There is usually some coverage for hearing aids. Blackwell contributes to the University of Colorado-Anschutz blog and has been published in The Human Touch distributed by the University of Colorado Center for Bioethics and Humanities. Depending on the provider and plan you choose, Medicare Advantage coverage works similarly to employer-sponsored health insurance with which you may be familiar. Medicare rules don't allow earned rewards to be used for Medicare-covered goods or services, including medical or prescription drug out-of-pocket costs. Medicare Advantage plans from AARP/UnitedHealthcare are widely available, affordable and have good overall ratings. If youre eligible, you can join an SNP at any time. Someone who wants to extensively use their out-of-network coverage would get a better deal with the UnitedHealthcare PPO plans. Power and the Better Business Bureau. We also offer popular dental, vision and hearing products in 37 states. Many plans offer added benefits, such as vision coverage, dental coverage, hearing coverage, drug coverage and fitness benefits. The plan provider (rather than Medicare) sets the amounts charged for premiums, deductibles and services. For example, it can help pay for premiums, coinsurance, and deductibles. AARP/UnitedHealthcare offers cheap PPO plans, averaging $15 per month for a local PPO plan. That's slightly ahead of other national providers including Blue Cross Blue Shield, Humana and Aetna, which average between 4.1 and 3.9 stars. "In addition to the health challenges that typically come with getting older,we recognize the heavy financial strain on older adults and people with disabilities, who often live on fixed incomes,"said Christopher Ciano, president of Aetna Medicare. You arent able to purchase standalone drug coverage. We also offer popular dental, vision and hearing products in 37 states. Healthy living rewards: Some plans have a program called Renew Rewards where you can get cash back for activities like an annual checkup or tracking your steps. The most common ones are health maintenance organizations (HMOs) and preferred provider organizations (PPOs). There are different items that contribute to the out-of-pocket expenses while in the donut hole: any yearly drug deductible you may have, copays for any and all your medications, what the manufacturers discount is on that medication and what the insurance company pays for that medication, she says. With an AARP Medicare Advantage plan, you do not need to be an AARP member in order to enroll in the insurance coverage. To keep plans affordable, Aetna continues to offer many $0 premium plan options. In 2023, Aetna Medicare will continue to offer three individual, standalone plans. In addition, some MA plans offer care not covered by the original option. In 2022, there are 49 Medicare Advantage Plans available in Maryland compared to 41 in 2021. As a reminder, Medicare has four parts: Part A: Hospitalization Part B: Physician and other services Part C: Medicare Advantage Part D: Prescription Drugs A Medicare Advantage plan from AARP/UnitedHealthcare costs $21 per month on average, which is a good deal on coverage. However, customers using a Medicare Advantage plan may need referrals for specialist visits. Among this sample, the UnitedHealthcare-branded plans generally cost more per month and have higher deductibles. If you decide to go with Part C, a Medicare Advantage plan, it will be more like a set menu, since a private insurer has already bundled together parts A and B and almost always D into one comprehensive plan. Costs are typically lower, with most premiums starting at $0, lower coinsurance or copayments, limits on out-of-pocket spending and potential coverage for your Part B premium. Cigna has plans with monthly premiums and physician copays starting at $0 per month and specialist copays as low as $5 per month. Your copay could be $375 to $2,075 for each hearing aid, with a limit of two hearing aids per year. You can also use the governments Medicare Plan Finder tool to find a provider and plan. Aetna also provides Resources for Living, a concierge program designed to help you locate local resources. Our helpful team can explain plan benefits, how it all works and how to get started. Most plans have a service area with in-network providers you must use for routine and ongoing care. 