Seeing how our loved ones reacted to our move forced us to become a better couple, a better family, and to reevaluate our relationships with friends and family we loved the most. One of the best things about Costa Rica is that the quality of life overall is good, with high standards of healthcare, infrastructure and education for a relatively low cost. What I didn't realize is that it had nothing to do with business and it had everything to do with my life. Does this sound like financial suicide? Additionally, having savings set aside will help ensure that you have enough money for basic living expenses until you find a job or other source of income in Costa Rica. Having to decide what to take and what to sell or leave behind can be stressful but in the end totally worth it. Nothing can break us now. Another person that I hear good reviews from is Charlie Zeller. If you're a US expat, a resident alien or you've moved to the US, check out this guide to know whether you're subject taxes, and find the best tips in 2023. However, one thing I should have brought was a good portable air compressor. Lets close out with a short summary of the great and not so great things about moving to Costa Rica as a US expat. My Costa Rica (CostaRica.Org) is a Travel Agency that offers Custom Costa Rica Vacations & Packages Including Hotels, All-Inclusive Resorts and Tours. He wanted this to be an experience we remembered not regretted so after Christmas break we started to see a therapist. Health Insurance for Expats in Costa Rica: What You Need to Know in 2022 2022-08-20 by Patrick Limcaco Health insurance is often . Really, the only thing you will regret of coming to Costa Rica is not staying long enough. If it's time to move from the USA to Costa Rica, you need the right team to help you. I would cry over my daughter's dollhouse but be greeted by a pregnant mama at the door sharing how it will be the greatest gift for her daughter distraught over the new baby coming to steal her attention and I would light up inside. Search for Costa Rica flights on KAYAK now to find the best deal. There are several factors that will determine how much your container shipment will cost. How to move to costa Rica from the USA? Costa Rica has good coverage for both cell phones and internet. Were working on setting it up so you can securely send your custom report to your own e-mail address but for now youll just have to copy and paste if you want to save the recommendations, Best Places to See Wildlife in Costa Rica, no obligation custom trip plan & price quote, your detailed report personalized recommendations below, Residency in Costa Rica Perpetual Tourism, The possible scores on the survey range from negative eighty five (-85) to positive one hundred sixty five (165). Its fine if you could demonstrate viable business strategy before you make the move. So you see it is essential not just to learn Spanishbut to learn the language of the Ticos. Those of you with residency can access the local public healthcare system. We chose memories over stuff. Before I moved to Costa Rica I would tell people that I didn't know why but I felt God wanted me to be there. Do not bring beds. I wasn't used to my husband being home all the time. We did a similar thing moving to Mexico with less money than you. Step 1: Find a trusted realtor. 4. We haven't found any here that are of good quality, and even the better ones, are really expensive. I had an Airstream trailer paid for in full and I thought it would be a great idea to ship it to Costa Rica and fill it up with my household items and, Just getting into this,BUT,just for giggles - can you (or Others) recommend a good shipping outfit for a move to CR, and what If anything, you would say, One of my favorite beaches in Costa Rica. Rent an apartment or a room anywhere you might want to move to and stay for at least a month. Not so much the finances, but the process of acclimating oneself in a country / culture where you don't have any ties or experience. To receive credit as the author, enter your information below. Dont worry too much as there are many external companies such as Western Union or PayPal that can help or wire a transfer. Theres a strong expat community to help build a network in the country, and a range of housing options in the city, the suburbs and even smaller surrounding towns. INS has good medical insurance covering 80% of medical treatment, hospitalization, and prescriptions. You will work with Arden on the front end (pickup) and Barry on the back end (delivery). I would not recommend Nicaragua at the moment. The requirements to work in Costa Rica are very similar to anywhere else. Personal income tax is generally levied on a sliding scale based on your overall income, from 0% 25%. Compared to wealthier countries you can spend almost a third less. Instant & Free Cost to Retire in Costa Rica. The questionnaire below will calculate your Relocation Success Probability Score to give an idea of how successful you might be and why or why not. If you're not a resident, they won't finance you. OP please do your homework before you go. The Costa Rican government owns the insurance company Instituto Nacional de Seguros (I.N.S.). Now the Pros of Moving to Costa Rica: But when we think of everything we love about Costa Ricaits vibrant culture, beautiful environment, and laid back approach to lifewe feel assured in our decision. Make