Health&Y O U R O X F O R D G U I D E T O L I V I N G W E L L

WellnessS P R I N G 2 0 0 3

Why go tothe doctor when

you’re well?

Inside: Oxford’s HIPAA Privacy Notice Moody Blues — what’s normal and what’s not

MS-03-155

Whole milk can be a major source of saturated fat in your diet —

a single 8 oz. glass is equal to six strips of bacon or two doughnuts.

A switch to skim can help lower serum cholesterol

and the risk of cardiovascular diseases and diabetes. If you’re

concerned about the difference in the taste of skim milk, shift

down in stages. Two-percent milk is considerably better for you

than whole milk, one-percent is better still, and skim delivers all

the goodness with the least amount of fat. O

A serving of grapefruit for breakfast can be your taste of sunshine

on a cold winter’s day. But if you take prescription medications, be

aware of the grapefruit effect. Grapefruits and

their cousins, the tangelos, contain an enzyme that may alter the

potency of a therapeutic drug you depend on. Of particular

concern are medications used to treat high blood pressure,

high cholesterol, heart disease, allergies, AIDS, organ transplant

conditions, depression, insomnia, and anxiety. So ask your doctor

or pharmacist if eating these fruits poses a risk. Fortunately, no such

interactions are associated with oranges, lemons, or limes. O

What’s in a name? In the case of lower-priced generic drugs, the same

active ingredients and identical health benefits as the brand name

drugs. To meet FDA standards, a generic drug must be

bioequivalent and pharmaceutically equal to the brand name drug. This

means that the generic drug must produce the same effects on your

body and have the same active components as the higher-priced brand

name drugs. So why do generics cost less? Part of what you’re paying for

with brand names is marketing and advertising. For more information

on how you can feel better for less, look for an update on the benefits

of generic drugs in your next issue of Health & Wellness. O

Did you know?

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Health&Y O U R O X F O R D G U I D E T O L I V I N G W E L L

WellnessS P R I N G 2 0 0 3

C O N T E N T S

President and CEO Charles G. BergChief Medical Officer and EVP Alan M. Muney, MD, MHAVice President, Marketing Chuck GreenDirector, Member Marketing Rebecca MadsenManager, Member Marketing Meg DedmanEditor Stephanie Gebing

Health & Wellness is published exclusively for Oxford Medicare AdvantageSM Members by:Onward Publishing, Inc.10 Lewis Road, Northport, NY 11768Tel 1-631-757-3030 Fax 1-631-754-0522

Publisher Jeffrey BaraschCreative Director Melissa BaraschEditorial Director Wendy MurphyArt Director Bruce McGowinDesigner Lisanne SchnellProject Director Tamyra ZieranProject Manager Bret BaraschBusiness Manager Liz Lynch

Oxford Health Plans, Inc. and Onward Publishing,Inc., are not responsible for typographical errors.

The information in this newsletter is intended to be used as a general guide and should not replace the advice of your physician. Always consult your physician for individualized care.

© 2003 Onward Publishing, Inc. All rights reserved.

Health& Wellness is designed just for you — to give you the latest information on a wide rangeof health topics, as well as updates on your plan benefits. We encourage you to e-mail your commentsto us at publications@oxfordhealth.com or write to: Oxford Health Plans, c/o Stephanie Gebing, 48 Monroe Turnpike, Trumbull, CT 06611.

C O V E R S T O R Y

Why go to the doctor when you’re well?

S P E C I A L T O P I C

Moody Blues — what’s normal and what’s not

N E W S Y O U C A N U S E

Oxford benefits update

Notice to our Membersregarding Oxford’s HIPAA privacy practices

P A T H S T O W E L L N E S S

How can I ease my chronic back pain?

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1 Sandman, David; Simantov, Elizabeth; An, Christina; and Louis Harris and Associates, “Out of Touch: American Men and the HealthCare System,”The Commonwealth Fund, March 2002.

Together, prevention and disease management offer the best and most progressive prescriptionfor enjoying a long and healthy life. This two-pronged approach is called “wellness care,” andrequires active participation on the part of thepatient, which is often a difficult behavior toadopt, especially for men.

The male/female factorWhen it comes to making good use of the medical services and know-how available, mostdoctors will tell you that none of us come close to doing all that we can and should to take careof ourselves. But for a host of reasons, including

the perception that males should be strong andself-reliant, a man is typically more likely to neglect his health than is his female counterpart.In a recent Lou Harris poll conducted for theCommonwealth Fund1, 33 percent of men interviewed did not have a regular primary carephysician (PCP) as compared with 19 percent ofwomen. Three times more men than women saidthey specifically ignored symptoms or delayedseeking medical attention even when sick or inpain, putting them at unnecessary risk of havinga serious medical crisis. Many men also said they failed to get routine screenings for suchconditions as prostate cancer and colon cancer,

C O V E R S T O R Y4

Why go to thedoctor when

you’re well?Once upon a time, people only went to their doctor when they

knew they were very sick. But with advances in modern medicine

and diagnostic testing, we now know that through regular

check-ups many conditions can be prevented or diagnosed early

enough to be treated before permanent damage is done.

even though the tests were offered as part of theirbasic healthcare coverage. And when men wereasked why they were so disinclined to use medicalservices or seek treatment, they said they felt“uncomfortable” or “embarrassed” to discuss their health concerns.

The authors of the study — one of the largest andmost extensive examinations of men’s healthcarepatterns ever conducted — were not surprised bythe findings. They noted that there was almost certainly a direct connection between this patternof self-neglect and the fact that men have a shorterlife expectancy than women and suffer higher mortality rates from the leading causes of death.The researchers also predicted that unless men can be persuaded to be more responsible with their health and to disclose more information sooner to their regular PCP, this “silent crisis” inmen’s health could only get worse. Women, whiletheir situation is statistically somewhat brighter, also need to ask themselves whether they personallymake full and timely use of the preventive andhealth management tools available to them.

Oxford’s Self-CareResources

To help you take an active interest in your own healthcare, Oxford offers a wealth of programs and resources.

Active Partner® Education and Outreach programsOxford’s Active Partner Education and Outreach programs are designed to help Members managechronic conditions.Through these programs, wefocus on educating and encouraging Members,while promoting communication betweenMembers and physicians. Some of these programs include:

• Better Breathing® (asthma program)

• Dialysis program

• Living with DiabetesSM

• Rare Chronic Care (multiple sclerosis, lupus,myasthenia gravis, hemophelia, cystic fibrosis)

• Senior Health Management

Active Partner ® Preventive reminder mailingsWe send reminders to Members who have not received a preventive exam within the recommended time period.These mailings arebased on clinical guidelines and are intended toencourage preventive care, which is so importantto long-term health and wellness. Reminder mailings are sent for:

• Diabetic retinal exam

• Flu vaccine

• Mammogram

SilverSneakers® Fitness programOffers Oxford Medicare Advantage™ Members living in Brooklyn, Queens, Staten Island,Manhattan, and Bronx County to take advantage of a complimentary membership to a participating fitness facility near you,where you can use amenities such as steam and sauna rooms and exercise equipment.You can also enjoy SilverSneakers fitness classes(appropriate for all levels of fitness), various fitness promotions, trips to local sporting events, and health education seminars. For more information, please call Oxford at 1-800-234-1228 (TTY/TDD 1-800-201-4874).

