I have a horizontal navigation (included in the post) Let me explain the screen shot..medical is a tab under health in the horizontal nav. when Medical is clicked the left vertical navigation (under medical) is the sub pages of medical. So the user will click the horizontal navigation and the vertical navigation is the sub pages in that section.....

I'm not sure if there is a question there, but ... if you wanted to know how to do it, you can use multiple menus configured to display different page "levels."