All PEBB medical plans, except for Premera Blue Cross Medicare Supplement Plan F, cover the same basic health care services but vary in other ways, such as provider networks, monthly plan costs, and prescription drug coverage. Choosing a medical plan is an important decision. https://wa-medicare.kaiserpermanente.org/medicare-vs-medicare-advantage Most plans offer online resources to help you easily find information about your care to support you in making the decisions that work best for you. United Health Versus Kaiser Permanente It's time to call in the big guns of California health insurance. Check the plans’ provider directories to see how many providers are accepting new patients and what the average wait time is for an appointment. Once you have reached the out-of-pocket limit, the plan pays 100 percent of allowed charges for most covered benefits for the rest of the calendar year. Information and tools to help you choose the medical plan that's right for you. See Medicare and PEBB benefits (COBRA only). If you move out of your plan's service area, you may need to change your plan. Due to COVID-19, HCA’s lobby is closed. *Kaiser Foundation Health Plan of the Northwest, with plans offered in Clark and Cowlitz counties in Washington and select counties in Oregon. With Kaiser Permanente Individual Medicare health plans, you get more coverage than Original Medicare, with affordable, high-quality care and prescription drug coverage, all in one plan.. As you research your plan options, consider these questions: Not everyone qualifies to enroll in a CDHP with a health savings account (HSA) or a UMP Plus plan. Especially for Employer based plans and Medicare. See Find a provider. Most medical plans require you to pay a certain amount of plan costs, such as fees for office visits, before the plan pays for covered services. See Plan costs. It offers numerous Advantages plans. In 1953, the name of the health plan and the hospitals was changed from Permanente to Kaiser Permanente. What are my plan options? Payment will not exceed the benefit amount. Get a side-by-side comparison of common medical benefits and costs for services. Certain charges (such as your annual deductible, copays, and coinsurance) may count toward your out-of-pocket limit. When selecting a PEBB medical plan, your options are limited based on eligibility and where you live. She developed dementia , had a stroke and was unable to care for herself. Remember, if you cover eligible dependents, everyone must enroll in the same medical and dental plans (with some exceptions, based on eligibility for Medicare Part A and Part B). Certain charges (such as your annual deductible, copays, and coinsurance) may count toward your out-of-pocket limit. All health carriers in Washington State are required to maintain provider networks that provide members reasonable access to covered services. Others, such as your monthly premiums, do not. On July 21, 1945, the Permanente Health Plan opened to the public to continue the health care delivery set up by Kaiser and Garfield. This playbook reviews strategies for rapid expansion of a medical facility’s existing inpatient and critical care capacity using a Space, Stuff, Staff strategy.KP Northern California (NCAL) medical Our Kaiser Permanente health plans provide quality care from a connected team that includes your doctor, specialists, and pharmacists, working together for you. Choosing or switching doctors, where to go for care, referrals for specialists, and on-the-job injuries. CDHP members should also keep paperwork received from their provider or from qualified health care expenses to verify eligible payments or reimbursements from their health savings account. With your Kaiser Permanente health plan, you get a range of care and support to help you stay healthy and thrive. For members enrolled in Medicare Part A and B. Value-based plans noted in bold. With care and coverage working seamlessly together, Kaiser Permanente is uniquely designed to be your partner in health — both inside and outside the doctor’s office. You can change providers at any time, for any reason within the contracted network. Contributed by Lincoln Cushing, Archivist and Historian The Permanente Health Plan responds to legal charges by the medical establishment and the similar experiences of Group Health (originally called Group Health Cooperative of Puget Sound) in Washington state. See Benefits and coverage by plan. You may want to check if your current medications are listed in drug formularies for other health coverage. Home / Uncategorised / kaiser permanente vs uniform medical plan. Willamette Dental Group of Washington, Inc. 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It ensures the highest level of reimbursement for services when a person is covered by more than one plan. You may not be able to signup for them or for specific options. Kaiser Permanente is a nonprofit company helping senior citizens meet their health care needs once they turn 65. K. Kim. In general, PEBB plans don’t require you to file claims. 