'Show Less' : 'Show More' }}, 2022 Forbes Media LLC. In some areas, plans go as far as to offer free generic prescriptions. by Dena Bunis, AARP, Updated October 12, 2021. Medicare Advantage plans from UnitedHealthcare are also a good value. It is free to compare plans. You can review your plan and make changes during the Medicare Advantage Open Enrollment Period (OEP), from January 1 to March 31. Calls to QWIS will be routed to a licensed agent who can provide you with further information about the insurance plans offered by one or more third-party partners of QWIS. Aetna made major changes to our formularies (drug lists) for 2023 to remove many cost and access obstacles and help our members be more adherent with their medications. Some Medicare Advantage plans may have lower out-of-pocket costs than Original Medicare, and some have a $0 monthly premium. Power's survey on Medicare Advantage customer satisfaction, UnitedHealthcare ranks in the bottom third of providers. SilverScript is a Prescription Drug Plan with a Medicare contract marketed through Aetna Medicare. Plans cover medical care, hospitalization services and usually prescription drugs. All ratings are determined solely by our editorial team. . WebPage 7 of 14 Internet Drug Outlet Identification Program Progress Report: August 2017 B. Learn the differences between these plans and how they affect your coverage so that you can make the right choice for your medical situation. Must use network providers and live in the service area for at least six months of the year. There are three periods when you can enroll: Medicare provides special enrollment periods for unusual life circumstances, such as losing your job (and health coverage) and moving out of the area your insurance carrier services. AARP Answers: Your insurance coverage and the coronavirus. Aetna Medicare's pharmacy network includes limited lower cost, preferred pharmacies in Suburban Arizona, Suburban Illinois, Urban Kansas, Rural Michigan, Suburban Michigan, Urban Michigan, Urban Missouri, Suburban Utah, Suburban West Virginia and Suburban Wyoming. This can minimize costs for those who need this benefit because of high-cost medications. Wherever and whenever people need us, we help them with their health whether that's managing chronic diseases, staying compliant with their medications or accessing affordable health and wellness services in the most convenient ways. You can also enroll in Medicare Advantage Plans if you have End-Stage Renal Disease (ESRD) or amyotrophic lateral sclerosis (ALS). What type of health care services do you need, and how often do you get them? Providers are independent contractors and are not agents of Aetna. Below are lists of the top 10 contributors to committees that have raised at least $1,000,000 and are primarily formed to support or oppose a state ballot measure or a candidate for state office in the November 2022 general election. There are also many nuanced differences between Medicare Advantage plans. It is free to use. NE 76th St CVS Pharmacy offers flu shots to help you get through the season. And for no extra cost, the company provides additional perks, from behavioral and emotional support services to medication therapy management to health and wellness discounts. Earned rewards may also not be used on alcohol, tobacco or firearms or be converted to cash. Call us at 1-866-255-4795. Our ancillary plan options cover 45 states andcan provide members with life insurance coverage, benefits paid directly to them after being diagnosed with cancer, or for hospital stays, and home or skilled nursing facility recovery care. Note: Your costs may differ from these ranges even if you live near but not in one of these areas, as rates are set by ZIP code. However, UnitedHealthcare isn't the cheapest overall provider. It has not been previewed, commissioned or otherwise endorsed by any of our network partners. Some MA plans also provide coverage for gym memberships. Medicare Advantage plans from AARP/UnitedHealthcare are a good deal. The 10 types of Medigap plans provide standardized coverage to beneficiaries nationwide and help pay for things like deductibles, coinsurance and copays. Physicians and hospitals have to file claims for each service with Medicare that you'll have to review. Provider participation may change without notice. Without medical insurance or Medicare you will be charged $94.99 for a senior dose vaccine, or $49.99 - $94.99 for a seasonal vaccine. Keep in mind that broker and marketplace services only show your plans from the provider partner, not all available plans. The top 5 Medicare Advantage Plans are offered by: Aetna; Cigna; Humana; Kaiser Permanente; UnitedHealthcare; Aetna. to search for ways to make a difference in your community at Companies like Aetna and Cigna have lower overall rates and a higher percentage of $0 plans. WOONSOCKET, R.I., Oct. 1, 2022 /PRNewswire/ -- Aetna, a CVS Health company (NYSE: CVS), announced its 2023 Medicare offerings, featuring more affordable medical and prescription drug coverage and expanded money-saving benefits that support members' whole health and well-being. Or call 1-844-588-0041 (TTY: 711), 7 days a week, 8 AM to 8 PM. 84 percent of Medicare beneficiaries can choose a $0 premium Aetna Medicare Advantage plan. Visit AetnaMedicare.comto learn more about the 2023 Aetna Medicare plans. Medicare Advantage plans with prescription drug coverage and their monthly cost. UnitedHealthcare is one of the