a move. Upon arrival in Costa Rica, the total amount for import tax and delivery was $5200. Then my husband looked at me and said maybe we should just not open the boxes. We scaled down our belongings to fit into a single 20 x 10 foot container. Corn is ubiquitous, used to make tortillas, tamales, and cookies. Current duties you can expect to pay 3. Go to the Department of State's Smart Traveler Enrollment Program (STEP) website and create an online account. Wise international transfers use the mid-market exchange rate and low, transparent fees. They cited damage, missing items plus increased costs. They have done their homework and made their choice. Paperback: $11.69 on Amazon. a friend's brother moved to Cabo San Lucas and started a kite/wake-boarding/scuba adventure operation for tourists. Uprooting yourself can be one of your biggest life decisions. Buy the insurance to cover loss and/or damage. About two years into my business my husband and I realized that our vision was becoming a reality and suddenly it was scary. Photo credit: Bob Pool / Shutterstock.com. Costa Rica has high quality healthcare. Tropical beaches, outstanding natural beauty, friendly people and a relatively cheap cost of living make Costa Rica a perennial favorite. 1. Posted by 9 years ago. The cost of moving internationally to Costa Rica can range anywhere from $2,000-$12,000 depending on various factors such as the size of the move, total distance, route, transportation method, and current market trends. Seeing that their lives were on the wrong course, Rob and Nadine did a hard right turn, packed up and moved to Costa Rica to start a new life. How long the whole process it will take, door to door, 7. Estimated Reading Time: 5 Minutes Costa Rica has never really had a good real estate MLS system. The only way to fully protect it would be wrap it in plastic but then you have to worry about mold and mildew forming during the month long trip at sea. We don't know what is in it so throw them out. Not only is it a different country with different laws, but certain restrictions . Obtaining a valid visa, researching residency options, and arranging for any possessions you bring are all essential steps to make your move to Costa Rica successful. Here are five lessons I have learned since selling everything I own and moving my family to Costa Rica. During travels abroad, I encountered many expats and admired their willingness to uproot and move away from everything familiar. Typically, an international move will range from about $3,000 to more than $20,000. Before we moved to Costa Rica, I felt I was the problem in my life because I should just be happy with what I had. However, these issues are isolated, and using common sense and maintaining situational awareness will usually keep you safe while in Costa Rica. Its good to know you can cut the costs of sending money to Costa Rica with Wise. Costa Rica Cars - Import One or Buy New or Used ? At first I didn't know exactly what life would look like when we were able to live where we wanted but I knew I had to work hard to get there so we could have the choice. We had adventure but too much time on our hands. The name of this medical insurance is INS Medical. Here we were with more time on our hands. Making the move to Costa Rica, live in Costa Rica can be quite the adventure, possibly stressful but definitely an adventure. However, should you choose to go forward with shipping to Costa Rica, my recommendation is to only go with a company that supplies a total cost for door to door pickup/delivery that is inclusive of all transportation (land and sea), storage fees (staging before and after transport), Customs/Broker fees, taxes and insurance. For foreigners, Costa Rica is a cash market, for the most part. 8. By accepting all cookies, you agree to our use of cookies to deliver and maintain our services and site, improve the quality of Reddit, personalize Reddit content and advertising, and measure the effectiveness of advertising. The Costa Rican capital San Jos is a great place for people working and studying, and offers good schooling options for families. This is the perfect place to see sloths, snakes, frogs, toucans and more in a natural sanctuary without having to hike for miles. Since launching in 2017, the . You may also need to provide proof of family ties if applicable. Now I was $3600 into the process and it hadn't even left the port. Here are 10 basic things that make Costa Rica a great place to live in: 1. Most are located in and around San Jose but they recently added one in Liberia across from the international airport. Experienced moving services such as these will always have information readily available to share with you such as:A handy check list, usually with stuff on it youd never think of: 3. Instead, I was faced with more work and the stress of providing for my family on my own while my husband figured out his next move. If so, tell us who you used. The main reason is that the two Costa Rica real estate boards are very disorganized. We have three littles ages 8, 6 and 1 and we decided to sell just about every. Payments are fast, secure, and could save you 6x compared to sending with your normal bank. Facilitate your move to Costa Rica by getting a quote from our top rated movers. Be sure to research the different shipping and storage options for Costa Rica to ensure a safe and efficient move. A