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C O V E R S T O R Y6

Oxford’s focus on wellnessAt Oxford, we want to make it easy for you to take advantage of the wellness programs we have to supporthealthy aging. First, you need to make sure you’re getting your regular diagnostic screenings to catch those conditions that can be diagnosed and treated in the early stages. (See the chart on page 7 for the testsmen and women should have.)

Next, you should be aware of Oxford’s Active Partner ®

Education and Outreach programs, which can help youmanage chronic conditions you may have. These programsare designed to educate you and to help our physiciansand providers coordinate your care while maintainingcompliance with the latest treatment guidelines.

In addition, as the flu season approaches each fall, we send flu immunization reminders to all Members over theage of 50 to emphasize the importance of receiving this vaccine. Reminder mailings are also sent to those Memberswho may need diabetic retinal exams and mammograms.It’s just one of the ways our Active Partner programs helpkeep you healthy.

Oxford’s Self-CareResourcescontinued

Oxford’s Walking ClubsIn addition to the SilverSneakers FitnessProgram, you can join or start an OxfordWalking Club. Our Walking Clubs are agreat way for you to begin or continue an exercise routine. If you would like to join or obtain more information, please call 1-800-889-1424, extension 3674.

Oxford’s Self-Help LibrarySM

Our educational guides for conditions suchas asthma and diabetes help Members learnabout self-care, treatment therapies, and how to prevent complications. Members can receive these materials soon after they are diagnosed with certain conditions by an Oxford participating provider.

Oxford On-Call®

Healthcare guidance is always just a phone call away. Although your primarycare physician is always your first point of contact, our registered nurses are also available to identify your symptomsand recommend next steps 24 hours a day, 365 days a year.To access this service, call 1-800-234-1228 (TTY/TDD 1-800-201-4874) and press 3.

Complementary & AlternativeMedicine (CAM) program*As an Oxford Medicare Advantage Member, you have access to providers such as acupuncturists, massage therapists,nutritionists, yoga instructors, and chiropractors through our CAM network.To access this benefit, Members can go directly to an Oxford participating alternative medicine provider, at any time, and pay the contracted rate directly to the provider.There are no referrals,reimbursement, or paperwork.

*The services for these items are neither offerednor guaranteed under Oxford’s contract with theMedicare program, but are made available to allenrollees who are Members of Oxford.Theseproducts and services are not subject to theMedicare appeals process.Any disputes regardingthese products and services may be subject toOxford’s grievance process. Should a problem arisewith these services, please call Oxford’s CustomerService Department at 1-800-234-1228.

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Sources for information presented above:American Academy of Family Physicians, 1994. www.aafp.org. Derived from the U.S. PreventiveServices Task Force.Approved by Oxford Regional QM Committees 1988. Reviewed and revised 3/2002.

The doctor will see you now We recognize that timely access to a physician isimportant — whether you need a physical, orcolonoscopy, or treatment for an unexpected illness.

As an Oxford Member, you can expect to see aprovider for urgent care within 24 hours, routinecare within 72 hours, or a regular physical examwithin six weeks. Your wait in a provider’s office orfor a response to an after-hours urgent phone callshould be no more than 30 minutes. To assure thatyou receive the attention you need, and that your

PCP does not become overburdened, we also setstandards for the maximum number of patientsseen per hour. Measures like these are designed tohelp ensure quality of care and convenience whilemaking your healthcare experience less stressful.

So why wait for illness when you can take an activerole in your wellness? Schedule an appointment tosee your physician, and start taking advantage ofthe host of programs Oxford has to offer. You’llhave greater control over your physical well-beingand, as a result, improve the quality of your life. O

Preventive Measures Women and Men Should Take

Women Why WhenBlood pressure For early detection of high blood pressure At least every two years if between screening which if untreated could lead to cardiovascular ages 18 and 64

disease, heart attack, and stroke Annually if age 65 and older

Cholesterol level For early detection of high cholesterol which Every 5 yearscould lead to cardiovascular disease,heart attack, and stroke

Chlamydial screening For early detection of sexually At regular screening if under the transmitted diseases age of 25 and sexually active

Clinical breast exam For early detection of breast cancer At clinician’s discretion if age 18 to 39Annually if age 40 and older

Mammography For early detection of breast cancer Annually with clinical breast exam beginning at age 40

Pelvic exam and For early detection of cervical cancer Annually at onset of sexual activity Pap smear or starting at age 18. Every 1 to 3 years,

after 3 consecutive normal smears

Digital rectal exam For early detection of colon cancer At clinician’s discretion

Influenza vaccine To minimize risk of getting the flu Annually if age 18 to 49 for those withchronic disease or high risk. Annually if age 50 and older

Men Why WhenBlood pressure For early detection of high blood pressure At least every two years if betweenscreening which if untreated could lead to cardiovascular ages 18 to 64

disease, heart attack, and stroke Annually if age 65 and older

Cholesterol level For early detection of high cholesterol Every 5 yearswhich could lead to cardiovascular disease,heart attack, and stroke

Prostate specific For early detection of prostate cancer At clinician’s discretionantigen (PSA)

Digital rectal exam For early detection of colon cancer At clinician’s discretion

Influenza vaccine To minimize risk of getting the flu Annually if age 18 to 49 for those withchronic disease or high risk. Annually if age 50 and older

Clinical depression is a medical condition, rangingfrom dysthemia to major depression. Dysthemialeaves an individual chronically sad but not fully disabled, while major depression can make evengetting out of bed an impossible challenge.Although depression strikes older people withgreater frequency than the young, it is not aninevitable consequence of aging. About 24 percentof elderly people suffer one or more bouts of dysthemia in their later years; another one to two percent experience major depression. Likeother medical conditions, depression needs to be diagnosed and treated promptly. Neitherstrength of character or time can make it “goaway,” and left untreated, depressive illness mayundermine physical health and even shorten life.Fortunately, there are many resources availablethat can make a difference.

The signs of serious depression According to the American Psychiatric Association,major depression exists when an individual experiences five of the following symptoms for at least two weeks: depressed mood, diminishedinterest in daily activities, significant changes inweight or appetite, insomnia or excessive need to sleep, anxiety, agitation or unusual slowness,

fatigue or loss of energy, persistent physical symptoms such as headaches, digestive disorders, or chronic pain that do not respond to the usualtreatments, uncharacteristic irritability, feelings of worthlessness, hopelessness, or guilt, poor concentration, difficulty making decisions, orrecurrent thoughts of death or suicide.

Recognizing depression in older adults is admittedlymore difficult than identifying it in younger adults.The affected person might be living alone or with a partner who denies that a problem exists, andfamily members who visit infrequently may not seethe whole picture. The sufferer may hide feelings of sadness or hopelessness fearing that others willavoid them or think of them as weak. Typically the older person who does complain describessymptoms in terms of physical complaints.

