MS-02-214
y o u r g u i d e t o l i v i n g w e l l
Following the mind|body connectionCan your mind make you well?
High anxiety – after September 11
Medical marvels
healthy mindhealthy body
y o u r g u i d e t o l i v i n g w e l l
Following the mind|body connectionCan your mind make you well?
High anxiety – after September 11
Medical marvels
healthy mindhealthy body
Spring 2002
Did you know?Sudden changes in the weather and atmospheric pressure may bring on a
barometer headache. That's the dull pain you feel when the air
pressure in your sinus cavities no longer matches the outside pressure, causing a
painful vacuum. Aspirin may relieve pain, but a nasal decongestant that shrinks sinus
swelling and drains passages may give longer lasting results. If the pain and fullness
persist, consult your physician. You may have a more serious infection. O
If you’re a woman of childbearing age, you should know about a key vitamin that may help
prevent birth defects, particularly spina bifida. Folic acid, found in leafy green
vegetables, orange juice, and peanuts, comes up short in many women’s diets. Ask your
doctor if a daily multivitamin containing 400 micrograms of folic acid is a good idea. O
Have you heard about the environmental hazard you may have right inside your
medicine cabinet? Sealed in a tiny glass tube, mercury has safely measured tempera-
tures for years, but on the loose, it’s extremely toxic. Many communities have issued a
thermometer recall, swapping environmentally safe, non-mercury
thermometers for old ones. Call your local or state environmental protection agency.
In no circumstances should you toss your old thermometer in the garbage! O
Want to avoid getting a cold? Wash your hands. Most respiratory infections are passed
along by what we touch, whether it’s a handshake or a doorknob. A recent study,
Operation Stop Cough, compared two groups of naval recruits —
those required to wash their hands with soap five times a day, and those who followed
their usual habits. The heavy handwashers prevailed — reducing colds by 45%. O
OO X F O R D H E A L T H . C O M
Visited any award-winning web sites lately?
At the end of 2001, www.oxfordhealth.com received two major accolades. For a second consecutive
year, CIO Magazine named us one of the top 50 web sites in the world. Judges for the Web Business
50 Awards found our site exemplary of the highest level of business value, design effectiveness,
and innovative technology use achievable on the web today. And that’s not all. A leading Internet
publication, eHealthcare Strategies & Trends, awarded us three eHealthcare Platinum Leadership
Awards — the highest award level — for Best Overall Internet Site, Best Interactive Site, and
Best e-Business Site.
Now handling approximately 400,000 web-based transactions per month, Oxford will continue to
blend technology and design with the needs of our Members, employer groups, providers, and
brokers. Check out the oxfordhealth Center, our newest addition to your personalized home page,
MyOxford,SM where you’re only a click away from the latest health news, exercise discounts,
preventive exam reminders, and more.
y o u r g u i d e t o l i v i n g w e l l
healthy mindhealthy body
healthy mindhealthy body
Spring 2002
C O N T E N T S
Chief Executive Officer Norman C. Payson, MDPresident and COO Charles G. BergVice President, Marketing Chuck GreenManager, Member Marketing Meg DedmanEditor Stephanie GebingMedical Editor Ronald C. Brown, MD, FACP
Healthy Mind Healthy Body® is published exclusively for Oxford Health Plans by:Onward Publishing, Inc.10 Lewis Road, Northport, NY 11768Tel 631-757-3030 Fax 631-754-0522
Publisher Jeffrey BaraschCreative Director Melissa BaraschEditorial Director Wendy MurphyArt Director Bruce McGowinDesigner Lisanne SchnellProject Management Tamyra ZieranBusiness Manager Liz Lynch
Oxford Health Plans, Inc., and Onward Publishing, Inc.,are not responsible for typographical errors.
The information provided 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 before undertaking any medication or treatment that could impact yourhealth. Please discuss any concerns you have about the information contained in this publication with your healthcare provider before acting on it.
© 2002 Onward Publishing, Inc. All rights reserved.
S P E C I A L T O P I C
High anxiety — after September 11
W E L L N E S S
Are you an apple or a pear?
N U T R I T I O N
Too much on our plates
C O V E R S T O R Y
Can your mind make you well?
P A T H S T O W E L L N E S S
How can I cure my insomnia?
P H Y S I C I A N S P O T L I G H T
The medical marvel team
N E W S Y O U C A N U S E
Membership updates
L I V I N G W E L L
Wine, women, & feeling woozy
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6
7
8
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18
23
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It’s spring — and Healthy Mind Healthy Body has a bright, new look.
This publication is designed just for you — to give you the latest information on a wide range of
health topics, as well as updates on your plan benefits. We hope you enjoy “your guide to living well.”
Please feel free to e-mail your comments to us at [email protected], or write to: Oxford Health Plans,
c/o Stephanie Gebing, 48 Monroe Turnpike, Trumbull, CT 06611.
8
1 3
S P E C I A L T O P I C4
High anxiety
These individuals are going through what mental health
professionals now recognize as post traumatic stress disorder
(PTSD). The defining element in PTSD is exposure to a
trauma whose impact overwhelms the individual's capacity
to recover and function adequately. Once thought to exist
specifically as a by-product of wartime combat, where it was
known as “shell shock,” PTSD is now seen to occur in a
wider range of circumstances. These include sexual assault,
domestic violence, or the experience of a horrendous
accident, catastrophic illness, or natural disaster. Manmade
acts of terrorism, like the attacks of September 11, are
among the most potent psychological wounds because
they are so unexpected and because their impact so often
goes beyond anyone's ability to imagine them.
Experts estimate that between one in four Americans
continue to experience some degree of heightened anxiety
since September 11, and that one in ten have symptoms
whose duration and severity will require some form of
RR E S O U R C E S
• Anxiety Disorder Association of America11900 Park Lawn Drive, Suite 200Rockville, MD301-231-9350www.adaa.org
• National Institute for Mental Health6001 Executive Boulevard, RM 8184 MSC 9663Bethesda, MA 20892-9663301-443-4513www.nimh.nih.gov
• Veterans Adminstration Centers Information800-827-1000www.va.gov/rcs
OO X F O R D I N F O
If you have questions about PTSD or Oxford’s Behavioral Health Program, you can e-mail us [email protected]
after September 11
Most of us have emerged from the tragic events of last September
emotionally intact. Thanks to the help of friends, family, clergy, and
the U.S. community, as well as much of the world, we have been able to
regain our bearings despite shock and sorrow. In some cases we have
emerged even stronger than before. But a surprisingly large number —
and this may include someone close to you — have not fared so well,
suffering prolonged changes in emotional and physical well-being.
5
D o Y o u H a v e P T S D ?