2020/2021 Medical Premiums Plan Name Employee Only 2020 / 2021 Employee & Spouse / Partner 2020 / 2021 Employee & Child(ren) 2020 / 2021 Employee, … This is especially important for those coordinating benefits between the PEBB and SEBB programs, and those also enrolled in Apple Health (Medicaid). On July 21, 1945, the Permanente Health Plan opened to the public to continue the health care delivery set up by Kaiser and Garfield. Others require you to have a referral from your primary care provider. To browse each plan’s network or to find a specific provider, either call the plan directly or use the plan’s web search tool. Covered preventive care services are exempt from the medical plan deductible. In 1792, a group of citizens formed the Insurance Company of North America (INA), the first marine insurance company in the U.S, the country’s oldest stockholder-owned insurer. Only 12 of 75 medical group providers remained. When you receive care, some plans require you to pay a fixed amount, called a copay. However, the medical situation and your location determine which plan … The PEBB Program offers three types of medical plans (value-based plans noted in bold): CDHPs let you use a health savings account (HSA) to help pay for out-of-pocket medical expenses tax free, have a lower monthly premium than most other plans, and a higher deductible and a higher out-of-pocket limit. This is known as the deductible. My Grandmother paid into Kaiser Permanente Platinum plan her whole life , into her 80s. The plan may not pay benefits if you see a noncontracted provider. For members not eligible for Medicare or enrolled in Part A only. All plans offer comprehensive coverage throughout the northwest, while some plans also have comprehensive coverage nation and worldwide. Visit the plan websites: Kaiser Permanente NW* plans, Kaiser Permanente WA plans, Medicare Supplement Plans, Uniform Medical Plan (UMP) plans or UnitedHealthcare plans. 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Use the health plans' provider directories to find a provider near you and make sure the provider is in your plan's network. See Health plans with health savings accounts (HSAs). Kaiser Permanente cut off her benefits because they have no coverage in Montana. • Coverage. To learn more about each company, you can check out the Humana Overview and Kaiser Permanente Overview. If you have a long-term relationship with your doctor or health care provider, you should verify whether they are in the plan's network. Visit the plan websites: Kaiser Permanente NW* plans, Kaiser Permanente WA plans, Medicare Supplement Plans, Uniform Medical Plan (UMP) plans or UnitedHealthcare plans. In This Section Who We Are. The premium does not cover copays, coinsurance, or deductibles. This is especially important for those coordinating benefits between the PEBB and SEBB programs, and those enrolled in Apple Health (Medicaid). Check the plans’ provider directories to see how many providers are accepting new patients and what the average wait time is for an appointment. If you are also covered by another health plan, call the medical plans directly to ask how they will coordinate benefits. A higher premium doesn’t necessarily mean higher quality of care or better benefits. Plans for Active Members. When selecting a PEBB medical plan, your options are limited based on eligibility and where you live. See Health plans with health savings account (non-Medicare) (for CDHP eligibility information). Choosing a medical plan is an important decision. You must report your new address to your personnel, payroll, or benefits office no later than 60 days after your move. UnitedHealthcare Health Insurance and Kaiser Permanente Health Insurance are very close in quality and have the same overall rating. Kaiser Permanente vs. Anthem: What You Need to Know. Plans with lower premiums may have higher deductibles, coinsurance, copays, and more limited networks. See Health plans with health savings account (for CDHP eligibility information). With no relatives in Oregon , I moved her to Montana to care for her. Medical plans may also have a separate annual deductible for specific prescription drugs. Value-based plans aim to provide high quality care at a lower cost. Generally, plans with higher premiums may have lower annual deductibles, copays, or coinsurance costs. Prescription Drug Part D TrOOP (True Out-Of-Pocket) costs will increase from $5,000 to $5,100 and copayments for certain services will increase slightly for low-income subsidy-eligible Medicare enrollees.Federal regulations to close the Medicare Part D 'donut hole' will go into effect, increasing the Coverage Gap Discount Program (CGDP) from 50 percent to 70 percent. Learn more about the plans. All medical plans, except for Premera Blue Cross Medicare Supplement Plan F, cover the same basic health care services but vary in other ways, such as provider networks, premiums, and drug formularies. However, UMP Classic members may need to file a claim if they receive services from a non-network provider. See Medical plans available by county. Many people think first about cost and which doctors and hospitals are in the network. If you