABA here the provider is getting screwed; LOA with UHC pays them only $43 per visit + our $20 copay) 5/
@RoKhanna I pay $190 bi-weekly ($4,950 annually for coverage for my wife, my son, and me through my employer. It's considered great insurance too. But the pain and suffering it has caused to a struggling special needs family is downright criminal. We will pay over $23K this year. 6/
@RoKhanna So for a family of three with a special needs child, out of pocket through UHC is $23K+ Medicare for all would beat that big time. Another thing about "Health Insurance" is it is really just a middle man extorting from the patients and extorting from providers through LOAs 7/
@RoKhanna There is no value add in this current value chain. The #HealthExtortionistsNotHealthInsurance charge an economic rent which is unnecessary. #HealthcareShouldBeARight. I made a little table not based on any real numbers, but eliminate UHC and everyone does better 8/8 
@RoKhanna @threadreaderapp #Unroll Please!