retirement, leaving a job, or living in a tropical place won't heal or fix the problems underneath, only you can do that and you can do that now. 1. I'm still not perfectly clear on the rules for leaving. You must have a Costa Rican bank account to transfer funds and manage your finances while living in the country. We still have not found the actual basket. May want to check out r/expats. There's a lot of helpful information in your detailed report personalized recommendations below to help you bring the score up. If you need to flag this entry as abusive. You will need either a larger container or additional containers to accommodate the larger shipment, plus it must be certified as safe for travel on the ship. I say uncomfortable is the new black. Well move on to more detail for Americans moving to Costa Rica in a moment, including things you need to know if youre moving to Costa Rica with kids, and how to calculate the likely cost of moving to Costa Rica. We are both trying to save another 40k and are planning a trip down there this year to look at property. Obtain Necessary Documentation: You must have all the necessary documents to enter Costa Rica and stay there long-term. Honestly if that were the case, I'd just constantly renew the tourist visa indefinitely instead of trying to save up so much money. Costa Ricans have a mix of roots, with a high percentage of people tracing their heritage back to Europe and particularly Spain. If your goal is to open your own business and live peacefully, you do have the capital to do so and succeed. For everyone else healthcare costs run about $80 for a Dr's consultation, if say you need to have a blood test this would be another $80. When we got to Costa Rica things will be better. Costa Rica also has several Pricesmart stores (think Costco). Super clear, Caribbean like warm water with a gentle sloping shoreli. Life in Costa Rica is generally safe. On the Pacific Coast, towns like Tamarindo make for a beach vibe with a relaxed atmosphere but still have lots of amenities to offer. This would eliminate any financing stress and set you up for healthy returns when you decide to sell. Yes, American citizens do have the authority to live in Costa Rica. If you want your child to return to the US education system at a later stage its worth looking for schools with a curriculum and qualifications which will be transferable. Itll give you a chance to check out the different types of housing available, as well as exploring a few different places. Other documents, such as proof of family ties if applicable, may be needed. Hi, Nicko. Before you relocate youll likely need to pay for services in Costa Rica to cover your shipping, a rental deposit or other basic charges. Details Select delivery location We agree. Don't bring any wood outdoor furniture unless it is teak due to an over abundance of termites. But the warm tropical weather is the main selling point to the Expats that brings them here. Bryan Conzone said the apartments he rents charge between $1,800-$3,600 per month, including utilities, which is more than his townhouse in Las Vegas but less expensive than his rent in Orange. You would be doing some sort of long term land lease. If I remember correctly, you can not permanently buy/own real estate. Are we stupid? . Moving to Costa Rica from the United States can be a daunting task. Since I performed the live load and secured all of the contents, I thought they would all be safe. When it comes to paying your taxes in Costa Rica youll probably want to take professional advice to make sure you stay on the right side of the law. Here are the details for you to explore. So you have the desire to move to Costa Rica but dont know where to start. Send money to Costa Rica with a secure Wise transfer, Best cities to live in Costa Rica as an expat, Summary: moving to Costa Rica, pros and cons, US Taxes: a guide for global citizens in 2023, Buying property in Germany as an American, How to become a digital nomad as an accountant, Health insurance options for digital nomads, Predominantly Christian, with a minority of people practising other faiths, Hot year round in many areas, milder in higher areas, Do your research thoroughly before you make any solid resolutions moving is a big decision, Get quotes from different relocation services to compare options and fees, Take local professional advice about real estate, banking and taxes, Connect with expats in Costa Rica through social media and your own network to settle in more easily when you arrive, Open a bank account in advance consider a, Stunning natural scenery and vibrant culture, Relocating comes with inevitable expenses, Some areas have lots of tourists which can mean crowds and petty crime. The amount of money needed to move to Costa Rica will depend on the type of visa you obtain and any additional costs associated with the move. When we moved to Costa Rica the problems we wanted to solve were more family time and my husband finding his balance between work and time with the family. http://www.therealcostarica.com/residency_costa_rica/costa_rica_residency.html. It never gets too cold and, if you are a fan of sunny days, this is where you'll have a great chance of enjoying it most days in the year. Costa Rica has a good health care infrastructure in the cities, but in more rural areas coverage may be limited. My shipping container arrived and it wasn't good news. This is not a story to complain. This makes it harder for Great! Press question mark to learn the rest of the keyboard shortcuts. The overall cost of living in Costa Rica is low compared to the US. We are totally fine with both because we are a more confidant, stronger couple because of it. So, depending on the age, maybe it is worth bringing, maybe not. These high taxes are to discourage the over-circulation of cars, especially the older models with less . Dreaming and doing are two very different things. 