Dr. Matthew Friedman, Director of the National Center for Post Traumatic Stress Disorder, says that the diagnostic criteria for this disorder include the following symptoms exhibited over an extended period:
• intrusive memories, flashbacks, or nightmares so real that the individual repeatedly relives the original emotional terror
• avoidance and numbing, in which the person goes to extrememeasures to avoid situations — places, people, activities —that may trigger memories, losing the capacity for intimacy and love in the process
• persistent irritability, agitation, hypervigilance, insomnia,uncontrollable crying, or a sense of doom
• underlying feelings of guilt and unworthiness in having survived
• growing dependence on alcohol and sedatives to lessen theemotional pain
professional help to regain balance. These long-term
sufferers are not simply “weak links” in a crowd of
braver hearts and thicker skins. Some have actually
performed heroically at the moment of crisis. In addi-
tion, those who were not physically close to the action
or lost a loved one can also experience PTSD. Many of
the affected witnessed the events on television and knew
no one who died or was injured. The fact is there are
few predictors in knowing who will suffer PTSD. One
thing is clear — anyone who has undergone some
earlier life-threatening experience is at heightened risk.
The worry for all of us is that these people have not
recognized their own suffering or have chosen to keep
it private rather than seek healing.
Though PTSD bears many symptoms in common with
depression and anxiety, certain features distinguish it.
Dr. Terence M. Keane, a leading researcher in PTSD,
describes “reliving, preoccupation with the traumatic
event, and avoidance” as key markers. Sufferers simply
cannot get the traumatic memory out of their waking —
or sleeping — hours, and they put a lot of emotional
energy into avoiding any associated thoughts or circum-
stances, with little success. People with PTSD experience
feelings of heightened anxiety at unexpected moments;
their hearts race, breathing quickens, blood pressure
rises, adrenaline surges, precisely as though they were
once again in imminent danger. They have trouble
concentrating. In their relationships with others they are
reluctant to trust or express affection. And activities
that once gave great pleasure no longer seem to matter.
As post traumatic stress disorder was not even formally
recognized until 1980, developing successful techniques
to treat it have come only in recent times. Exposure
therapy is perhaps the most commonly applied
technique. It rests on the premise that traumatized
individuals can gradually learn to control their fears by
reliving the experience in a safe, therapeutic setting —
through talking or writing about it. Trauma-focused
group therapy and one-on-one counseling are also
helpful, sometimes in combination with a short-term
regimen of anti-depressant medications. Ultimately,
the goal is not to erase memory of a tragic event —
none of us should or will ever forget September 11
or any other life-changing trauma — but to transform
it so that mind and body can once again function in a
calm and healthful manner. O
W E L L N E S S6
Are you anapple or a pear?It’s not uncommon for the fat in your body to
migrate as you get older, shifting gradually from
arms, legs, face, and neck to the torso. It’s also
fairly routine to put on two to four additional
pounds per decade, due to slowing metabolism
and decreased physical activity. But as doctors
and nutritionists have continued to gather data
on the consequences of weight shift and weight
gain, they have come to realize that unhealthy
excess is not just about the number of pounds,
but where those pounds are.
People whose excess weight is concentrated around the chest, waist and
belly develop a body type that is familiarly termed “apple,” for the obvious
similarities. People whose weight settles primarily around hips, buttocks
and thighs are often termed “pears.” Experts say that if you’re an apple,
you are at higher risk of developing health problems than if you’re a pear.
The reason, most researchers think, is that vital organs — heart and lungs
especially — must work harder when the extra fat is inside the belly under
the abdominal muscle wall. The result is a higher incidence of heart
disease, stroke, hypertension, diabetes, and cancer.
Any informal survey you take on the street or at the gym will tell you that
gender and hormones play a role in determining where body fat is stored.
Men at any age are more likely to be apples. And although women in their
younger years tend toward pear shapes, many will thicken in the middle at
menopause so that they, too, become apples. O
How Do You Shape Up?
• Measure your waist at the navel andhips at their widest
• Divide the number of inches at thewaist by the number at the hips toget your waist-to-hip ratio (WHR)
• For example, a waist of 28" and hipsof 40" yields a .70 WHR; a waist of38" and hips of 35" works out to a1.09 WHR
•Who may need to lose a few? Men over .95 WHR; Women over .80 WHR
•Weight to height is another factor to consider, so be sure to discuss any concerns with your doctor
7N U T R I T I O N
A funny thing happened on the way to America’s obsession with “low
fat.” Even while we have made some progress in reducing the percentage
of fat in our national diet — down from 40% to 33% on average —
our population has continued to gain weight. And lots of it.
Too much on our platesHow can that be, you wonder? The answer is that our portion sizes have ballooned well beyond the
recommended U.S. Department of Agriculture “serving sizes,” by which food labelers and consumers
tally calories. Accordingly, many of us are eating a good deal more at every meal than we realize. One
nationally recognized expert on nutrition estimates that this “portion inflation” is largely responsible
for the majority of Americans overeating by as much as 25%.
Just look around at our heaping plates. Fast
food restaurants invariably feature “double,” “giant,”
“jumbo,” and “super” take-out meals. Supermarkets,
which once sold fresh fruits, vegetables, and meats
to the customer’s order, now package most goods
in huge “family” and “economy” sizes, so that we
end up putting larger quantities of food on the
table. Even restaurants are in on the act. Where
the 10-inch plate was once the industry standard,
12-inch plates and “all-you-can-eat” buffets have
taken their place.
Recommended solution: spend some
time finding out what a “standard serv-
ing” really looks like. Measure out the
serving sizes recommended by the
USDA Food Pyramid or those in the
“Nutrition Facts” box on packaged
foods. Serve meals at home on smaller
plates. Skip second helpings. And for-
get about joining “the clean plate club.”
There’s no virtue in eating more than
you want just to be polite! O
Even theall-American
muffin hasgrown. Once
1 1/2 ounces insize, today'scontenderscan tilt the
scale at up to8 ounces.
Theirs vs. Ours
Foreigners never cease to be amazed at the bounty on our tables — and how readily we consume it all. Experts have noted that every time Americans adopt an ethnic snack food, the food grows larger, sometimes doubling and tripling in size and calories.Nutritionist/R.N. Melanie Polk of the American Institute for Cancer Research has studied the transformation of several favorite imports:
The Original U.S.“Improvement”
Classic French Croissant 1 ounce, 174 calories 2 ounces, 270 calories
Polish Bagel a svelte 1 1/2 ounces, 4 ounces or more, often116 calories stoked with raisins and
slathered with cream cheese or butter
South of the Border a 5-inch tortilla wrapped twice the size and asQuesadilla around a small amount of many as 1200 calories
filling, around 550 calories
C O M P L E M E N T A R Y & A L T E R N A T I V E M E D I C I N E8
Can your mind
9
When national radio talk-show host Diane Rehm began to
lose her voice, she consulted her family physician, underwent
numerous tests, and tried vocal exercises and medications.
When she could no longer speak above a whisper, she had to
stop working. Specialists at a speech disorders clinic diagnosed
spasmodic dysphonia: her vocal muscles were in spasm,
virtually strangling her voice. The doctors prescribed periodic
injections to temporarily paralyze her overactive muscles.