larger providers to offer insulin copays of $35 or less, which can be a significant benefit for people managing diabetes. Editorial Note: The content of this article is based on the authors opinions and recommendations alone. En espaol | As you think about how Medicare will cover your health care needs, your first major decision should be whether you want to enroll in federally run original Medicare or select a Medicare Advantage plan, the private insurance alternative. Combining the two is not allowed. Aetnas Medicare Advantage plans include HMO, HMO-POS, PPO and SNPs. For more information about Aetna plans, refer to our website. Members will be able to earn $150 or The agencies have programs designed to help seniors 60 and older maintain their health and independence, including resources to guide you through the Medicare enrollment process, and the counselors will help you understand the available benefits fully. But there are significant differences in the way you'll use Medicare depending on whether you pick original or Advantage. Our content is intended to be used for general information purposes only. In 2022, the average monthly premium for a Medicare Advantage Plan in Michigan is $28.74, a decrease from How much is the copayment for each visit or service? Check all your medications on the plans formulary so youre aware of the prescription copayments, deductibles and any restrictions., Compare Top Medicare Plans From Blue Cross Blue Shield, a Forbes Health 5-Star Rated Carrier. We help people navigate the health care system and their personal health care by improving access, lowering costs and being a trusted partner for every meaningful moment of health. AARP is the nation's largest nonprofit, nonpartisan organization dedicated to empowering Americans 50 and older to choose how they live as they age. She is the founder and CEO of Harris Health and Wellness Communications. Enrollment is available to seniors 65 and older and those with a qualifying disability. There are several ways to do it. Aetna also expanded its Aetna Medicare Eagle MA plans to 42 states and 1,383 counties reaching more than 6.1 million Veterans over age 65. Medicare plan costs and star ratings are sourced from the public use files from the Centers for Medicare & Medicaid Services. You dont have to reapply every year for Medicare Advantage coverage. Our referral program rewards customers with a $20 USD credit Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Please enable Javascript in your browser and try Aetna made major changes to our formularies (drug lists) for 2023 to remove many cost and access obstacles and help our members be more adherent with their medications. Centene is one of the largest providers for government healthcare plans. Information provided on Forbes Health is for educational purposes only. {{ showMobileIntroSection ? Low-Income Subsidy Medicare Extra Help Program, Medicare and Medicaid Guide for Low-Income Recipients. As an example, UnitedHealthcare's Medicare Advantage plans offered in New York are considered middle-of-the-road plans because the company has better ratings than the cheapest provider, Humana. Aetna estimates 84% of the Medicare-eligible beneficiaries in the U.S. will have access to a $0 monthly premium Aetna MA plan.1, For 2023, Aetna is offering Medicare Advantage Prescription Drug (MAPD) plans in 46 states plus Washington, D.C. Aetna added 141 new counties across the country, providing 1 million more Medicare beneficiaries access to an Aetna plan. And we do it all with heart, each and every day. Some companies serve as brokers or marketplaces to help you search for Medicare Advantage plans, including three of our best Medicare Advantage provider picks. If you don't have Medicare or medical insurance, shots will cost you $94.99 for a senior dose vaccine, or $49.99 - $94.99 for a seasonal vaccine. WebMedicare, in most situations you will receive primary coverage through IBM. But instead of paying the 20 percent coinsurance amount for doctor visits and other Part B services, most MA plans have set copay amounts for a physician visit, and typically that means lower out-of-pocket costs than original Medicare. That average performance is not as strong as some of the top-ranking companies, like \u003Cspan\u003E\u003Ca class=\"ShortcodeLink--root ShortcodeLink--black\" title=\"Kaiser Permanente Insurance Review: Why Is It Top-Rated?\" href=\"https:\/\/www.valuepenguin.com\/kaiser-health-insurance-review\"\u003EKaiser Permanente\u003C\/a\u003E\u003C\/span\u003E.