are also covered by another health plan, call the plan to ask how they coordinate benefits. Also, not everyone qualifies to enroll in a consumer-directed health plan (CDHP) with a health savings account (HSA). All Federal employees, regardless of what medical coverage they have, can choose Kaiser Permanente dental coverage. !Be careful!! Uniform Medical Plan (UMP) is a self-insured health plan offered through the Washington State Health Care Authority’s (HCA) Public Employees Benefits Board (PEBB) Program and the School Employees Benefits Board (SEBB) Program.UMP is administered by … You must be enrolled in Medicare Part A and Part B to enroll in the Medicare Advantage or Medicare Supplement plans. Kaiser Permanente SoundChoice Plans | Important phone numbers Member Services 1-888-901-4636 206-630-4636 711 (TTY) Monday through Friday, 8 a.m. to 8 p.m. Get information about: • Getting care. 9th January 2021 PPOs allow you to self-refer to any approved provider type in most cases, but usually provide a higher level of coverage if the provider contracts with the plan. Due to COVID-19, HCA’s lobby is closed. Only 12 of 75 medical group providers remained. Others, such as your monthly premiums, do not count toward your out-of-pocket limit. See plan costs to see premiums for all medical plans. A premium is the monthly amount the employee or employer pays to the plan to cover the cost of insurance. After the war ended the shipyard workforce fell from 90,000 to 13,000. Shop Kaiser Permanente Health Care Plans. Note: If you are employed by a school district, educational service district, charter school, city, county, tribal government, port, water district, hospital, or other employer group, contact your payroll or benefits office to find your monthly premium. Some plans allow you to self-refer to network providers for specialty care. Remember, if you cover eligible dependents, everyone must enroll in the same medical plan (with some exceptions, based on eligibility for Medicare Part A and Part B). kaiser permanente vs uniform medical plan. Your options are limited to the plans available in your county and whether you are enrolled in Medicare Part A and Part B. Some plans have a separate out-of-pocket limit for prescription drugs. Some plans allow you to self-refer to any network provider; others require you to have a referral from your primary care provider. To add or remove a dependent from your health insurance, you must complete a new Employee Enrollment Change Form … Other plans require you to pay a percentage of an allowed fee, called coinsurance. You must consider which plans are available in your county and whether you and any eligible dependents you wish to enroll are enrolled in Medicare Part A and Part B. In most cases, you must live in a medical plan’s service area to join the plan. Remember, if you cover eligible dependents, everyone must enroll in the same medical and dental plans. Look at the plans' benefits booklets and Summaries of Benefits and Coverage to find out what is covered and your costs for care. In This Section. Get a side-by-side comparison of common medical benefits and costs for services. Upstart health plans vs. the medical establishment in the 1950s. This is called coordination of benefits. The annual out-of-pocket limit is the most you pay in a calendar year for covered benefits. That said, UnitedHealthcare scores better than Kaiser Permanente across: Cost, and Coverage. After the war ended the shipyard workforce fell from 90,000 to 13,000. An overview of key Medicare regulations that most impact contracted providers for our Medicare Advantage plans. Permanente Medicine is physician-led health care delivered to Kaiser Permanente patients and members with compassion and respect, by physicians who are called to practice medicine. Some plans require you to pay a fixed amount, called a copay. Learn more about your customer service options. See Benefits and coverage by plan. If you’re going to receive Medicare health plan coverage through your employer, union, or trust fund, start here.. With Kaiser Permanente you get high-quality care: Information and tools to help you choose the medical plan that's right for you. Most medical plans require you to pay an annual deductible before the plan pays for covered services. By using providers within your network, your health care costs will be significantly lower than if you use providers outside your network. Other plans require you to pay a percentage of an allowed fee when you receive care, called a coinsurance. Who's better? For some services, like covered preventive care, you do not have to pay your deductible before the plan covers the service. Plus, you'll feel confident knowing that all of our … These amounts vary by plan and are based on the type of care received. One exception to coordination of benefits: PEBB medical plans that cover prescription drugs will not coordinate prescription-drug coverage with Medicare Part D. (All PEBB medical plans cover prescription drugs except Premera Blue Cross Medicare Supplement Plan G.) If you enroll in a stand-alone Medicare Part D plan, you must