But the injections alone gave only short-lived relief. Rehm,
who suspected that underlying emotional tensions might
also be at play, decided to supplement her therapy with
acupuncture. So far, the combination is working and Rehm
is happily back at the microphone. “Healing may come in
the form of acceptance,” she says, “in learning to deal with
yourself and others in a different way, and in maintaining
a sense of peace in the face of affliction.”
make you wel l?
OO X F O R D I N F O
RR E S O U R C E S
C O M P L E M E N T A R Y & A L T E R N A T I V E M E D I C I N E10
Rehm is just one of millions of Americans who have come to
realize what the ancients knew long ago — that the mind can be an
important partner in healing a sick body. Mind/body medicine is,
to put it mildly, having something of a rebirth in the West. After
decades of being considered scarcely better than witchcraft —
acupuncture, shiatsu, meditation, herbal medicines, and many
other forms of complementary and alternative medicine (CAM) are
getting a second respectful look.
The obstacle to the acceptance of CAM has always been that modern
Western medicine expects scientific data to explain how therapies work
before using them on patients. And up until recently, mind/body
therapies had nothing but ancient tradition, faith, and folklore to
support them: no clinical studies, no statistical surveys, no diagnostic
testing methods that would validate them in ways that Western doctors
were trained to recognize. But this is changing now.
Many of the most compelling scientific discoveries to date focus
in the area of neurobiology, or the biology of the brain and nervous
system, and how it deals with psychological stress. Recent studies
show that extreme psychological stress can affect body chemistry.
In some instances, too much stress alters the delivery of natural
hormones that keep our systems functioning smoothly. Stress can
also suppress the immune system, the body’s principle defense
against invading organisms and other infectious agents. Bottom
line: poorly managed stress is now believed to be a significant
causative factor in many infections, cardiovascular disease, cancer,
and emotional imbalances including depression. So, it seems clear
that any therapy that can reduce stress and make you feel better
may also have the potential to make your body better able to resist
disease and/or heal itself physically, if you can harness those
natural strengths.
Members can access Oxford’s Complementaryand Alternative Medicine network in one ofthree ways:
• Standard In-Network Benefits — WheneverMembers need to make medically necessaryvisits to participating chiropractors andnaturopaths (in CT), they may need a referral (depends on plan type) from theirprimary care physician (PCP) and must payan office copayment.
• Contracted Rate — Members can go directlyto any participating provider at any timewithout a PCP referral.They pay a speciallycontracted rate directly to the provider atthe time of their visit.The contracted rate isnot an insured benefit, but rather a fair andstandardized rate for appropriate care.
•Alternative Medicine Rider — This optionalpurchase for employer groups allowsMembers to make medically necessary visits (subject to a copayment) to participatingacupuncturists, chiropractors, and naturopaths(in CT) without a PCP referral.When purchased, the rider replaces any standard in-network benefits.
• An excellent introductory book on the mind/body connection is Alternative MedicineFor Dummies by our own James Dillard, MD,with a new edition released in 2001.
• The classic book on stress and health is TheRelaxation Response by Herbert Benson, MD,Wm. Morrow & Co., reissued in 2000. Orcheck your local library for books devotedto CAM therapies like yoga, acupuncture,and psychoneuroimmunology.
• The National Center for Complementaryand Alternative Medicine (NCCAM) at theNational Institutes of Health has its ownweb site www.nccam.nih.gov.
• The Food and Drug Administration’s quarterly, FDA Consumer, is also availableonline at www.fda.gov, and offers regularupdates on CAM.
Healthy
Alternatives
Acupuncturists
Chiropractors
Herbal Medicine
Massage Therapists
Megavitamins
Naturopaths
Nutritionists
Yoga Instructors
11
Baby boomers are leading the trend toward all kinds of alternativetherapies — nearly half of all Americans aged 35 to 49 use at least one.
Some modes of stress management are as simple as taking more time
out of your life to do things that you enjoy. That may include adding a
couple of vacation days to your weekend when you feel the pressures
of your routine life wearing too heavily on the spirit. It may mean
developing a new hobby that gets you out among new friends and
relieves anxiety or tension in the bargain. It may be as easy as going for
a brisk walk in the park at lunchtime. But if your stress is chronic and
you or your doctor suspect that it’s having a direct and measurable
impact on your health, you may be a candidate for a formal program
such as cognitive behavioral therapy, relaxation training, or yoga, under
the guidance of a certified trainer.
In perhaps the most dramatic example of the new interest in all
aspects of CAM, Congress asked the National Institutes of Health (NIH)
to get involved. In 1998, the NIH established the National Center for
Complementary and Alternative Medicine (NCCAM) with a budget of
some $50 million to study the safety and effectiveness of any therapeutic
practices their staff thought worthy of scientific investigation. In the nearly
five years since then, NCCAM has been given ever larger budgets — over
$100 million in 2001 — as the scope of its research grows. The Center is
currently pursuing, in the words of its director, Dr. Stephen E. Strauss,
MD, a broad spectrum of human “behavioral, biomedical, social and
spiritual components…that interact on a continuing basis in health and
disease.” NCCAM is also working energetically to see that as evidence to
support any given therapy is developed, the information finds its way into
mainstream medical practice.
Oxford’s Chief Doc:
Go on Vacation!
One in six U.S. employees is so overworked he/she
is unable to use up annual vacation time, despite
the fact that Americans have the least vacation time
in the industrialized world, a landmark national
survey reveals.“This survey is a wakeup call for
Americans to realize that taking a vacation is not
frivolous behavior. It’s essential to staying healthy,”
said Alan Muney, MD, Chief Medical Officer and
Executive Vice President at Oxford Health Plans.
“Regular vacations are preventive medicine —
they cut down on stress-related illness.”
Annual Vacation Days
Italy . . . . . . . . . . . . . . . . . . . . . . 42
France . . . . . . . . . . . . . . . . . . . . 37
Germany . . . . . . . . . . . . . . . . . . 35
Brazil . . . . . . . . . . . . . . . . . . . . . 34
Britain . . . . . . . . . . . . . . . . . . . . 28
Canada . . . . . . . . . . . . . . . . . . . . 26
South Korea . . . . . . . . . . . . . . . . 25
Japan . . . . . . . . . . . . . . . . . . . . . 25
U.S. . . . . . . . . . . . . . . . . . . . . 13
C O M P L E M E N T A R Y & A L T E R N A T I V E M E D I C I N E12
Developing the kinds of broadscale studies that evidence-based Western medicine
relies on is a slow process, but already NCCAM has issued one major “Consensus
Statement” on the usefulness of acupuncture in several medical conditions — chief
among them postoperative pain, facial pain, and nausea. Among scores of other
ongoing studies at NCCAM, is one on meditation in reducing hypertension and
other cardiovascular diseases. Another examines the usefulness of self-hypnosis and
osteopathic manipulation in treating children with cerebral palsy. Still others focus
on yoga in multiple sclerosis and on Tai Chi in preventing frailty in the elderly.