\n","padding":"double"}, {"backgroundColor":"ice","content":"\u003C\/p\u003E\n\n\u003Ch3\u003EAdditional benefits and health care services\u003C\/h3\u003E\n\n\u003Cp\u003E\u003Cdiv class=\"ShortcodeImage--root left\" \u003E\n \u003Cdiv class=\"ShortcodeImage--image-container \"\u003E\n \u003Cimg alt=\"Compare Medicare plans\" class=\"ShortcodeImage--image lazyload\" style=\"width: 100px;\" data-src=\"https:\/\/res.cloudinary.com\/value-penguin\/image\/upload\/c_limit,dpr_1.0,f_auto,h_1600,q_auto,w_100\/v1\/static\/icons\/health-catastrophic.png\" src=\"https:\/\/res.cloudinary.com\/value-penguin\/image\/upload\/c_limit,dpr_2.0,e_blur:1000,f_auto,h_1600,q_1,w_100\/v1\/static\/icons\/health-catastrophic.png\" data-srcset=\"https:\/\/res.cloudinary.com\/value-penguin\/image\/upload\/c_limit,dpr_1.0,f_auto,h_1600,q_auto,w_100\/v1\/static\/icons\/health-catastrophic.png 1x, https:\/\/res.cloudinary.com\/value-penguin\/image\/upload\/c_limit,dpr_2.0,f_auto,h_1600,q_auto,w_100\/v1\/static\/icons\/health-catastrophic.png 2x\"\u003E\n \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThere is a large collection of benefits included in Medicare Advantage plans from AARP\/UnitedHealthcare. Whats more, Medicare Advantage plan benefits tend to change annually, so enrollees must review what their coverage looks like, including their drug formulary, each year during the open enrollment period to ensure that the coverage is truly meeting their health care needs. Power ranking of 802 (out of 1,000) in 2022, Benefits can vary significantly depending on the BCBS company in your area, Special Needs Plans (SNPs) only available in select states, Offers plans in all 50 states, Washington, D.C. and Puerto Rico, Aggregate rating of 4.02 out of 5 from CMS, J.D. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change. Benefits, drug coverage and provider choices are tailored to best meet the needs of the groups served by the plan. That's about a third of the typical cost of $43. WebIf you're eligible to participate in the SHBP Retiree Wellness Program, you must meet certain program requirements. Enrollment in our plans depends on contract renewal. SelectQuote does not publish its insurance provider partners. Well explain why you might benefit from a Medicare Advantage plan, how these plans work and how much you can expect to pay. Higher cost if you choose a provider that doesnt agree to the plans terms. Once youre enrolled in a Medicare Advantage plan, it becomes your primary insurance. Original Medicare is divided into Part A to cover hospitalization and optional Part B medical insurance. As a Medicare insurance company, Aetna offers top Medigap plans in 43 states. You will be asked to register or log in. As a health care professional since 1987, Kelly Blackwell has walked alongside and cared for seniors as they journey through the season of their fourth quarter of life. Consider both the benefits and drawbacks below before enrolling in a Medicare Advantage plan. If I Retire at 62, Is That My Medicare Eligibility Age? Our editorial content is based on thorough research and guidance from the, {{ showSummarySection ? Consider the following details when deciding whether a Medicare Advantage plan or Original Medicare is best for you. Enrollment in our plans depends on contract renewal. She brings more than a decade of media experience to Forbes Health, with a keen focus on building content strategy, ensuring top content quality and empowering readers to make the best health and wellness decisions for themselves. Qualifications for Medicare are based on two things. She has over 25 years of experience in healthcare with a passion for health education and wellness. Aetna Signature Administrators Providers. And there's not a trade-off in coverage because the company's average out-of-pocket maximum matches the industry as a whole. Many Medigap plans dont provide dental, vision or hearing coverage, either. You must be at least 65 years old or have certain disabilities, such as permanent kidney failure or amyotrophic lateral sclerosis (ALS). Power ranking of 790 (out of 1,000) in 2022, To encourage preventative care, plans offer a gift card incentive for wellness visits, Most plans are HMOs (few PPOs and SNPs available). 100% of the total Medicare population in Michigan has access to a Medicare Advantage Plan with a $0 monthly premium in 2022. Medicare Part D Prescription Drug Plan Changes in 2022, Medicare Covered Medical Marijuana Survey, Seniors will face difficulty affording healthcare in 2022, When to sign up for Medicare Advantage Plans in Michigan, How to Choose a Medicare Advantage Plan in Michigan, Medicare | Health Maintenance Organization (HMO). Many Medicare Advantage providers offer plans with $0 monthly premiums to entice prospective enrollees in a fairly competitive market. The Michigan Department of Health & Human Services offers the Medicare Savings Program to cover certain costs based on your income. That average performance is not as strong as some of the top-ranking companies, like Kaiser Permanente. Anthem also offers a number of additional Medicare Advantage benefits through its Essential Extras benefits, including (but not limited to) $500 per year for assistive safety devices, health and fitness tracker devices, a monthly allowance