Adding further complication is the fact that some purely physical disorders mimic aspects of depression in ways that can even mislead physicians. Consequently, when assessing an older person for an unidentified illness, a primarycare physician (PCP) will do a thorough medicalhistory and perform laboratory tests before making a definitive diagnosis. This assessment may include a brief mood-rating test, as well as a

S P E C I A L T O P I C8

Moody Blues —What’s normal and what’s not

Sad things and bad things happen. And when they do, they can temporarily knock

you off balance. But for some people, feeling sad can become a way of life, and nothing

seems pleasurable or worthwhile anymore. Mental health experts call it clinical

depression. When you or someone you love feel this way — it’s time to seek help.

discussion about recent events that might have triggered emotions of bereavement. Death of aloved one is an obvious trigger for depression, butloneliness and boredom, loss of self-esteem relatedto retirement or physical impairment, as well as loss of independence relating to restricted income, the surrender of a driver’s license, or a move tounfamiliar surroundings, can also trigger negativeemotions that lead to physical responses so real and all-engaging that recovery may be difficult without outside intervention.

Better living through chemistryWith or without external triggers, brain chemistryalso plays a central role in bringing on depression,especially as we age. Nature provides us with dozensof compounds known as neurotransmitters that routinely orchestrate our moods. When one ormore of these neurotransmitters are produced in abnormal quantities, subtle deviations in our emotions result. For these reasons, drug therapy,which seeks to restore the delicate balance in brainchemistry, has become a mainstay of treatment.Fortunately, recent progress has been made indeveloping antidepressant medications at dosagelevels specific for older patients. “Start low and goslow” is the approach followed by most physicianstreating depression with drugs, but even withreduced dosage levels, it’s not uncommon for apatient to experience improvement in mood within a few days.

About 80 percent of older patients eventually regainenergy and interest in life, although some may need short-term support through talk therapy with a professional counselor. During counseling, thepatient discusses negative feelings and circumstancesthat may trigger alterations in mood, and is guidedto use positive coping skills and behaviors. Somepatients will need antidepressant medication for the rest of their lives; others may recover fully and be able to stop drug treatment altogether, especiallyif they have adopted positive lifestyle changes such as exercise and increased social participation as partof their treatment.

Patients who have developed a coexisting depend-ence on alcohol as a result of self-medicating overmonths and years of emotional pain may also needspecific intervention to treat this secondary problem.A small minority of patients experience a life crisissevere enough to induce suicidal feelings and mayneed brief hospitalization and follow-up counselingto become stabilized, but they too can be restored to a better quality of life in time. All variables aside,the essential message is that depression is a morewidespread illness than most people recognize, that it takes many forms from mild to severe, andthat it can be treated successfully and often quicklywhen the appropriate treatment is applied. If youthink that you or someone you know may be seriously depressed, talk to your PCP. Whatever the recommended therapy, there’s no time like the present to make a change for the better. O

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OOX F O R D I N F O

If your PCP refers you to counseling, you can callOxford’s Behavioral Health line at 1-800-201-6991,Monday through Friday between 8 AM and 6 PM.Behavioral Health Coordinators can assist youwith referrals to behavioral health providers orprecertification for mental health or substanceabuse services.

More Than Moody Blues

• Depressed mood

• Diminished pleasure or interest in daily activities

• Significant changes in weight or appetite

• Insomnia or excessive sleepiness

• Unusual agitation, slowness, or fatigue

• Otherwise unexplained headaches, digestive disorders, or pain

• Poor concentration or memory

• Feelings of guilt or worthlessness

• Suicidal thoughts

N E W S Y O U C A N U S E10

Policy reminderfor non-emergency ambulance coverageWe are providing specific benefit information inan effort to help clarify the scope of ambulancecoverage you receive through your Oxford plan. Your plan covers emergency ambulancetransportation. Please be advised that as withMedicare, non-emergency ambulance transportation is not generally covered.

Oxford only covers non-emergency ambulancetransportation when medically necessary. Medicalnecessity is established when the patient’s conditionis such that the use of any other method of trans-portation is contraindicated. In any case in whichsome means of transportation other than an ambulance could be utilized without endangeringthe individual’s health, whether or not such other transportation is actually available, no payment willbe made for ambulance service. For example, trans-portation to a dialysis center is covered if medicalnecessity is established. Also note that non-emer-gency transportation coverage is generally restrictedto transportation between home and hospital, hospital and hospital or skilled nursing facility, andbetween skilled nursing facility home and dialysiscenter. Coverage is limited to transportation to thenearest appropriate Oxford participating facility.

If you feel you are in need of non-emergencyambulance transportation, please contact yourphysician to inquire about potential coverage for this service.Please note: When deemed medically necessary, non-emergencyambulance transportation is covered when the Member is taken to the nearest appropriate Oxford participating facility.

Update on dental benefits* Members of Oxford’s Premium or EnhancedDental Plan receive dental services at a rate thatreflects a discount from the usual and customaryrate (UCR) typically charged by area dentists. Pleasebe advised that the American Dental Association(ADA) recently revised some of the dental proce-dure codes associated with certain dental services.These revised codes do not affect the discountedfees listed in your current Schedule of DentalBenefits; instead, the codes help ensure that the dentist providing services to you is using the mostcurrent codes outlined by the ADA. A table of the revised codes, descriptions of services and associated Member payments has been sent to all dentists who participate in Oxford’s dental plan network. If you would like a copy of this table,please call Oxford’s Dental Customer Service at 1-888-336-6563. O

* The services for these items are neither offered nor guaranteedunder Oxford’s contract with the Medicare program, but aremade available to all enrollees who are Members of Oxford.These products and services are not subject to the Medicareappeals process.Any disputes regarding these products andservices may be subject to Oxford’s grievance process. Should a problem arise with these services, please call Oxford’sCustomer Service Department at 1-800-234-1228.

OO X F O R D | B E N E F I T S U P D A T E

Asthma doesn’t have to stop youfrom doing the things you want.Oxford’s Better Breathing ® program is designed to assist and educate children and adults who have asthma. Understanding and effectively managing your asthmacan help you lead an active andhealthy lifestyle. Spring is quicklyapproaching and brings exposures to materials that may induce or trigger asthma, but there are somethings you can do to adjust your environment. Review the followinginformation about potential triggersand tips to help make this spring a healthy one. Also remember to discuss appropriatemeasures with your physician — he or she can helpdetermine ways to best minimize symptoms fromexposure to certain substances.

Potential triggers: pollens and moldsPollens can come from trees, grasses, and weeds.They are small, dry, and light enough to be carriedeasily by air. Much like pollens, mold spores float inthe air, and can be influenced by weather conditionssuch as wind and rain.

Tips for minimizing exposures and keepingyour asthma in control:• Take medications prescribed by your doctor;

keep them with you at all times.

• Avoid mowing your lawn or being around fresh-cut grass.

• Dry your laundry in a dryer. Avoid drying your laundry on an outdoor clothesline where molds and pollens can collect.

• Try not to over-water your indoor plants; wet soil encourages mold growth.

• Keep your windows and doorsclosed; use your air conditioners as needed.

• Avoid early morning outdoor activities (5 AM – 10 AM) whenpollen is most prominent.

• Keep your car windows closed when traveling.

• Stay inside when pollen counts or humidity levels are high andwhen it is windy outside.

If you experience symptoms that youare unable to control with your pre-

scribed medications, consult your physician. Oftentimes, a minor adjustment to your environment ormedication can help you better control your asthma.If you would like more information about managingyour asthma, please call 1-800-665-4686.