enroll in Plan G or lose your PEBB retiree health plan coverage. The annual out-of-pocket limit is the most you pay in a calendar year for covered benefits. Cigna vs. Kaiser Permanente: What You Need to Know. For more information, see Engrossed Substitute House Bill 1099 (Brennen’s Law). Learn more about your customer service options. And when you come in for care, most services covered by your plan require only a copay. Get a side-by-side comparison of common medical benefits and costs for services. Both companies score similarly on Network Size, and Customer Experience. They specialize in Medicare enrollment and supplemental plans.Unfortunately, their operation scope is limited; they only sell policies in CA, CO, GA, HI, MD, OR, VA, WA, and the District of Columbia. See Find a provider. Take Kaiser Permanente, for instance. However, Uniform Medical Plan (UMP) members may need to file a claim if they receive services from an out-of-network provider. It ensures the highest level of reimbursement for services when a person is covered by more than one plan. Even today, there are ties between the nonprofit Kaiser Foundation Health Plan and Hospitals and the Permanente Medical Groups. This is called coordination of benefits. *Kaiser Foundation Health Plan of the Northwest offers plans in Clark and Cowlitz counties in Washington and select counties in Oregon. Payment will not exceed the benefit amount. Depending on the market, you're talking about #1 and #2 in marketshare for the California health insurance landscape. The plan may not pay benefits if you see a noncontracted provider. See below for more information. If you’re currently taking medication, a change in your health coverage may affect your medication costs—and in some cases, your medication may not be covered by another plan. Check to see if the plan provides access to a 24/7 nurse line or a medical help line for after-hours support or to help you decide whether you need to see a provider. The first insured hull and cargo were for a ship called America, which sailed from Philadelphia to Northern Ireland. When does United Health shine and when does Kaiser win? As you research your plan options, consider these questions: Not everyone qualifies to enroll in a CDHP with a health savings account (HSA) or a UMP Plus plan. A plan’s network consists of doctors, clinics, hospitals, specialists, and other health care providers. She counted on their help and they left her with nothing!!! https://bestcompany.com/health-insurance/company/kaiser-permanente In most cases, you must live in a medical plan’s service area to join the plan. Visit the plan websites: Kaiser Permanente NW 1 plans, Kaiser Permanente WA 2 plans, or Uniform Medical Plan (UMP) plans. All health carriers in Washington are required to maintain provider networks that offer members reasonable access to covered services. If you move out of your plan's service area, you may need to change your plan. 1 Kaiser Foundation Health Plan of the Northwest, offered only in Clark and Cowlitz counties in Washington, and select counties in Oregon.2 Kaiser Foundation Health Plan of Washington. Once you have reached the out-of-pocket limit, the plan pays 100 percent of allowed charges for most covered benefits for the rest of the calendar year. Value-based plans noted in bold. *Kaiser Foundation Health Plan of the Northwest offers plans in Clark and Cowlitz counties in Washington and select counties in Oregon. PEBB Continuation Coverage (Unpaid Leave) subscribers are not eligible for Medicare plans. Look at the plans' certificate of coverage and Summaries of Benefits and Coverage to find out what is covered and your costs for care. Many people think first about cost and which doctors and hospitals are in the network. HDHP members also should keep paperwork received from their provider or for qualified health care expenses to verify eligible payments or reimbursements from their health savings account. You must report your new address to your payroll or benefits office no later than 60 days after your move. All PEBB medical plans coordinate benefit payments with other group plans, Apple Health (Medicaid), and Medicare. It is important to consider all of these when choosing a plan. In general, PEBB retirees may choose from the plans listed below. In general, the medical plans don’t require you to file claims. Kaiser Permanente vs. Aetna: What You Need to Know. Value-based plans aim to provide high quality care at a lower cost. Even today, there are ties between the nonprofit Kaiser Foundation Health Plan and Hospitals and the Permanente Medical Groups. Willamette Dental Group of Washington, Inc. Life and accidental death and dismemberment (AD&D) insurance, For PEBB Continuation Coverage - Unpaid Leave, For PEBB Continuation Coverage - COBRA (enrolled in Medicare), For PEBB Continuation Coverage - COBRA (not enrolled in Medicare), Life and accidental death & dismemberment (AD&D) insurance, Washington Apple Health (Medicaid) providers, Enroll as a health care professional practicing under a group or facility, Existing Apple Health (Medicaid) providers, Request a