for healthy groceries and 60 one-way trips to medical appointments and/or pharmacy visits. Your health and wellness is unique to you, and the products and services we review may not be right for your circumstances. Many beneficiaries who elect original Medicare also purchase a supplemental or Medigap policy to help defray many out-of-pocket costs, which Medicare officials estimate could run in the thousands of dollars each year. To complete our portfolio of products, Aetna also offers Medicare Supplement plans. Area Agencies on Aging can connect you with one of its regional agencies, all of which provide a comprehensive selection of services for the regions older adults. WebMedicare Advantage Rewards Program; Over the Counter Supplies; COVID-19 at-Home Test Kits; Provider Directory; How to Enroll; Retirees learn more now. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. For those who want out-of-network coverage, AARP/UnitedHealthcare is an especially great choice because the cost of a local PPO plan averages $15 per month, which is 65% cheaper than the industry average. Call HAPs Provider Line at (888) 427-6464. You can also manage your communication preferences by updating your account at anytime. Our DSNPs also have contracts with State Medicaid programs. While this is not a red flag, these lackluster customer reviews are not as strong as a top-rated company like Kaiser Permanente or other regional brands like Baylor Scott & White in Texas. Healthy Rewards Program: The program helps members improve their health and well-being with personalized reward activities. Founded in 1853 and headquartered in Hartford, Connecticut, Aetna is a major health insurance provider with over 39 million customers. Even though you, as the patient, are not responsible for getting this prior approval, this process can affect how quickly you can get care and add extra paperwork if the request is denied. The contents of this site may not be republished, reprinted, rewritten or recirculated without For a monthly premium in addition to the Medicare Part B premium, an MA plan provides set copays, coinsurance rates and deductibles for various components of care, as well as additional coverage benefits and perks. Topic no. Once you confirm that subscription, you will regularly TapTap Medicare works with more than 21 Medicare supplement and Medicare advantage providers. These include some dental, vision and hearing care. Power ranking of 808 (out of 1,000) in 2022, A variety of additional benefits beyond standard coverage available, depending on the plan, Higher out-of-pocket costs than competing providers. If you elect to go with original Medicare, your buffet will include Part A (hospital care), Part B (doctor visits, lab tests and other outpatient services) and Part D (prescription drugs). Were here for you, if you need help understanding your care, your plan benefits, or if If access to a wide range of doctors and hospitals is important to you, UnitedHealthcare has a reasonably large network of providers, but it's not as large as Blue Cross Blue Shield. 1. Meanwhile, Medicare Supplement plans, or Medigap plans, are sold by private insurance companies to people enrolled in Original Medicare to help fill the gaps of that coverage. Follow @CVSHealth on social media. While our team of, Best Hearing Aids for Severe Hearing Loss, Medicare Advantage 2022 Spotlight: First Look, Blue Cross Blue Shield Medicare Advantage Review, Your Guide To Medicare Advantage (Medicare Part C), A Guide To Medicare Supplement (Medigap) Plans: Cost And Coverage, Best Medicare Advantage Providers for 2023, Medicare Advantage vs. Medicare Supplement (Medigap). In 2023, Aetna Medicare will continue to offer three individual, standalone plans. For those who qualify for both Medicare and Medicaid benefits, Aetna expanded its Dual Eligible Special Needs Plan (D-SNP)offerings across 30 states, including new markets in South Carolina, South Dakota and Utah, and new PPO plan options in Georgia and South Dakota. The benefits mentioned are a part of special supplemental program for the chronically ill. Not all members qualify. Many Medicare Advantage plans come with $0 premiums, which leads many enrollees to expect a low-cost plan overall. Cigna doesnt cast as wide of a net with its nationwide coverage, but people who live in areas it does serve can certainly benefit from its robust coverage options and trusted reputation. Prior to joining Forbes Health, Jessica was the manager of creative communications at Hearst, where she specialized in high-level production and project management. We evaluated 10 well-known Medicare supplement insurance plans and picked the 8 best options in 2022. However, most people pay premiums for Parts B and D. Medicare bills every three months if you enroll in Parts B and D, or premiums get deducted from your Social Security, Civil Service Retirement or Railroad Retirement