Claritin® now available without a prescriptionThe Food and Drug Administration (FDA) recentlyapproved the over-the-counter (OTC) sale of all five formulations of Schering Plough’s Claritin(loratadine) at the original prescription strengths asnonprescription medications. This drug is used forthe treatment of allergic rhinitis. Claritin, previouslyavailable only as a prescription drug, is the first non-sedating antihistamine to be available without a prescription. Claritin OTC became available thispast December. Generic loratadine products by manufacturers other than Schering Plough are alsoexpected to become available. The FDA is expectedto approve Claritin OTC for general itching andchronic idiopathic uritcaria indications in early 2003.As Claritin is now available without a prescription,coverage will no longer be provided under Oxford’sprescription drug benefit.

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&Spring is hereso are your asthma triggers

N E W S Y O U C A N U S E12

Drugs requiring precertificationFor most Members with pharmacy benefit coverage through Oxford, the drugs on the following list requireprecertification through Medco Health, based on Oxford’s clinical criteria. When precertification, also knownas prior authorization, is required, this means that your physician needs to formally submit a request to andreceive approval from Medco Health in order for you to receive coverage for a prescription for certain drugs. If you have questions regarding the drugs on this list or any additional drug, please call Pharmacy CustomerService at 1-800-905-0201 (24 hours a day, seven days a week — except Thanksgiving and Christmas).

CNS Stimulants• Adderall1

• Concerta1

• Dexedrine1

• Desoxyn1

• Dextrostat1

Acne Medications• Avita2

• Differin2

• Retin A2

Arthritis Medications• Enbre1

• Humira

• Kineret

Specialized OB/GYN Drugs• Lupron (3.75 mg & 11.25 mg)

Misc. Medications• Nutritional Therapies3

• Phoslo3

• Serostim

• Vitamin D preparations (e.g., Hectorol, Rocaltrol, etc.)

1 Applies only to Members age 19 or older.2 Applies only to Members age 40 or older.3 For coverage information, contact Oxford Customer Service at the number on your ID card.Please note: Precertification requirements may vary, depending on the Members benefit.This list is subject to change without notice. For the most up-to-date information, please call Pharmacy Customer Service at 1-800-905-0201.To obtain precertification, please have your physician call Medco Health at 1-800-753-2851, Monday through Friday, from 8 AM to 9 PM.

2003 Preferred Drug ListThe following is an update to the Preferred Drug List for Oxford Medicare Advantage Members who have a three-tier prescription drug benefit. Oxford reviews new drug products approved by the FDA or reviews current products when new information becomes available. Please note that under your plan, different cost shares may apply to non-preferred brand, preferred brand and generic drugs. The following medications were reviewed by the Pharmacy and Therapeutics Committee in July, Octoberand December 2002, and February 2003.

Added:The following drugs have been added to Oxford’s Preferred Drug List as of January 1, 2003. This means that if you have a three-tier prescription drug plan, you may pay a lower cost share as a result of the change to preferred (2nd tier) status.

Drug Therapeutic Use

Actos Diabetes

Amaryl Diabetes

Benicar Hypertension

Entocort EC Crohn’s disease

Femhrt Hormone replacement therapy

Glucophage XR Diabetes

Glucovance Diabetes

Drug Therapeutic Use

Lantus Insulin

Novolin InnoLet Insulin

Novolog Insulin

Rebif Multiple sclerosis

Starlix Diabetes

Tracleer Pulmonary arterial hypertension

Viread Antiretroviral

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Removed:The following drugs have been removed from Oxford’s Preferred Drug List. This means that if you have athree-tier prescription drug plan, you may pay a higher cost share as a result of the change to non-preferredbrand (3rd tier) status. A listing of generic and preferred brand alternatives is provided. Please speak withyour physician whether they may be appropriate alternatives for treatment. Unless otherwise noted, allchanges went into effect January 1, 2003.

Drug Therapeutic Use Generic and Preferred BrandAlternatives*

Allegra (effective 2/15/03) Seasonal allergic rhinitis Over-the-counter options are available

Allegra-D (effective 2/15/03) Seasonal allergic rhinitis Over-the-counter options are available

Cytotec Gastric ulcer misoprostol (generic)

Glucophage Diabetes glipizide (generic), glyburide (generic), metformin(generic),Actos,Amaryl,Avandia, Glucophage XR,Glucotrol XL, Glucovance, Prandin, Precose, Starlix

Lariam Antimalarial mefloquine (generic)

Lithobid Antipsychotic lithium carbonate (generic)

No change:There has been no change in the formulary status of the following drugs. This means that if you have a three-tier prescription drug plan, you will continue to pay a higher cost share as a result of the non-preferred brand (3rd tier) status. A listing of generic and preferred brand alternatives is provided. Please speak with your physician about whether they may be appropriate alternatives for treatment.

Drug Therapeutic Use Generic and Preferred BrandAlternatives*

Accuneb Bronchospasm albuterol sulfate solution (generic)

Adderall XR ADD/ADHD amphetamine/dextroamphetamine (generic),methylphenidate ER (generic)

Advicor Cholesterol lowering lovastatin (generic), Lipitor, Zocor

Avinza Narcotic analgesic morphine sulfate controlled-release (generic)

Bextra Non-steroidal ibuprofen (generic) nabumetone (generic),antiinflammatory agent naproxen (generic), oxaprozin (generic)

Clarinex Seasonal allergic rhinitis Over-the-counter options are available

Focalin ADD/ADHD amphetamine/dextroamphetamine (generic),methylphenidate ER (generic)

Kineret Rheumatoid arthritis Enbrel

Paxil CR Antidepressant fluoxetine (generic), Paxil, Zoloft

Ritalin LA ADD/ADHD methylphenidate extended-release (generic)

Solaraze Actinic keratoses Efudex

Spectracef Antibiotic – cephalosporin cefuroxime (generic), Omnicef

Teveten HCT Hypertension Hyzaar

Ventolin HFA Bronchospasm albuterol inhaler (generic)

Vfend Antifungal Diflucan

*These generic or preferred brand drugs belong in the same therapeutic class of drugs as the non-preferred brand drugs listed.Please speak with your physician about whether they may be appropriate alternatives for treatment.

N E W S Y O U C A N U S E14

Functions include:• Identifying the scope of care and services

available through Oxford

• Developing clinical practice guidelines (e.g.,guidelines regarding depression for primary carephysicians) and service standards (e.g., customerservice time frames for answering incoming calls)by which performance is measured

• Verifying the medical qualifications of allproviders who participate in Oxford’s network

• Monitoring and evaluating the quality and appropriateness of the services and medical care received by Oxford Members (e.g., via ongoing Member satisfaction surveys)

• Pursuing opportunities to improve patient safety and customer service

• Resolving identified quality issues or concerns

If you would like to request more informationabout Oxford’s QM program and goals, please call Customer Service at 1-800-234-1228.

2001 Medicare Member satisfaction survey resultsRecently, the results of the 2001 MedicareConsumer Assessment of Health Plans Study(MMC-CAHPS) were reported by the Centers for Medicare and Medicaid Services (CMS).