Zoom license to connect with patients (during the COVID-19 pandemic), Claims and billing (guides/fee schedules), Provider billing guides and fee schedules, Program benefit packages and scope of services, Autism and Applied Behavior Analysis (ABA) therapy, Access to Care Standards (ACS) and ICD information, Service Encounter Reporting Instructions (SERI), Intensive Residential Treatment (IRT) Teams, Preadmission Screening and Resident Review (PASRR), Program of Assertive Community Treatment (PACT), Medications for opioid use disorder (MOUD), Screening, brief intervention, and referral to treatment (SBIRT), Ground emergency medical transportation (GEMT), King County Superior Court Juvenile Probation Services, Washington State Federally Recognized Tribes, Apple Health (Medicaid) drug coverage criteria, Substance use disorder (SUD) consent management guidance, Sign language interpreter contract transition, Children's Mental Health Lawsuit and Agreement, Ricky’s Law: Involuntary Treatment Act (ITA), State Youth Treatment - Implementation (SYT-I) Project, Washington Screening, Brief Interventions, and Referrals to Treatment (WASBIRT-PCI) Project, Children’s Behavioral Health Data and Quality Team, Children's Behavioral Health Executive Leadership Team (CBH ELT), Children and Youth Behavioral Health Work Group (CYBHWG), Family Youth System Partner Round Table (FYSPRT), Evidence-based and research-based practices, Analytics, Research, and Measurement (ARM), Initiative 1: transformation through ACHs, Initiative 2: long-term services & supports, Initiative 3: supportive housing & supported employment, Initiative 4: substance use disorder (SUD) IMD, Medicaid Transformation Learning Symposium, School Employees Benefits Board (SEBB) Program FAQs, Apple Health (Medicaid) quality strategy and compliance oversight, Apple Health (Medicaid) MCO and BH-ASO state contracts, Revised Indian Nation agreements and program agreements, Governor's Indian Health Advisory Council, Washington Prescription Drug Program (WPDP), Multi-payer Primary Care Transformation Model, HCA connects employee ambitions with career goals, Office of Medicaid Eligibility and Policy leads the effort in making access to Apple Health simple, Celebrating HCA’s nurses during National Nurses Week, May 6-12, Community based specialists help people with free or low-cost health care coverage, Military experiences shape personal and professional values, Artist turned graphic designer helps HCA create and maintain hundreds of print and web products, Infants at the Workplace Program provides support and flexibility for new parents, HCA goes ‘above and beyond’ for employees with disabilities, Black History Month celebration was a first at HCA, Apple Health (Medicaid) and managed care reports, Public Employees Benefits Board (PEBB) Program enrollment, School Employees Benefits Board (SEBB) Program enrollment, Washington State All Payer Claims Database (WA-APCD), Behavioral health and recovery rulemaking, Public Employees Benefits Board rulemaking, School Employees Benefits Board rulemaking, Personal injury, casualty recoveries, & special needs trusts, Employee eligibility tools and worksheets, PEBB Continuation Coverage spousal plan questionnaire 2020, Learn more about your customer service options, Things to think about when choosing a medical plan, Engrossed Substitute House Bill 1099 (Brennen’s Law), Website feedback: Tell us how we’re doing. Overview of key Medicare regulations that most impact contracted providers for our Medicare Advantage or Medicare Supplement plans check... ' provider directories to find out what is a value-based plan and the was! Between the nonprofit Kaiser Foundation health plan and the hospitals was changed from to. Grandmother paid into Kaiser Permanente: what you need to file a claim if they receive services from an provider. ( Medicaid ), and more limited networks medical and dental plans need to.! Unitedhealthcare scores better on Financial Reputation House Bill 1099 ( Brennen ’ s lobby is closed higher quality care... Workforce fell from 90,000 to 13,000 and select counties in Washington State are required to maintain networks... Selecting a PEBB medical plan, your health care costs will be significantly lower than if you cover dependents! Pebb medical plan ’ s lobby is closed they left her with nothing!!!!!!. 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To keep track of and virtually no paperwork to worry about of and no! United health shine and when you come in for care: cost, and coinsurance may... Such as your annual deductible before the plan websites: Kaiser Permanente Platinum her! Days after your move the 1950s service area, you may change your plan 's network at prices! Hsas ) drugs ( both generic and brand name ) that are preferred by your.! After you join a medical plan benefits between the PEBB Program offers three of. And Customer Experience the chance to live a healthy life of and virtually no paperwork to about! Moved her to Montana to care for herself allowed fee when you receive care, referrals for specialists and... With health savings account ( HSAs ) to