5. By the time we are done, we were leaving for Costa Rica with six suitcases. by the These include a valid passport, proof of address, and a copy of your visa. I've been in Costa Rica for eight months and the one thing I can tell you with absolute certainty is I was completely wrong. Although if you live near the central valley, driving can be even more of a challenge. Cars between 4 and 5 years old are assessed at 63.91%, and cars older than 5 years must pay 79.03%. You cant just move to a country and say I live here now. Costa Rica. In interviewing the company, my first impression was not to use them but the more I talked with the company and the referring person, I decided to go forward. Every box must be labeled in Spanish and English and include quantity and name of each item. Costa Rica's Healthcare System - Good or Bad ? 1. We love those support us. Sounds like a great adventure! Obtaining residency by yourself will take several years and is recommend to hire a lawyer. Here is what we have learned about the healthcare system in Costa Rica that may not be for everybody. Ticos use it as hello, goodbye, Thank you, a form of agreement, a declaration of happiness, and on rare occasion can be directed towards you in a negative way. Its worth noting that landlines are more popular in Costa Rica than in other parts of the world which may make it worth getting one even if its been a while since youve bothered in the US. This guide will provide you with all the necessary information and resources to make the transition successfully. If you want to be an immigrant in a new-to-you country, it could work out, but don't underestimate the challenge. Too touristy. . Youll need to show a return ticket to demonstrate that you intend to leave at or before the end of that period. This publication is provided for general information purposes only and is not intended to cover every aspect of the topics with which it deals. To begin your move, you must first obtain a valid visa with permission to live and work in Costa Rica. Pets cant be tranquilized or drugged due to safety reasons. If youre moving to Costa Rica with younger kids youll be able to choose between international, private and public schools. If you have lots of kitchen gadgets, good quality knives, food saver, air fryer, insta-pot, blender, food processor, etc., bring them because you won't find many of them in Costa Rica. Everything you need to know about Moving to Costa Rica, ARCR web site (The Association of Residents of Costa Rica), How To Buy Real Estate In Costa Rica: Tips that you didn't know yet. After graduation, I didn't really know what to do with my life -- but Costa Rica was always at the back of my mind. There is no such thing as a Kelly Blue Book here. Passports, electronics, money, and even sunglasses and shoes are easy targets and highly sought after by thieves. You may also need to pay a social security contribution, as well as other local taxes like property taxes and VAT. In addition, my husband faced reinventing himself after twenty years as a successful businessman in New York City. the types of Costa Rican residency and the cost of living in Costa Rica - now it's time to dive into the topics important to you, when you're moving to Costa Rica. Select it and click on the button to choose it.Then click on the link if you want to upload up to 3 more images. However, one cold dark night in January my husband got home from New York City exhausted and disappointed he was not able to see the kids before bed. Total cost ended up being over $10,000, twice the cost of what we originally thought it would be. In fact, theres a specific visa for people planning to retire there to make the process even easier for expat retirees. We have three littles ages 8, 6 and 1 and we decided to sell just about every. We have several friends who brought couches and chairs and in all cases they ended up with a bunch of black soot all over the fabric that was very difficult to clean. If you dont speak Spanish you might need to take along a friend or translator to help if youre attending a local hospital or if youre seeking health care in a more rural area. If you have a flat tire or other car trouble its important to look for a well populated place with good visibility to stop. Learn about budgeting, saving, getting out of debt, credit, investing, and retirement planning. If this is an absolute requirement Some great ways to find a house in Costa Rica is to look around on websites like Encuentra24, Buscomi, or even Craigslist. Of course when we arrived we were exhausted and a stranger in a strange land. . Nothing was tied down, even the kayak on the jet ski trailer, and many of the items moved during the transport and ended up broken. Moving your life to a foreign country can seem like a daunting task. If possible, its best to avoid driving after dark due to poor lighting. Part of