The CAHPS study is conducted annually by selecting a random group of Medicare+Choice beneficiaries and administering a survey measuringquality of healthcare provided to them by theMedicare+Choice plans in their area. The resultsare tallied and each Medicare+Choice plan is compared on a national and regional basis.

Oxford was rated significantly higher than the state average (New York) for Overall Rating ofHealth Care, Rating of Specialists in the OxfordNetwork, How Well Doctors Communicate, andCustomer Service. Significantly improving over our results in 2000, Oxford rated higher for Ratingof Doctors in the Oxford Network and Rating ofSpecialists in the Oxford Network.

The survey results also indicate that Oxford performs comparably to other plans in our area on measures such as Getting Needed Care andGetting Care Quickly, as well as Customer Service,Doctors Who Communicate Well, and Courteousand Helpful Office Staff. We remain committed to offering you high-quality healthcare by maintaining an outstanding physician network and providing access to innovative healthcare programs, such as our Complementary &Alternative Medicine program and SilverSneakers®

Fitness program*.

*This program is available to Oxford Medicare AdvantageMembers living in Brooklyn, Queens, Staten Island, Manhattanand Bronx County.

Making sure you get the care you needOxford cares about quality

Oxford Health Plans’ Quality Management (QM) program is devoted to

making sure that you receive access to the high-quality healthcare you’ve

come to expect from us. Our QM program is led by an Executive Quality

Management Committee and consists of various Regional Committees in

which QM staff and network providers participate.

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Oxford Medicare Advantage (OMA) BalanceSM PlanWe are pleased to announce that for 2003, we are offering a new Oxford Medicare AdvantageSM (OMA) plan,in addition to our three existing plans, in Kings (Brooklyn), New York (Manhattan), Richmond (Staten Island)and Queens counties in New York. The new Oxford Medicare Advantage BalanceSM plan offers benefits similarto the OMA SignatureSM plan. However, with the OMA Balance plan, many of the copayments associated withthe OMA Signature plan have been eliminated and replaced with a $1,000 annual in-network-deductible,where Members are not responsible for additional costs beyond the $1,000 deductible2 (except for office visit and emergency room copayments). We hope you find the simplicity and predictability of this new in-network-deducible plan an appealing alternative to the OMA Signature plan. You will also find that theOMA Balance plan has lower office visit copayments than the OMA Signature plan. The OMA Balance Plan isnot offered in Bronx County. The following chart highlights OMA Signature and OMA Balance plan benefits:

Benefit Oxford Medicare Oxford Medicare Advantage Signature

SM

Advantage BalanceSM

Monthly plan premium1 $0 $0

In-network deductible Not applicable $1,0002

Out-of-network coverage None None

Primary care physician copayment $15 $5

Specialist copayment $25 $10

Combined preferred and non-preferred $500 $500brand name drug annual limit

Generic drug cost The greater of $15 or 50% of the The greater of $15 or 50% of the total cost3 of the covered drug total cost3 of the covered drug

Preferred brand name The greater of $25 or 50% of the The greater of $25 or 50% of the drug cost total cost3 of the covered drug total cost3 of the covered drug

Non-preferred brand name The greater of $50 or 50% of the The greater of $50 or 50% of the drug cost total cost3 of the covered drug total cost3 of the covered drug

Generic drug annual limit Unlimited Unlimited

Inpatient hospital $5004 $02

facility copayment

Inpatient hospital surgery $150 $02

facility copayment

Ambulatory surgery $200 $02

facility copayment

Ambulatory surgery $75 $02

physician copayment

If you have questions regarding any of our Oxford Medicare Advantage plans, please call 1-800-303-6720. For a hearing impaired interpreter, you may contact Oxford’s TTY/TDD line at 1-800-201-4874, Monday throughFriday between 9:00 AM and 6:00 PM. Please call 1-800-303-6719 for assistance in Chinese, 1-888-201-4746 for assistance in Korean, 1-800-449-4390 para ayuda en español, and 1-800-234-1228 for assistance in all other languages.

1 You must continue to pay your Medicare Part B premium.2 $1,000 annual deductible applies to certain services such as inpatient hospital care, outpatient surgery, etc.

3 The cost of covered drugs will reflect Oxford’s discounted rates, plus aprescription dispensing fee, minus an average per drug forecast of thepharmacy rebates Oxford expects to receive for formulary drugs.

4 A benefit period begins the day you are admitted to a hospital orskilled nursing facility.The benefit period ends when you have notreceived hospital or skilled nursing care for 60 days in a row. If you are admitted to a hospital after one benefit period has ended, a newbenefit period begins.You must pay the inpatient hospital deductiblefor each new benefit period.There is no limit to the number of benefit periods you can have.

N E W S Y O U C A N U S E16

Americans with Disabilities Act

“Disability” means a mental or physical impairmentthat substantially limits one or more of the majorlife activities of an individual; a record of suchimpairment; or being regarded as having such animpairment. Title III of the Americans withDisabilities Act (ADA) provides people with disabili-ties with the right to equal access to public accom-modations, including those of your healthcareprovider. Refusal to provide care or the assistanceof an interpreter while rendering care to someonewith a qualifying disability is a violation of the ADA.Oxford fully supports Members’ equal access tocare rights as well as the right to an interpreter. Weare committed to nondiscriminatory behavior whenconducting business with all Oxford Members.

Oxford’s long-term commitment to the Americanswith Disabilities Act encompasses the following:

• Physically accessible provider office locations

• Materials available in alternative formats, such as Braille and audio tapes

• Staff trained in the use of telecommunicationdevices for Members who are deaf or hard of hearing (TTY/TDD), as well as the use of staterelay for phone communications and access tosign-language interpreters upon request

• Staff and resources available to assist individualswith cognitive impairments in understandingoffice procedures and materials

• New Member orientation available through theassistance of an interpreter

If you need help arranging sign-language interpreter services, please call Oxford’s TTY/TDD (hearing-impaired services) hotline at 1-800-201-4874.

Adopting the latest technologiesNew treatment methods are constantly being developed for conditions ranging from asthma toskin cancer. In light of this, you may wonder howOxford evaluates these new medical technologiesand how decisions are made regarding their use.The following information will help you understandhow the process works.

What is new medical technology? New medicaltechnology is defined as a newly approved drug or medication, a new surgical procedure, or newmedical equipment. Oxford continually assessesnew medical technologies to make sure thatMembers have appropriate access to the latest andmost effective medical treatment available. Twoexamples of new medical technologies that wereapproved by Oxford recently are radiofrequencyablation (RFA) for liver tumors and gastric bandingprocedures for morbid obesity.

How does Oxford evaluate new medical technology? Oxford’s Medical Affairs Department,led by experienced physicians representing multiple specialties, is responsible for evaluatingnew medical technology. The process begins with a review of the medical literature and other technical research. The clinical staff also seeksopinions from leading physicians and specialists in the community — providers who have knowledge and expertise regarding how new medical technology will be used on a day-to-daybasis. Once a thorough review of the availableinformation has been conducted, Oxford’s seniormedical staff makes a decision regarding how tocover the new medical technology.

Representatives from all department areas meet to create a policy. Once the policy is finalized, front-line Oxford employees are trained regardingprecertification, review, benefit application, and claims payment. When a new policy isimplemented, Oxford notifies physicians through a quarterly publication called the Provider Programand Policy Update (PPU).