NCCAM is also devoting a considerable amount of time and budget to getting a
better understanding of the so-called “placebo effect,” in the expectation that what
they learn will open other doors to the healing powers of the mind. And
NCCAM is funding a host of rigorous studies on botanical medicines,
including one on St. John’s wort, an herb long used in traditional and
folk medicine to treat depression.
We at Oxford Health Plans are of course excited by the data coming out
of the NCCAM and its network of 15 research centers around the country.
We have believed in the healing potentials of many CAM therapies for a
long time. That’s why Oxford built the first credentialed complementary and
alternative medicine network in the country. And that’s why today we can offer
Members access1 to more than 2,400 fully credentialed complementary and
alternative medicine providers. We also encourage the more than 50,000 physicians
in our network to integrate these services in their treatment plans whenever they
think it appropriate.
We are gratified to know that our benefit plans meet the wishes and expectations
of our Members, including those who fall within the age category of “Baby
Boomers.” In a Member survey conducted last year2, more than half of our
respondents used one or more of our Complementary and Alternative Medicine
program benefits or therapies, which include acupuncture, chiropractic, massage
therapy, naturopathy (in CT only), nutritional counseling, and yoga instruction.
And we feel confident that as you become more comfortable in integrating
CAM with the conventional medical therapies provided by your primary care
and specialist physicians, this trend will only grow. O
That’s why Oxford built the first credentialedcomplementary and alternative medicine network in the country.
1 Benefits and access to complementary and alternative providers vary by state2 Member Study about Complementary and Alternative Medicine, January 2001
13P A T H S T O W E L L N E S S
AAQHow can I cure my insomnia?
In these stressful times, sleep problems are common. Short-term insomnia is usuallytraceable to an upsetting event, illness, or jet-lag, and resolves on its own. However, ifinsomnia becomes habitual, affecting your overall well-being, it requires treatment.
Conventional ResponseChronic insomnia can have complex physiologicalor psychological causes, including underlying stressor depression. Often the problem is not theamount of sleep you get, but the quality. Manyinsomniacs actually sleep more than they realize,but their sleep is fitful and unsatisfying.
PHYSICAL EXAM. You should have a compre-hensive physical, including blood tests to check for hormone imbalances. To track actual sleep and wake patterns, your physician may want a dailyrecord of what you eat and drink, stressful events,the exact time you rise and retire, nighttime wakenings and possible triggers (nightmare, legcramp, loud noise, the need to urinate, uncomfort-able room temperature), and how tired you feel the next day. If you are sleepy, your doctor may recommend an overnight sleep study. This candetect the abnormal breathing that causes sleepapnea, with its repeated sleep disturbances.
TIPS. Avoid caffeine, nicotine, and alcohol late in the evening. Try to skip daytime naps. Exerciseregularly, finishing at least three hours before bed-time. Make your sleep environment comfortable.
MEDICATIONS. The right remedy ultimately liesin treating causes. Sleeping pills may be helpfultemporarily, but are not recommended for long-term therapy.
RONALD C. BROWN, MD, FACP,
is Vice President of Medical Programs for Oxford. He is a graduate of Yale University School of Medicine, was trained in internal
medicine at Roosevelt Hospital in New York City, and is a board-certified internist.
This information is offered for your interest and information. It is not intended as advice and should not replace your doctor’s recommendation or treatment plan.Comments on this column can be mailed to Oxford Health Plans, c/o Stephanie Gebing, 48 Monroe Turnpike,Trumbull, CT 06611, or e-mailed to [email protected].
JAMES DILLARD, MD, DC, CAc,is the founding Medical Director of Oxford’sComplementary and Alternative Medicine program andis Chairman of the Oxford Chiropractic Advisory Board.He is a board-certified medical doctor, a doctor of chiropractic, and a certified medical acupuncturist.
Complementary & Alternative ResponseAlternative medical approaches to insomnia also beginwith the search for psychological and physical stressors,with the goal of counseling the patient on improvingsleep “hygiene.” The bedroom should become an oasis for sleep — free of noise, TV, and other daytimedistractions. A regular sleep schedule should be established, without daytime naps or stimulants such as caffeine and adding appropriate daily exercise. Alsocalming the mind and body before bedtime throughsome relaxation or behavioral approach is helpful. Here are some complementary approaches that havebeen specifically endorsed by the National Institutes of Health for treating insomnia either alone or in combination with conventional therapies:
YOGA AND TAI CHI. These Eastern exercises havebeen shown effective in preparing the mind and bodyfor sleep and reducing nighttime wakening. Carriedout regularly before bedtime, they involve repetitionof a “suitable” sound or mantra and sequential tensingand relaxing of all major muscle groups.
RELAXATION TECHNIQUES. Though they comefrom different philosophical roots and take somewhatdifferent forms, various types of controlled meditationand progressive muscle relaxation all aim to slow the body’s metabolic activity by decreasing heart rate, respiration, and blood pressure. Massage and bio-feedback are still other approaches. They decrease theoutput of certain hormones involved in alertness, too.
RR E S O U R C E S
How’s your sleep? To find out,visit www.sleepfoundation.org
P H Y S I C I A N S P O T L I G H T14
The medical
Young Jeremy Gustafson
and his mother visit with
Dr. John Persing in the
Pediatric Craniofacial Center
at Yale-New Haven
Children’s Hospital.
15
It’s a typical Friday morning at the Pediatric Craniofacial
Center at Yale-New Haven Children’s Hospital in downtown
New Haven, CT, one of the many specialty clinics in Oxford’s
network. Though it’s only 8:15 AM, the cheery second floor
waiting room of the Yale Physicians Building is already full
of parents and children. Two members of a group calling
themselves “Families Helping Families,” are also there.
As satisfied parent-veterans of the Center, they have “been
there, done that,” and they use this opportunity to help out
in any way they can, answering questions, providing snacks
and toys, and offering reassurance.
ma r ve l t eam
RR E S O U R C E S
P H Y S I C I A N S P O T L I G H T16
Backstage, Dr. John A. Persing, a pediatric plastic surgeon, and a
multi-disciplinary team that includes a neurosurgeon, an orthodontist, a
psychologist, a geneticist, a physical therapist, and a speech pathologist,
are getting ready to see today’s patients. In all, there are 35 youngsters and
their families scheduled. Some are old friends, nearing the completion of
treatment after months and even years of care at the Center. Others are in
midstream, returning postsurgically to have the craniofacial team evaluate
progress. Still others are infants and their worried parents being seen for
the first time. Unlike the returnees, who chat easily with one another like
old pals, the newcomers sit anxiously, not sure what lies ahead. They are
here because their pediatrician or family physician, or perhaps the parents
themselves, have detected something about their child’s head or facial
formation that does not seem “right.”