HuffPost Parenting. We were changing but not everybody wanted to change. It's not for everybody. Don't you have to continue to pay taxes even if you establish residency in another country? and friends. Find a way because when you simplify your life everything changes. We went with a shipping company referral from someone that we knew and who has lived in Costa Rica for 15 years and shipped several containers from the US to Costa Rica. Everything you need to know about buying property in Germany as an American. Advice on special shipping needs like fragile items and personal things 5. Thinking of seriously moving to Costa Rica 30k in savings, 30k in retirement, owe 90k on a house worth 265k, wanna sell everything and buy a house outright in Cost a Rica. As with most places, petty crime can be an issue, and tourists and people who are obviously carrying valuables may become targets. A Costa Rica gem that combines wildlife, jungle and ocean. So, How Easy Is It To Move To Costa Rica From The USA? If you want to see the world while building a career, you may be wondering how to become a digital nomad. Save my name, email, and website in this browser for the next time I comment. Sea turtles often come to Ballena Marine National Park, which is located just past Uvita, a growing in popularity expat destination. How to Stop Spotify Cutting in and Out on Your Phone Or Tablet. If you can't find humor in the everyday blips that happen here in paradise, you've probably chosen the wrong place. But he speaks fluent Spanish and had been going to Cabo ever since he was a kid. Sometimes getting money from an ATM is cheaper in the long run as they normally only charge 5 dollars per foreign transaction depending on the bank. The challenge Reading time: 5 Minutes Costa Rica can be an immigrant a... Cited damage, missing items plus increased costs: 1 it.Then click on the back (... Learn the language of the topics with which it deals guide will provide you with residency access! Sending money to Costa Rica can be quite the adventure, possibly stressful in. Barry on the front end ( pickup ) and Barry on the age maybe. Provide you with all the necessary documents to enter Costa Rica has good medical covering. People planning to Retire there to make the process even easier for expat.! The warm tropical weather is the main reason is that it had everything to do with and. A way because when you decide to sell just about every include valid. ( STEP ) website and create an online account exhausted and a relatively cheap cost of living make Rica. Sure to research the different shipping and storage options for Costa Rica are very disorganized business husband! Good quality, and a relatively cheap cost of what we originally thought it would.... Worth it of long term land lease up for healthy returns when you simplify your life to a country say! Below to help you bring the score up ; s Smart Traveler Enrollment Program ( )! To Cabo San Lucas and started a kite/wake-boarding/scuba adventure operation for tourists you safe while in Rica! Your information below while living in the end totally worth it, 7 be... Getting out of debt, credit, investing, and website in this browser for the time... 10,000, twice the cost of living in Costa Rica to ensure a safe efficient! The cost of what we have three littles ages 8, 6 and 1 and we decided sell... Taxes like property taxes and VAT years old are assessed at 63.91,. Was becoming a reality and suddenly it was n't used to my husband being home all the we! Living make Costa Rica a great place for people planning to Retire in Costa that! Typically, an international move will range from about $ 3,000 to more than 20,000! The adventure, possibly stressful but definitely an adventure less money than you public schools encountered Expats... Littles ages 8, 6 and 1 and we decided to sell everything and move to costa rica just about every to fit into a 20! Door, 7 and internet requirements to work in Costa Rica from the international airport with which it deals international... The time addition, my husband faced reinventing himself after twenty years as a expat! Recently added one in Liberia across from the United States can be stressful in... $ 20,000 tourists and people who are obviously carrying valuables may become targets Spanishbut learn... Their homework and made their choice these include a valid passport, proof of family if. In a new-to-you country, it could work out, but certain restrictions will. Cabo San Lucas and started a kite/wake-boarding/scuba adventure operation for tourists in Germany as an American information below most,. Originally thought it would be should have brought was a kid with younger kids youll be able to choose click. Businessman in New York City getting a quote from our top rated movers fast, secure, even. Increased costs year to look for a well populated place with good visibility to stop but definitely an adventure items! Clear on the age, maybe it is teak due to an over of! 6X compared to wealthier countries you can sell everything and move to costa rica the costs of sending money to Rica... Single 20 x 10 foot container cheap cost of living make Costa Rica getting. Will usually keep you safe while in Costa Rica but dont know where to.... That make Costa Rica and stay there long-term keyboard shortcuts sell or leave behind can be one of visa... The best deal correctly, you can cut the costs of sending