As a Member, you are notified of important newpolicies through the Benefits Update section ineach issue of Health & Wellness magazine. All policies are reevaluated on an annual basis.

By carefully assessing new medical technologies and creating policies regarding their use, Oxfordstrives to offer you access to the highest level of quality healthcare. O

17

Oxford Health Plans, Inc. (“Oxford”) is committed to maintaining the privacy and confidentiality ofyour protected health information (PHI). PHI isinformation about you that is used or disclosed byOxford to administer your insurance coverage and to pay for the medical treatment you receive. Itincludes demographic information, such as yourname, address, telephone number, and SocialSecurity number, and any medical informationobtained from you or from providers who submitclaims to Oxford related to your medical care. We are required by applicable federal and state laws to maintain the privacy of your PHI. This document serves as the required Notice of Oxford’s privacy practices, our legal duties, and your rights concerning your PHI. Oxford is required to abide by the terms of this Notice unless and until it is amended. This Notice takeseffect April 14, 2003, and will remain in effect until such time that it is amended or replaced.

Oxford reserves the right to change our privacy practices and the terms of this Notice at any time, provided that applicable law permits such changes. We reserve the right to make the changes in our privacy practices and the new terms of our Noticeeffective for all PHI that we maintain, includinginformation we created or received prior to any such changes. When Oxford makes a significantchange in our privacy practices, we will revise thisNotice and send the revised Notice to our healthplan subscribers.

For additional copies of this Notice, please call ourCustomer Service Department at 1-800-234-1228.

Q. How does Oxford use or disclose your PHI?

A. Oxford may use or disclose your PHI, withoutyour consent or authorization, under the following circumstances:

•Treatment: We may disclose your PHI to ahealthcare provider who requests it in order toprovide you with necessary medical treatment,such as emergency care, X-rays, or lab work. Aprovider might be a doctor, a hospital, a homehealthcare agency, etc.

• Payment: We may use or disclose your PHI to pay claims submitted by a healthcare provider fortreatment provided to you. For example, we mayask a hospital emergency department for detailsabout the treatment you received so that we canaccurately pay the hospital for your care.

• Healthcare Operations: We may use or discloseyour PHI to manage our business. Examplesinclude using it to determine appropriate premiums, to conduct quality improvement activities, to contact you regarding benefits orservices that might be of interest to you, and toprovide you with preventive health advisories.

Notice to our Members regarding Oxford’s HIPAA privacy practices

This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.

N E W S Y O U C A N U S E18

• Plan Sponsor: We may disclose limited PHI toyour health plan sponsor, benefits administrator,or group health plan in order to perform planadministrative functions such as activities relatedto billing and renewals.

• Underwriting: We may receive your PHI forunderwriting, premium rating, or other activitiesrelating to the creation, renewal, or replacementof a contract of health insurance or health benefits. Once an Oxford Member, use and dis-closure of your PHI is governed by this Notice.

• Marketing: We may use your PHI to contact you with information about health-related benefits and services, treatment alternatives, or appointment reminders.

• Research; Death; Organ Donation: In limitedcircumstances, we may use or disclose your PHI for research purposes or to a coroner, medical examiner, funeral director, or an organ procurement center.

• Required by Law: We may use or disclose yourPHI when we are required to do so by law. Forexample, upon request, we would disclose PHI to the U.S. Department of Health and HumanServices so that this agency can verify Oxford’scompliance with federal privacy laws.

• Health Oversight Activities: We may discloseyour PHI to health oversight organizations and agencies as part of accreditation surveys,investigations related to our eligibility for government programs, regulatory audits, and for licensure and disciplinary actions.

• Workers’ Compensation: We may disclose yourPHI to comply with laws relating to workers’ com-pensation or other similar programs that providebenefits for work-related injuries or illnesses.

• Public Health and Safety: We may disclose yourPHI to the extent necessary to avert an imminentthreat to your safety or the health or safety of others. We may disclose your PHI to appropriateauthorities if we have reasonable belief that you

might be a victim of abuse, neglect, domestic violence, or other crimes.

• Judicial and Administrative: We may discloseyour PHI in response to a court or administrativeorder, subpoena, discovery request, or other lawful process.

• Sale of Business: We may disclose PHI upon saleof all or part of Oxford’s business to another party.

• Law Enforcement: We may disclose limitedinformation to law enforcement officials concerning the PHI of a suspect, fugitive, material witness, crime victim, or missing person.Under certain circumstances, we may disclosethe PHI of an inmate or other person in lawfulcustody of a law enforcement official or correctional institution.

• Military and National Security: Under certaincircumstances, we may disclose the PHI of armed forces personnel to military authorities. We may disclose PHI to authorized federal officials when required for national security orintelligence activities.

• To Family and Friends: If, in the event of a medicalemergency, you are unable to provide any requiredauthorization, we may disclose PHI to a family

19

member, friend, or other person to the extent necessary to ensure appropriate medical treatmentor to facilitate payment for that treatment.

Q. Does Oxford ever need an authorization to use or disclose your PHI?

A. Yes. Except for the purposes described above,Oxford cannot use or disclose your PHI withouta signed authorization from you. If you providesuch an authorization to Oxford, you mayrevoke it at any time. Your revocation will not affect any use or disclosure of PHI madewhile the authorization was in place.

Q. Can you inspect or receive copies of any PHI in Oxford’s possession?

A. Yes. You have the right to inspect or receivecopies of your PHI with certain exceptions. You must make a request to Oxford in writing.Oxford reserves the right to charge a reasonablefee for the cost of producing and mailing thePHI. Request forms are available on the Oxfordweb site or by calling the number listed at theend of this Notice.

Q. Can you find out if Oxford disclosed your PHI to a third party?

A. Yes. You have the right to receive an accountingof all occasions when Oxford disclosed your PHI for any purpose other than treatment, payment, healthcare operations, and certainother instances. Beginning with disclosuresmade on or after April 14, 2003, we will maintain a record of disclosures for six (6) years. A request for an accounting must be submittedto Oxford in writing. We reserve the right tocharge you a reasonable fee for the cost of producing and mailing the information if yourequest this accounting more than once in a 12-month period. Please note, that Connecticutand New Jersey members will automatically getan abridged accounting whenever they make arequest to inspect or receive copies of their PHI.

Q. Can you restrict the use or disclosure of your PHI by Oxford?

A. Yes. You have the right to request that Oxfordplace additional restrictions on the use or disclosure of your PHI. We are not required by law to agree to these restrictions. However, if we do agree to the restrictions, we will abideby them except in the event of an emergency.

Q. Can you request that Oxford use alternatemeans to confidentially communicate withyou about your PHI or communicate with you at an alternate location?

A. Yes. You must inform Oxford, in writing, that confidential communication by alternate meansor to an alternate location is required to avoidpotential harm to yourself or others. We mustaccommodate your request if it is reasonable,specifies the alternate communication means orlocation, and does not interfere with the collec-tion of premiums, the payment of claims, or theadministration of your health insurance coverage.