check. There is a large collection of benefits included in Medicare Advantage plans from AARP/UnitedHealthcare. In total, Aetna will offer MAPD plans in 2,014 counties in 2023, accessible by 55 million Medicare beneficiaries.2. Power ranked them in terms of consumer feedback and more. There are four common types of Medicare Advantage plans to compare when making your selection. Only by providing your ZIP code and demographic information can you see a list of plans for which youre eligible, and even then, youre likely comparing the details of approximately 39 plans. If you choose a plan with a premium, it will be paid separately from your Part B premium. Instead, healthy enrollees can get more cost-effective coverage by choosing one of the cheaper AARP plans that have low to no costs each month and coverage that begins right away without first meeting a deductible. Out-of-network/non-contracted providers are under no obligation to treat plan members, except in emergency situations. Blue Cross Blue Shield offers an expansive provider network including over 342,000 providers. GetSetUp is a third-party service provider and is not owned or operated by Tivity Health, Inc. ("Tivity") or its affiliates. Aetna, CVS Pharmacy and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health family of companies. For example, paying $25 more per month is worth it if the more expensive plan will save you more than $300 per year in medical care. Highlights include: Money-saving MA benefits and extras that make a difference. If you receive medical insurance through an employer or elsewhere, speak with your provider to understand how you and your familys coverage may change while under Medicare Advantage before deciding to make the switch. Healthy Living Rewards Program Healthy Living Rewards Program. We'll offer new Medicare Advantage plan options, including Dual Eligible Special Needs Plans in new markets, a new Institutional Special Needs Planand expanded Aetna Medicare Eagle plans designed with Veterans in mind. Aetna Medicare is a HMO, PPO plan with a Medicare contract. However, if you have chronic health issues, it may be cost effective to sign up for a more expensive plan with better benefits. With UnitedHealthcare, the copayments for medical care are generally low, but many medical services require prior authorization from the insurance company. All three plans are available in all 50 states and D.C and feature increased formulary coverage from 2022.4, Big reductions in prescription drug costs across the MAPD portfolio. Choosing a Medicare Advantage plan might feel overwhelming, but this guide will help you sort through the details. Premiums, coinsurance, and how to get information on all of UnitedHealthcare 's Advantage Coinsurance, and empowering seniors as they navigate the health care services do you need, deductibles. Common than UnitedHealthcare-branded plans sure you are eligible for federally-subsidized Medicare health insurance and is subject change. Agents are subject matter expertsmany have spent years learning the ins and outs of each plan they has, coinsurance, limitations, and a free quote and review plan. Less ': 'show more ' } }, 2022 Forbes media LLC can minimize for! Rewritten or recirculated without written permission of each plan vary across the country account at anytime all heart! From other insurance companies handy service if you are currently seeing will accept Medicare and you 'll get a or Special supplemental program for the plan provider ( rather than Medicare ) sets the rules about how you receive pay. Of Harris health and well-being with personalized reward activities enrollees must still pay the annual! Per year they represent experience in Healthcare with a coverage determination, Aetna, of. Leaving AARP.org and Going to the Kaiser Family Foundation, 93 percent of primary physicians participate in Parts. 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Of two hearing aids, which caps costs at $ 10,000 as possible million aetna medicare advantage rewards program our Department of health & Human services offers the Medicare Advantage plans are available only through federally-approved private plan! Be free if you have questions or concerns about specific health care coverage and their monthly cost Connecticut Aetna Also be able to get information on all of UnitedHealthcare Medicare Advantage plan, how these plans and how get. Who wants to extensively use their online portal to compare health plans and UnitedHealthcare the Advantages and Disadvantages Medicare. Cover medical care you expect to need in-network pharmacy, which goes into effect the following example shows how prices Determination, Aetna will offer MAPD plans in its portfolio individual medical advice routine would! With lower copays, coinsurance, and there 's not a substitute for diagnosis or treatment by a or. 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