Within the next few hours, everyone here will get answers and very possibly
something to smile about, for that is what Dr. Persing and his colleagues,
Drs. Joseph Shin and Charles Duncan, are committed to providing. Together
they offer the very highest levels of surgical excellence and innovative technique
in pediatric bone and skull reconstruction, a specialty that until a few years
ago would have seemed beyond imagining. The work they do is literally life-
changing. Though the children treated here rarely suffer from life threatening
illnesses, the craniofacial malformations they present are generally predictive
of difficult futures for them and their families if not corrected. The clinic's team
is widely known for working marvels.
As they do every week, this morning the team will see youngsters in
varying stages of craniosynostosis, positional plagiocephaly, and congenital
malformations of the face. Craniosynostosis, Dr. Persing explains, refers to
skull shape irregularities that are virtually always present at birth but that
may only become evident to the eye in the first months of life. The irregular-
ities occur as a result of the premature closing of one or more of the natural
sutures or expansion joints normally found between the boney plates that
make up an infant’s skull. Were this condition to go untreated, the skull will
grow unevenly, giving the child at the very least a misshapen head; possibly,
it will stunt the development of the growing brain as well. “There’s a certain
urgency to identifying these kids early, as early treatment is recommended to
reduce the likelihood of later brain dysfunction,” says Dr. Persing, “and for
that we have to rely on the alertness of primary doctors and parents.”
Dr. Persing confers with Dr. Joseph Shin, the Center's Director, regarding patient care.Dr. Shin specializes in “internal distraction osteogenesis,” a state-of-the-art surgicaltechnique used in remodeling underdeveloped midface and jaw bone structures.
• For more information on recommendedsleep positions for newborns and the young,as well as other issues related to child medicine, go to the American Academy ofPediatrics (AAP) web site at www.aap.org.
• Yale Craniofacial Center information can be found at www.med.yale.edu, or call 1-877-YALEMEDS.
• The Craniosynostosis and PositionalPlagiocephaly Support Foundation maintains a web site at www.cappskids.org.
OO X F O R D I N F O
• Craniosynostosis is a relatively uncommon disorder, with an estimated occurrence nogreater than one in 2,500 live births. If youhave a young child whose head or facialstructure does not seem to be developingnormally, discuss your concerns with yourchild's physician.
• Oxford maintains a comprehensive network of primary care physicians, pediatricians, andother child development specialists within the tri-state area.
• Log on to www.oxfordhealth.com for other pediatric topics and links to resources.
17
“Ideally, we like to perform the surgery before the sixth month, even
earlier if the infant is in vigorous health otherwise and can handle the
stress of surgery well. We use diagnostic imaging to locate the problems
definitively and then we may actually open fused sutures and even lift the
skull cap slightly to make room for normal growth.”
Positional plagiocephaly is a fancy name for skull deformities that can
occur either during a traumatic birth or later as the result of a problem in
a developing neck muscle or habitually lying too long in the same position
in the first months of life. “Ironically, we are seeing a great increase in
positional plagiocephaly in recent years as the result of pediatricians urging
parents to put babies to sleep on their backs,” Persing notes. “Skulls are still soft
and malleable in the early months of life, and we see babies whose heads have
become almost perfectly flat in back as a result. The ‘back to sleep’ campaign
has been very successful in reducing the incidence of SIDS, but it has not
stressed adequately the need to turn sleeping babies’ heads left one night,
right the next, and so on, to reduce the tendency toward flattening. We also
recommend more supervised tummy time during awake hours. Once the bones
at the back of the head have flattened, some kind of correction is advisable.
Primary treatment is physiotherapy in which we work to lengthen and loosen
one or more of the affected neck muscles. This in turn encourages greater flex-
ibility and head movement, which is often enough to restore natural shape in a
few weeks.” The team also treats syndromes that result in severe facial disfigure-
ment, including cleft palate and pediatric tumors. Misaligned bones are coaxed
to grow in ways that bring jaws and cheekbones and unevenly seated eye sockets
into more natural contours, and with little or no visible scars to show for it.
“What keeps all of us here motivated through the long hours and intense
work is the enormous reward we get from the children and families. We see
them come in for the first time, often frightened and apprehensive, some even
in despair. First we give them a better understanding of what is happening.
Then we give them a detailed plan of how we can help. And finally, we do
things medically that permanently change the quality of their lives. A child’s
smile, a parent’s gratitude when the disfigurement is corrected and the
youngster no longer feels like an outsider, is truly wonderful. Who could
not feel privileged to be involved?” O
Within the next few hours everyone here will get answersand very possibly something to smile about, for that is whatDr. Persing and his colleagues provide.
Chloe Bennett displays one of the smiles her Mom andDr. Persing’s team love to see.
N E W S Y O U C A N U S E18
Membership updatesPromoting appropriate care
Through the media or your own research, you may have heard of some managed care organizations
that offer “rewards” or “bonuses” to providers who limit and/or deny care. Please note that Oxford
Health Plans does not compensate providers for denials of service, nor do we offer incentives to
encourage denials. Oxford encourages the use of appropriate care and services to prevent and/or
treat illnesses. All utilization management decisions made by an Oxford participating provider or
staff member are based on the appropriateness of the care and service that is being requested. For
details about your own benefit coverage, please check your Certificate of Coverage.
Oxford cares about qualityOxford 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.
Functions of Oxford’s QM program include:• Identifying the scope of care and services available
through Oxford
• Developing clinical practice guidelines (e.g., guidelinesregarding depression for primary care physicians) and serv-ice standards (e.g., customer service timeframes for answer-ing incoming calls) by which performance is measured
• Verifying the medical qualifications of all providers who participate in Oxford’s network
• Monitoring and evaluating the quality and appropriatenessof the services and medical care received by OxfordMembers (e.g., via ongoing Member satisfaction surveys)
• Pursuing opportunities to improve patient safety and customer service
• Resolving issues identified as quality issues or concerns
If you would like more information about Oxford’s QM
program and goals, please contact Customer Service by
calling the number on your Oxford ID card, and a
description will be sent to you.
Americans with Disabilities Act“Disability” means a mental or physical impairment that
substantially limits one or more of the major life activities
of an individual; a record of such impairment; or being
regarded as having such an impairment. Title III of the
Americans with Disabilities Act (ADA) provides people
with disabilities with the right to equal access to public
accommodations, including those of your healthcare
provider. Refusal to provide care or the assistance of an
interpreter while rendering care to someone with a
qualifying disability, is a violation of the ADA. Oxford
fully supports Members’ equal access to care rights as
well as the right to an interpreter. We are committed to
nondiscriminatory behavior when conducting business
with all Oxford Members.