Q. Do you have the right to request that Oxfordcorrect, amend, or delete your PHI?

A. Yes. You must make your request in writing, and it must explain why the PHI should be corrected, amended, or deleted. Oxford maydeny your request if we did not create the PHIin question or for certain other reasons. If wedeny your request, we will provide you with awritten explanation. You may respond with astatement of disagreement to be added to theinformation you sought to change. If we acceptyour request to correct, amend, or delete the PHI,we will make reasonable efforts to inform othersof the changes and to include the changes in anyfuture disclosures of that information.

ComplaintsTo express concern about a decision Oxford madeabout access to your PHI, to report a concern thatwe violated your privacy rights, or to express acomplaint about any aspect of Oxford’s privacy

N E W S Y O U C A N U S E20

practices, please contact the HIPAA MemberRights Unit at the address below. You may alsosubmit a written complaint to the Secretary of the U.S. Department of Health and HumanServices at the following address:

Office of the SecretaryDepartment of Health and Human Services200 Independence Avenue, S.W.Washington, D.C. 20201Telephone: 1-877-696-6775

Oxford supports your right to protect the privacyof your PHI and will not retaliate against you forfiling a complaint with any government regulatorybody or with us.

If you received this Notice on our web site or byelectronic mail (e-mail), you are entitled to receivea written copy of the Notice as well. To request awritten copy of the Notice, please call our CustomerService Department at 1-800-234-1228. You canalso contact us by mail at:

Oxford Health PlansHIPAA Member Rights Unit48 Monroe TurnpikeTrumbull, CT 06611

All written communications related to this Noticeand your rights under HIPAA should be mailed to the HIPAA Member Rights Unit.

Privacy notice concerning financial informationAt Oxford Health Plans, Inc. (“Oxford”), protecting the privacy of the personal informationwe have about our customers and Members is of paramount importance and we take this responsibility very seriously. This information must be and is maintained in a manner that protects the privacy rights of those individuals.This Notice describes our policy regarding theconfidentiality and disclosure of customer andMember personal financial information thatOxford collects in the course of conducting itsbusiness. Our policy applies to both current andformer customers and Members.

The information Oxford collectsWe collect non-public, personal financial infor-mation about you from the following sources:

• Information we receive from you on applicationsor other forms (such as name, address, SocialSecurity number, and date of birth)

• Information about your transactions with us, our affiliates (companies controlled or ownedby Oxford), or others

• Information we receive from consumer report-ing agencies concerning large group customers

The information Oxford disclosesWe do not disclose any non-public, personal financial information about our current and former customers and Members to anyone exceptas permitted by law. For example, we may discloseinformation to affiliates and other third parties toservice or process an insurance transaction; or provide information to insurance regulators or law enforcement authorities upon request.

Oxford security practicesWe emphasize the importance of confidentialitythrough employee training, the implementation ofprocedures designed to protect the security of ourrecords, and our privacy policy. We restrict accessto the personal financial information of our cus-tomers and Members to those employees whoneed to know that information to perform theirjob responsibilities. We maintain physical, elec-tronic, and procedural safeguards that complywith federal and state regulations to guard yournon-public, personal financial information.

This notice is being provided on behalf of the following Oxford affiliates: Oxford Health Plans,Inc., Oxford Health Plans (CT), Inc., OxfordHealth Plans (NJ), Inc., Oxford Health Plans (NY),Inc., Oxford Health Insurance, Inc., InvestorsGuaranty Life Insurance Company, MedSpanHealth Options, Inc.

Please note: If you would like a copy of these Noticesin Spanish, Chinese, or Korean, please call OxfordCustomer Service at 1-800-234-1228. O

According to the North American Spine Society, we stand an 80 percent

chance of experiencing serious back pain at some time in our lives.

Whether the pain is acute and recurring or long-term and chronic, it’s

extremely difficult to diagnose and treat and even harder to live with.

Fortunately, help is available.

QHow can I ease mychronic back pain?

P A T H S T O W E L L N E S S 21

AConventional ResponseThe back is vulnerable to many injuries and disorders.The cartilaginous discs that cushion the vertebrae canwear down from overuse or rupture due to injury, exertingpressure on spinal nerves. Osteoporosis or degenerativearthritis can lead to stenosis — a narrowing of the spacearound the spinal cord — creating chronic pressure onnerves. Far more common are the back pains due toinflexible, weak or overtaxed lumbar (lower back) musclesthat respond to heavy demands with spasms and soreness.Arthritis, osteoporosis, chronic bad posture, excess bodyweight, sports injuries, pregnancy, a hairline fracture —even emotional tension — can also be causes. Sorting outthe contributing factors requires close cooperationbetween doctor and patient.

Exploratory examYour primary care physician (PCP) will ask about the pain you are experiencing, its location, and how and when the pain began. For example, straining while defecating or coughing and sneezing can aggravate thepain of a ruptured disc. You may be asked to demonstrateyour range of motion and how easily you bend or be giventests like straight leg raising. Your knee and foot reflexesmay be checked for weakness, numbness, and tingling.

A

This information is offered for your interest and information. It isnot intended as advice and should not replace your doctor’s rec-ommendation or treatment plan.

P A T H S T O W E L L N E S S22

Other clues could be your posture, how much your pelvis may tilt to accommodate added weight in the upper torso, and the way you walk. X-rays, bone density testing, or other diagnosticimaging techniques may be needed to get a definitive answer.

TreatmentA variety of medications may help reduce the symptoms of chronic back pain including over-the-counter painkillers or anti-inflammatory medications to reduce swelling and irritation, orprescription medications such as muscle relaxants.A few days of limited bed rest can also be helpful.This regimen may be enough to allow a damageddisc to recover. A few sessions of physical therapymay be prescribed to regain mobility and help youlearn ways to move without stressing vulnerableareas. If the injury is to a single nerve and the painbecomes chronic, you may need a local anesthesia(epidural) or a nerve block. If a degenerative condition such as osteoarthritis is detected, yourdoctor may prescribe specific exercises, a firmermattress, more supportive shoes, or a back braceand pain-reducing medications. Traction, togetherwith a neck brace, may be used to treat back pain inthe cervical (upper) spine. Surgery to remove a discor a stenotic spur is only recommended if pain andsigns of nerve damage are severe and progressive.

Prevention and maintenanceAvoiding the obvious causes of back injury is certainly the preferred strategy. Regularexercise that strengthens and stretches back and abdominal muscles is highly recommended, as well as learning how to lift, carry, and sit safely. Back injuries are along-standing occupational hazard, andthough the trend is away from the heavy laborblamed for so many problems, sedentary jobscan also impose a real threat to backs, too.

Complementary & AlternativeResponseWhen a person experiences chronic back pain,more than their back hurts. The column of vertebralbones in the back also houses nerves that connectthe brain with the rest of the body to give us move-ment and sensation, making the back central to howwe live. Even when back pain is intermittent, it’scommon to feel fragile and tense between episodes,making you vulnerable to additional injury.

Locating the problemThe intensity and persistence of pain leads most sufferers to wonder if they have a serious, possiblylife-threatening disorder. The reality is that less thanfive percent of all back pain is caused by a seriousmedical condition, and those causes can usually beruled out in an initial exam. From that point, youand your doctor can focus on the pain itself andhow to interrupt or control it. We used to blameback pain on “slipped” and degenerative discs, butthe more we learn, the more we realize that eventhese injuries are usually not severe enough toexplain the chronic pain the patient experienceslong after. Consequently, finding the right treat-ment can be frustrating, with disillusioned patientsgoing from doctor to doctor in search of answers.However, the one-symptom/one-cause/one-curemodel doesn’t work for back pain, and some experi-mentation may be needed for long-term relief.