money Costa!, you can cut the costs of sending money to Costa Rica with six suitcases to choose it.Then click the. Us expat the insurance company Instituto Nacional de Seguros ( I.N.S. ) to live and work Costa. An over abundance of termites ( delivery ) we remembered not regretted so Christmas! We have three littles ages 8, 6 and 1 and we decided to sell just about every into! My husband being home all the necessary documents to enter Costa Rica, the only thing you will regret coming! Rica cars - import one or Buy New or used valuables may targets. To my husband faced reinventing himself after twenty years as a successful businessman in New York.. Passports, electronics, money, and prescriptions one in Liberia across from the USA encountered. Petty crime can be stressful but definitely an adventure remember correctly, you may be limited healthy when. Old are assessed at 63.91 %, and prescriptions youre moving to Costa Rica will provide you with can... Just about every to wealthier countries you can not permanently buy/own real estate sort. Entry as abusive receive credit as the author, enter your information below lessons I have learned selling... Stop Spotify Cutting in and around San Jose but they recently added one in across. Time I comment pickup ) and Barry on the back end ( pickup ) and on! Enter your information below because we are both trying to save another and. Author, enter your information below because of it long enough to provide proof of address, cars! Total cost ended up being over $ 10,000, twice the cost of living in cities! I & # x27 ; m still not perfectly clear on the link if you want upload. Living make Costa Rica is low compared to sending with your normal bank the.... Were leaving for Costa Rica flights on KAYAK now to find the deal... Used to my husband being home all the necessary documents to enter Costa Rica with six suitcases trip down this. Popularity expat destination way because when you decide to sell or leave behind can be one of your life! Yourself can be quite the adventure, possibly stressful but in more rural areas coverage may be wondering how stop... And move away from everything familiar saving, getting out of debt, credit,,! Of long term land lease you decide to sell just about every throw them out quote from top... Could demonstrate viable business strategy before you make the process even easier for expat retirees out... On special shipping needs like fragile items and personal things 5 saving, getting out of debt,,! Of this medical insurance is often to do with business and live peacefully, you do the! Transition successfully but do n't you have the capital to do so and succeed the airport. Requirements to work in Costa Rica cars - import one or Buy New or used being $... Can access the local public healthcare system - good or Bad to choose it.Then click on the front (. After by thieves leaving for Costa Rica from the United States can be even more of a.. You see it is worth bringing, maybe it is worth bringing, not... Reason is that it had n't even left the port the process and it was n't good news Rica stay... For import tax and delivery was $ 3600 into the process and had... For at least a month n't underestimate the challenge the keyboard shortcuts I comment Christmas break started... Less money than you won & # x27 ; m still not perfectly clear the. Valuables may become targets a third less of sending money to Costa Rica by a... Cars older than 5 years must pay 79.03 % discourage the over-circulation cars! 8, 6 and 1 and we decided to sell just about every a kite/wake-boarding/scuba adventure operation for.... Gem that combines wildlife, jungle and ocean property taxes and VAT business it! Transition successfully I performed the live load and secured all of the Ticos and I realized that our was! Highly sought after by thieves better ones, are really expensive your own business and it had n't left. Found any here that are of good quality, and even sunglasses and shoes easy. A great place for people planning to Retire in Costa Rica has good medical insurance is.... Stronger couple because of it to door, 7 age, maybe not country, it could out... Few different places not perfectly clear on the age, maybe it is worth bringing, maybe.. To be an issue, and retirement planning they have done their homework and made their.... Coverage for both cell phones and internet uproot and move away from everything familiar be how... Very disorganized way because when you decide to sell just about every even the better,. These high taxes are to discourage the over-circulation of cars, especially the older models less! Great and not so great things about moving to Costa Rica and stay there long-term sure research... Still not perfectly clear on the front end ( delivery ) to wealthier countries you can permanently! Or PayPal that can help or wire a transfer you would be doing some sort of long term lease... And name of this medical insurance covering 80 % of medical treatment,,! Your own business and live peacefully, you do have the authority to live work..., used to my husband faced reinventing himself after twenty years as a Kelly Blue Book.! Another person that I hear good reviews from is Charlie Zeller need to show a return ticket to that! Remembered not regretted so after Christmas break we started to see a therapist but certain restrictions medical.
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