Oxford’s long-term commitment to the Americans with Disabilities Act includes:• Physically accessible provider office locations
• Materials available in alternative formats, such as Braille,and audio tapes
19
• Staff trained in the use of telecommunication devices forMembers who are deaf or hard of hearing (TTY/TDD), aswell as the use of state relay for phone communications andproviding access to sign-language interpreters upon request.
If you need help arranging sign-language interpreter
services, please contact Oxford’s TTY/TDD (hearing-
impaired services) hotline at 800-201-4875.
Language servicesOxford Service Associates are available to assist you
in several languages, including Spanish and Chinese.
To speak with a Service Associate:
• In Spanish, call 800-449-4390
• In Chinese, call 800-303-6719
• In English and other languages, call the number on your Oxford ID card
Adopting the latest technologiesNew treatment methods are constantly
being developed for conditions ranging
from asthma to skin cancer. In light of
this, you may wonder how Oxford evalu-
ates these new medical technologies and
how decisions are made regarding their
use. The following information will help
you understand how the process works.
What is new medical technology? New
medical technology is defined as a newly approved drug or
medication, a new surgical procedure, or new medical
equipment. Oxford continually assesses new medical
technologies to make sure that Members have appropriate
access to the latest and most effective medical treatment
available. Two examples of new medical technologies that
were approved by Oxford recently are radiofrequency
ablation (RFA) for liver tumors and gastric banding
procedures for morbid obesity.
What is the evaluation process? Oxford’s Medical Affairs
Department, led by experienced physicians representing
multiple specialties, is responsible for evaluating new med-
ical technology. The process begins with a review of the
medical literature and other technical research. The clinical
staff also seeks opinions from leading physicians and spe-
cialists in the community — providers who have knowledge
and expertise regarding how new medical technology will
be used on a day-to-day basis. Once a thorough review of
the available information has been conducted, Oxford’s
senior medical staff makes a decision regarding how to
cover the new medical technology.
Representatives from all department areas then meet to
create a policy. Once the policy is finalized, front-line
Oxford employees are trained regarding precertification,
review, benefit application, and claims payment. When a
new policy is implemented, Oxford notifies physicians
through a quarterly publication called the Provider
Program and Policy Update (PPU).
As a Member, you are notified of important new policies
through this Membership updates section in Healthy Mind
Healthy Body magazine. All policies are re-evaluated on an
annual basis.
By carefully assessing new medical technologies and
creating policies regarding their use, Oxford strives to
offer you access to the highest level of quality healthcare.
Maximizing in-network coverageFrom time to time, Members are confused by the differ-
ence between a provider who is a “participating provider”
with Oxford and one who “accepts Oxford insurance.”
When a provider acknowledges that he or she “participates”
with Oxford, the provider is indicating that he or she has a
contractual arrangement with Oxford, whereby the provider
participates in Oxford's network. For authorized services
received from participating providers, your financial
responsibility is limited to the in-network cost share (the
portion of costs you are responsible for as outlined in your
Certificate of Coverage) listed on your Oxford ID card.
A provider who “accepts Oxford” might not be a
participating, or contracted provider. Obtaining services from
providers who “accept Oxford,” but are not participating
providers, will generally be covered under your out-of-net-
work benefit, if applicable. Visits to non-participating
providers are subject to applicable deductible, coinsurance,
and charges above the usual and customary rate as noted in
your Certificate of Coverage and Summary of Benefits.
In most cases, to be eligible for in-network coverage, you
must receive properly authorized care from a participating
provider. Please note: The waiver of coinsurance and
deductibles is improper and can be a potential indicator
of fraudulent or unnecessary services.
Oxford has a comprehensive network of providers in order
for Members to have access to quality care. To maximize your
in-network coverage, be sure to verify your provider's partici-
pation with Oxford before you receive services. You can verify
a provider's participation with Oxford by visiting Oxford’s
web site at www.oxfordhealth.com, or by calling Customer
Service at the number on your Oxford ID card.
N E W S Y O U C A N U S E20
Now you and your doctors have one point of contact for your pharmaceutical needs
• Pharmacy Customer Service Line:800-905-0201 (24 hours a day, 7 days a week — except Thanksgiving and Christmas)
• Merck-Medco Home Delivery PharmacyService (mail-order service): 800-905-0201(24 hours a day, 7 days a week — exceptThanksgiving and Christmas)
Duane Reade, Albertsons (Acme) and Walgreens joined
Merck-Medco's pharmacy network effective January 1, 2002.
These pharmacies, in addition to those included on the list
of national pharmacy chains you recently received in your
Merck-Medco Welcome Kit, participate in Merck-Medco's retail
pharmacy network.
For Members who have a three-tier prescription drug benefitOur three-tier prescription drug benefit provides Members with
the option of paying the lowest copayment for generic drugs, a
higher copayment for preferred brand drugs, and the highest
copayment for non-preferred brand name drugs. At right is an
updated list of changes to Oxford’s Preferred Drug List, effective
January 1, 2002. As always, we encourage Members to speak with
their doctor about the generic or preferred brand alternatives that
can help keep their copay expenses to a minimum.
Effective January 1, 2002, Oxford contracted with a new pharmacy benefits manager,
Merck-Medco Managed Care, L.L.C., to administer Oxford’s retail and mail-order
pharmacy services for Members who have pharmacy coverage with Oxford. Merck-Medco
Managed Care, L.L.C., assumed most responsibilities which were previously managed
by Express Scripts®, Inc., and Caremark. Working with Merck-Medco enables Oxford to
better manage prescription drug costs, and provides you with comprehensive clinical
programs and industry-leading customer service. Additionally, the consolidation of
retail pharmacy and mail-order services with Merck-Medco will provide you and your
providers with one point of contact for your pharmaceutical needs.