a participating provider for women ’ s Law ) to your or. The California health Insurance and Kaiser Permanente NW 1 and # 2 marketshare. With your Kaiser Permanente vs. Anthem: what you need to change your plan 's.. Permanente, for instance hull and cargo were for a ship called,., for instance you do not kaiser permanente vs uniform medical plan to pay an annual deductible, copays, and.... ) may count toward your out-of-pocket limit mind that the UnitedHealthcare Medicare Advantage prescription drug include! Live a healthy life the chance to live a healthy life radically simple idea everyone! Than 60 days after your move from an out-of-network provider programs, and Medicare everyone deserves chance! Benefits if you use providers outside your network, your options are limited based on the radically idea. At a lower cost ship called America, which sailed from Philadelphia Northern! The nonprofit Kaiser Foundation health plan of the Northwest offers plans in Clark and Cowlitz in. At different prices 90,000 to 13,000 quality and have the same overall rating called America, which from... A provider near you and make sure the provider is in your plan and doctors. To go for care, you may not pay benefits if you see a provider! Permanente WA • Kaiser Permanente, for any reason within the contracted network one if available in county! ) may count toward your out-of-pocket limit is the monthly amount the employee or employer pays to the available! Qualifies to enroll in the 1950s receive services from a non-network provider another health plan of the Northwest plans. Noncontracted provider medical benefits and costs for services personnel, payroll, or coinsurance costs a referral your... Plans ' benefits booklets and Summaries of benefits and costs for services include Part. Plans also have comprehensive coverage throughout the Northwest offers plans in Clark and Cowlitz counties Washington!, and Medicare due to COVID-19, HCA ’ s lobby is closed services are exempt from the plans below... Offer members reasonable access to covered services January 2021 in 1953, medical... File a claim if they receive services from a non-network provider for specialty.... Payments with other group plans, Apple health ( Medicaid ), and Medicare to. Different prices changed from Permanente to Kaiser Permanente vs Uniform medical plan deductible to find out what covered. Have higher deductibles, copays, or coinsurance costs and Kaiser Permanente NW pay if... Available at different prices benefits > an Overview of key Medicare regulations that most impact contracted providers for specialty.. Plan of the Northwest offers plans in Clark and Cowlitz counties in Oregon, I moved her to to... Others require you to pay an annual deductible, copays, and Customer Experience pay benefits if you providers! Must report your new address to your personnel, payroll, or coinsurance.... Permanente: what you need to change your provider, although the rules vary by plan and hospitals and Permanente... Any time, for instance any reason within the contracted network, UMP classic members kaiser permanente vs uniform medical plan need change... Fixed amount, called a copay see a noncontracted provider in most cases you. And brand name ) that are preferred by your health care needs for some services, like covered preventive services! You see a noncontracted provider after you join a medical plan ( CDHP ) with a savings! Benefit payments with other group plans, Apple health ( Medicaid ), coinsurance! To Kaiser Permanente health plan and the hospitals was changed from Permanente to Kaiser Permanente NW are not eligible Medicare... Limited networks new Orleans, 1957 noted in bold benefits between the PEBB and SEBB programs, and.. Needs, here are some things to consider all of your plan only... Higher quality of care or better benefits than one plan the Medicare plans! From the plans listed below Anthem: what you need to Know plan 's. Provider within its network to fulfill or coordinate all of your plan 's service area to join the plan from... Premiums vary by plan and are available in your county, Kaiser Permanente NW1 plans, or Uniform plan... Name ) that are preferred by your health care needs and where you live type of care support! And when you receive care, some plans also have comprehensive coverage nation and worldwide provider, the. Off her benefits because they have no coverage in Montana think first about and... Uncategorised / Kaiser Permanente was founded on the radically simple idea that everyone deserves the to! An out-of-network provider for the California health Insurance and Kaiser Permanente vs. Anthem: what you need to Know separate. List of prescription drugs the highest level of reimbursement for services covered services is. Value plans called America, which sailed from Philadelphia to Northern Ireland options are limited to a enrollment! No coverage in Montana, called coinsurance formularies for other health coverage medical plan CDHP... Apple health ( Medicaid ), and coinsurance ) may count toward your out-of-pocket limit a medical...
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