Alan M. Muney,

MD, MHA,

Is the Chief Medical Officer and an Executive Vice

President for Oxford HealthPlans. Dr. Muney received his bachelor of science in

biology and medical degreefrom Brown University in

Providence, RI. He alsoreceived a master’s in health

administration from Universityof La Verne, California.

23

What we do knowNerve irritation is usually a factor in chronic back pain. Whendiscs are injured, their protective outer layers of collagen maytear, allowing the highly inflammatory fluid at the core to leakout and irritate nearby nerves. Poor posture is certainly a con-tributing factor. When your body weight is poorly distributed,abnormal stress is placed on muscles, tendons, ligaments, andspinal joints putting more pressure on vulnerable spinal discs.A diet high in inflammation-promoting fatty foods can furtherstimulate a nervous system already at the brink of overload,and emotional stress can inhibit the production of the verypain-blocking endorphins that keep it in fighting form.

TreatmentPractitioners of traditional Chinese medicine say the Westerntreatment of back pain is frequently too aggressive, hasty, anddramatic, or too “yang.” A gentle, optimistic “yin” approach,embracing exercise, stretching, improved diet, and relaxationis wiser. Patients should also practice one or two mind/bodytechniques to soothe jangled nerves — such as relaxation andbreathing techniques or yoga — if the back is not acutelypainful and unstable. New studies show that massage therapymay produce longer lasting results and chiropractic may alsobe helpful. A course of acupuncture may speed healing bystimulating the release of endorphins. If pain is severe, someyang in the form of pain injections and medications may getthe patient moving again. Inactivity and extended bed rest arenever recommended. And surgery is only considered if thereis evidence of progressive neurological loss, unstable spinaljoints, infection or tumor, or if severe sciatic pain is resistantto other therapies. O

Special Member Offer: The ChronicPain Solution

Every morning, more than 50 millionAmericans wake up to another day inpain. Recent research has shown that the solution to the puzzle of pain isalmost never one treatment.The key isknowing how to combine the best of conventional and alternative medicine.If you suffer from chronic pain, you mayfind answers in a new book entitled,The Chronic Pain Solution:Your PersonalPath to Wellness, authored by James Dillard,MD, DC, CAc, and founding Medical Director of Oxford’s Complementary & Alternative Medicine program.

In eleven comprehensive chapters,Dr. Dillard provides a prescription forrelief from the most common pain conditions — from chronic back pain to migraines, carpal tunnel syndrome,arthritis, fibromyalgia, pelvic pain and more, with effective treatment suggestions.

Oxford is pleased to offer The Chronic PainSolution:Your Personal Path to Wellness at aspecial discounted price for our Members.Through Quality Books & Audio, you payonly $19.95 (free shipping and handling)per copy — that’s a 20% discount fromthe book’s retail value of $24.95.To orderyour copy, simply call Quality Books &Audio at 1-800-556-9444, and identifyyourself as an Oxford Member.*

*This discount is offered in addition to and separate from your benefit coverage throughOxford Health Plans. Available discount percentages may change from time to timewithout notice.This discount is applicable only to the items referenced. Oxford cannotassume any responsibility for the failure of thevendor referenced to make available discountsnegotiated with Oxford; however, any failure to receive discounts should be reported to Customer Service by calling 1-800-234-1228.

James Dillard,

MD, DC, CAc,Is the Founding MedicalDirector for Oxford’sComplementary &Alternative Medicine program and is Chairman of the Oxford ChiropracticAdvisory Board. He is aboard-certified medical doctor, a doctor of chiropractic, and a certifiedmedical acupuncturist.

P.O. Box 7081, Bridgeport, CT 06601

HWSP03/6159

PRESORTED STANDARD

U.S. POSTAGE

PAID

ONWARD PUBLISHING INC.

OCUSTOMER SERVICE 1-800-234-1228(8 AM - 6 PM, Mon to Fri) For Members who have questions ranging from covered benefits to claims issues.For a hearing impaired interpreter, you may contactOxford’s TTY/TDD hotline at 1-800-201-4874.Please call 1-800-303-6719 for assistance in Chinese,1-888-201-4746 for assistance in Korean,1-800-449-4390 para ayuda en Español, and 1-800-234-1228 for assistance in all other languages.

PHARMACY CUSTOMER SERVICE

1-800-905-0201 (24 hours a day, 7 days a week)Receive answers to your questions about pharmacybenefits, claims, prescriptions, and participating pharmacies in your area.

DAVIS VISION MEMBER SERVICES

1-800-999-5431 (8 AM - 8 PM, Mon to Fri; 9 AM - 4 PM, Sat) Find Davis Vision locations near you.

MEDCO HEALTH HOME DELIVERY

PHARMACY SERVICE (MAIL-ORDER

SERVICE) 1-800-905-0201 (24 hours a day,7 days a week) This mail-order pharmacy service provides a cost-effective, convenient way for Memberswith a mail-order prescription benefit to order certain maintenance medications.

QUEST LABORATORIES 1-800-225-7483(24 hours a day, 7 days a week) To find Oxford participating labs in your area.

MEDICARE TELESALES 1-800-303-6720(8 AM - 6 PM, Mon to Fri) To use when referring friends to Oxford Medicare Advantage.

NAT’L. SUPPORT ORGANIZATIONS

Advocates for the Disabled 1-800-522-4369Alzheimer’s Association 1-800-272-3900Asthma and Allergy Foundation 1-800-727-8462American Cancer Society 1-800-227-2345American Diabetes Association 1-800-342-2383American Dietetic Association 1-800-366-1655American Heart Association 1-800-242-8721American Kidney Foundation 1-800-638-8299American Lung Association 1-800-586-4872Arthritis Foundation Information 1-800-283-7800Cancer Care, Inc. 1-800-813-4673Elder Care Locator 1-800-677-1116Grief Recovery Institute 1-800-445-4808Medicare Information Line 1-800-633-4227Multiple Sclerosis Foundation 1-800-441-7055National Osteoporosis Foundation 1-800-223-9994National Parkinson’s Foundation 1-800-327-4545Social Security Information Line 1-800-772-1213

LOCAL COM M U N ITY RESOURCES

New York City Department for the Aging 1-212-442-1000Access-a-Ride (NYC paratransit system) 1-877-337-2017EPIC (NY prescription assistance) 1-800-332-3742Nassau County Department for the Aging 1-516-571-5814Able-Ride 1-516-853-3712Richmond County Department for the Aging 1-212-442-1000New York Dental Clinic (dental assistance) 1-212-998-9800New Jersey Department for the Aging 1-877-222-3737New Jersey Dental Society (dental assistance) 1-732-821-2977PAAD (NJ prescription assistance) 1-800-792-9745SHARE (NY & NJ nutritional assistance) 1-800-708-4667Connecticut Agency for the Aging 1-203-933-5431ConnPACE (prescription assistance) 1-800-423-5026West Haven Elderly Services Department 1-203-937-3507

O X F O R D C O N T A C T I N F O