Therapeutic Class Affected Medication Until 12/31/01 Effective 1/1/02 Generic or preferredof Drug you paid the… you pay the… alternatives to non-preferred
drugs* Effective 1/1/02 (UPPER CASE — preferred brand drugs, lower case — generic drugs)
ACE inhibitors MONOPRIL Preferred brand copay Non-preferred brand copay captopril, enalapril,ACCUPRIL
Acne therapy AVITA Preferred brand copay Non-preferred brand copay generics**,ACCUTANE, DESQUAM-X, KLARON,METROGEL, METROCREAM, NOVACET,TAZORAC
Androgens TESTODERM,TESTODERM TTS Preferred brand copay Non-preferred brand copay ANDRODERM,ANDROGEL
Antiarrythmics PROCANBID Non-preferred brand copay Preferred brand copayBETAPACE/AF, NORPACE/CR, Preferred brand copay Non-preferred brand copay generics**, ETHMOZINE, PROCANBID,QUINIDEX RYTHMOL,TAMBOCOR,TONOCARD
Antibiotics-miscellaneous CLEOCIN 300 MG Preferred brand copay Non-preferred brand copay clindamycin
Anticonvulsants CARBATROL Non-preferred brand copay Preferred brand copay CARBATROL, CELONTIN, DEPAKENE, DEPAKOTE,DIASTAT, DILANTIN, FELBATOL, GABITRIL,LAMICTAL, MEBARAL, MESANTOIN, MYSOLINE,NEURONTIN, PARA DIONE, PEGANONE,TEGRETOL,TEGRETOL XR,TOPAMAX, ZARONTIN
Antifungals SPORONOX Preferred brand copay Non-preferred brand copay DIFLUCAN
Antihypertensive combinations ACCURETIC Non-preferred brand copay Preferred brand copayMONOPRIL HCT Preferred brand copay Non-preferred brand copay captopril/hctz,ACCURETIC, LOTREL
Antiparkinson drugs PERMAX Non-preferred brand copay Preferred brand copayAKINETON, KEMADRIN, QUARZAN, Preferred brand copay Non-preferred brand copay carbidopa/levodopa, COMTAN, LARODOPA,SINEMET CR MIRAPEX, PERMAX, REQUIP,TASMAR
Antiplatelet drugs PLAVIX Non-preferred brand copay Preferred brand copayTICLID Preferred brand copay Non-preferred brand copay ticlopidine, PLAVIX
Antipsychotics CLOZARIL, SERENTIL, SEROQUEL, Preferred brand copay Non-preferred brand copay generics**, MOBAN, ORAP, RISPERDAL,SPARINE ZYPREXA
Anxiolytics BUSPAR Preferred brand copay Non-preferred brand copay buspirone
Beta agonist-oral BRETHINE Preferred brand copay Non-preferred brand copay terbutaline
Calcium channel blockers ADALAT CC, DILACOR XR,TIAZAC Preferred brand copay Non-preferred brand copay diltiazem er/xr, nifedipine er, verapamil er/sa,NORVASC, NIMOTOP
Cephalosporins OMNICEF Non-preferred brand copay Preferred brand copayCEFZIL, DURICEF SUSPENSION Preferred brand copay Non-preferred brand copay generics**, CEFTIN SUSPENSION, OMNICEF
Estrogens CLIMARA, ESTRATEST, Non-preferred brand copay Preferred brand copayESTRATEST HS,VIVELLE Non-preferred brand copay Preferred brand copayALORA, COMBIPATCH, ESTINYL Preferred brand copay Non-preferred brand copay generics**, CLIMARA, ESTRATEST, ESTRATEST
HS, ESTRING, PREMARIN, PREMARIN VAGINAL, PREMPHASE, PREMPRO,VIVELLE
Headache therapy BELLERGAL-S, SANSERT,WIGRAINE Preferred brand copay Non-preferred brand copay generics**,AMERGE, CAFERGOT, ERGOMAR,FIORICET #3, IMITREX, MAXALT
HMG ZOCOR Non-preferred brand copay Preferred brand copayPRAVACHOL Preferred brand copay Non-preferred brand copay LIPITOR, ZOCOR
Interferons BETASERON, COPAXONE Preferred brand copay Non-preferred brand copay AVONEX
Intranasal steroids RHINOCORT AQUA Non-preferred brand copay Preferred brand copay BECONASE, BECONASE AQ, FLONASE,RHINOCORT, RHINOCORT AQUA
Miscellaneous pulmonary agents ADVAIR Non-preferred brand copay Preferred brand copay
Narcotic analgesics DILAUDID, ROXICODONE Non-preferred brand copay Preferred brand copayMS CONTIN Preferred brand copay Non-preferred brand copay generics**, DILAUDID, DURAGESIC,
OXYCONTIN, ROXICODONE
Nitrates IMDUR, NITROSTAT Preferred brand copay Non-preferred brand copay isosorbide mononitrate, nitroglycerin tab sl
Oral contraceptives ESTROSTEP FE, LOESTRIN, Non-preferred brand copay Preferred brand copayLOESTRIN FE Non-preferred brand copay Preferred brand copayMODICON, OVRAL Preferred brand copay Non-preferred brand copay ALESSE, ESTROSTEP FE, LOESTRIN, LOESTRIN FE,
LO/OVRAL, MICRONOR, ORTHO-CEPT,ORTHO-CYCLEN, ORTHO-NOVUM,ORTHO TRI-CYCLEN, OVRETTE,TRIPHASIL
Other cardiovascular CATAPRESS TTS Non-preferred brand copay Preferred brand copay
Proton Pump Inhibitors NEXIUM Non-preferred brand copay Preferred brand copayPREVACID Preferred brand copay Non-preferred brand copay NEXIUM
Quinolones TEQUIN Non-preferred brand copay Preferred brand copayFLOXIN Preferred brand copay Non-preferred brand copay AVELOX, CIPRO, LEVAQUIN,TEQUIN
Topical antifungals SPECTAZOLE Non-preferred brand copay Preferred brand copayLOPROX, NIZORAL Preferred brand copay Non-preferred brand copay generics**, LOTRISONE, SPECTAZOLE
Topical antivirals ZOVIRAX OINTMENT Preferred brand copay Non-preferred brand copay DENAVIR
Topical corticosteroid - high potency PSORCON E Non-preferred brand copay Preferred brand copayTEMOVATE, ULTRAVATE Preferred brand copay Non-preferred brand copay generics**, DIPROSONE AEROSOL, HALOG,
HALOG E, PSORCON E, SYNALAR HP
Topical corticosteroids - medium potency CORDRAN, CORDRAN SP, PANDEL Non-preferred brand copay Preferred brand copayCUTIVATE, DERMATOP Preferred brand copay Non-preferred brand copay generics**, CORDRAN, CORDRAN SP, PANDEL
Topical corticosteroids - low potency DESOWEN LOTION Non-preferred brand copay Preferred brand copayACLOVATE Preferred brand copay Non-preferred brand copay generics**, DESOWEN LOTION
* 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.
** Numerous generic drugs belong in this class of drugs and are available as alternatives. Please consult your physician.
N E W S Y O U C A N U S E22
Drugs requiring precertification
Oxford Health Plans has a mission to help maintain and improve
the overall health of its Members through the appropriate use
of drug therapy. In order to accomplish this, Oxford and our
pharmacy benefits manager, Merck-Medco, have established
programs to help ensure that our Members receive drug therapy
that is appropriate and economical.
For most Members with pharmacy benefit coverage through
Oxford, the drugs on the following list require precertification
through Merck-Medco, based on Oxford's clinical criteria.
Precertification, also known as prior authorization, means that
your physician needs to formally submit a request to, and receive
approval from, Merck-Medco in order for you to fill a prescription
for certain drugs. If you have questions regarding the drugs on this
list or any other drug, please call Merck-Medco's customer service
line at 800-905-0201 (24 hours a day, 7 days a week except
Thanksgiving and Christmas).
Enrollment update — student verificationadministration
Oxford has simplified the student verification process by ask-
ing student dependents to verify their status only once a year —
during the fall semester.
• During the last week of August, all student dependents willreceive a Student Verification Form that must be completedand submitted by the deadline indicated.
• Dependents who are no longer students or who fail to submit a valid fall Student Verification Form will be terminated effective November 30, of the year for which verification is being requested.
• Coverage for dependents who have reached the age limit fordependent status will terminate effective November 30, of theyear in which they reached the limit.
Please note: Dependents who are no longer students and wish
to elect COBRA or State Continuation (SC), must submit an
Addition/Termination/Change Form, with the signature of their
Benefits Administrator, if applicable, and a Member Enrollment
Form, indicating the election of COBRA/SC within the appro-
priate timeframes as identified in your Certificate of Coverage.
New Jersey Small Groups: Please note that dependents who are
no longer eligible for student status can elect COBRA coverage.
Dependents are not eligible for State Continuation coverage for
loss of dependent status.
ANABOLIC STEROIDS
• Androderm Patches
• Anadrol - 50
• AndroGel
• Android
• Deca Durabolin
• Depo Testosterone
• Halotestin
• Methyltestosterone
• Oxandrin
• Testoderm
• Testosterone
• Winstrol
CNS STIMULANTS
• Adderall1
• Concerta1
• Dexedrine1
• Desoxyn1
• Dextrostat1
ACNE MEDICATIONS
• Avita2
• Differin2
• Retin A2
PROTON PUMP INHIBITORS
• Aciphex
• Nexium
• Prevacid
• Prilosec
• Protonix
IMPOTENCE DRUGS
•Viagra
ARTHRITIS MEDICATIONS
• Bextra
• Celebrex
• Enbrel
•Vioxx
• Kineret
SPECIALIZED OB/GYN DRUGS
• Lupron (3.75 Mg & 11.25 Mg)
MISC. MEDICATIONS
• Nutritional Therapies
• Phoslo
• Serostim
•Vitamin D Preparations (ie. Hectorol, Rocaltrol)
To obtain prior authorization, please have your
provider call Merck-Medco directly at 800-753-2851,
Monday through Friday from 8 AM - 9 PM.
1 Applies only to Members 19 years of age or older.2 Applies only to Members 40 years of age or older.Please note: precertification requirements may vary, depending on theMember’s benefit.For the most up-to-date information, please call Merck-Medco's pharmacy customer service line at 800-905-0201.
&
Lately, even this formula has been questioned. The consensus is that no
harm is done as long as you drink moderately, are otherwise healthy, take
no medications that might interact adversely with alcohol, and do not
operate dangerous equipment, including a car, within two to three hours.
Indeed, there may even be a small bonus to your cardiovascular health in a
daily glass of wine. But defining moderation is tricky.
In studies underwritten by the National Institutes of Health, researchers
have determined that women are more vulnerable to alcohol's effects than
men — even allowing for differences in size — than had previously been
recognized. One reason is that women have half as much of the enzyme
that breaks down alcohol in the stomach, so twice as much alcohol goes
directly into the bloodstream. Thus women feel the alcohol sooner, and
their body has to work harder to rid itself of any toxic effects. Women's
mental processes are also more impaired by drinking. This may also be
related to alcohol absorption, but researchers also suspect that women's
hormones play a role. Impairment is particularly noticeable in tests
involving memory and divided attention, skills that are critical in driving
a car, when the operator must simultaneously watch the road, anticipate
turns, control speed and distance, and carry out a host of other rapid
moves. The health consequences of a woman drinking even moderately
during pregnancy are, of course, even worse for her unborn child.
So to bottom line it, if you or someone you know drinks alcohol
regularly, now’s a good time to take a look at what is considered safe
and healthful for your gender, age and circumstances, and, if needed,
make some changes. O
23L I V I N G W E L L
Wine,women feeling woozyA great deal has been written about the benefits and risksof drinking alcoholic beverages. Historically, guidelineshave been based on studies of adult males, and thenadapted to fit the generally smaller frames of women. Thishas led most authorities to recommend no more than twodrinks daily for men; one for women and elderly people.
P.O. Box 7081, Bridgeport, CT 06601
HMHBSP02/5258
PRESORTED STANDARD
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ONWARD PUBLISHING INC.
importantinfomation
insideCheck out the latest news
about your Oxford coverage
in the Membership updates
section of this issue and
start making the most
of your benefits.
CUSTOMER SERVI CE 800-444-6222 (8 AM - 6 PM, Mon to Fri)To reach a Service Associate, please call the toll-free Customer Service number on your Oxford ID card,or call 800-444-6222. For a hearing impaired interpreter you may contact Oxford’s TTY/TDD hotline at 800-201-4875. Please call 800-303-6719 for assistance in Chinese, 800-449-4390 para ayuda en Español,and for all other languages, call the number on your Oxford ID card.
OXFORD ON-CALL® 800-201-4911 (24 hours a day, 7 days a week)Registered nurses offer you healthcare guidance, around the clock.
PHARMACY CUSTOMER SERVICE LINE 800-905-0201 (24 hours a day, 7 days a week)Receive answers to your questions about pharmacy benefits, claims, prescriptions, and participating pharmacies in your area.
MERCK- MEDCO HOME DELIVERY PHARMACY SERVICE (MAIL-ORDER SERVICE)
800-905-0201 (24 hours a day, 7 days a week)This mail-order pharmacy service provides a cost-effective,convenient way for Members with a mail-order prescription benefit to order certain maintenance medications.
OXFORD EXPRESS® 800-444-6222 (24 hours a day, 7 days a week)Touch-tone phone options let you confirm eligibility, check the status of a claim, request a new Member ID cardor physician roster, and more.
OXFORD’S FRAUD HOTLINE 800-915-1909 (24 hours a day, 7 days a week)If you suspect healthcare fraud on the part of Members, companies, or providers, please call our confidentialfraud hotline.
DIABETES PROGRAM LINE 888-585-0631 (8 AM - 4:30 PM, Mon to Fri)Program coordinators provide information about Oxford’s Living with DiabetesSM program, or send educationalmaterials upon request.
BEHAVIORAL HEALTH LINE 800-201-6991 (8 AM - 6 PM, Mon to Fri)Behavioral Health Coordinators provide information such as referrals to behavioral health providers or precertification for mental health or substance abuse services.
OXFORD HEALTHY MOTHER, HEALTHY BABY® LINE 888-200-9234 (8 AM - 5 PM,7 days a week) Experienced nurses answer questions and offer educational materials about prenatal and newborn care.
ASTHMA PROGRAM LINE 888-201-4254 (8 AM - 4:30 PM, Mon to Fri)Program Coordinators provide information about Oxford’s Better Breathing® program, or send educational materials upon request.
RESOURCES ON THE INTERNET AT www.oxfordhealth.comMYOXFORDSM
Log on to access your policy and benefit information, and perform transactions such as checking claims status, selecting a primary care physician, and ordering materials and Member ID cards.
WELLNESS RESOURCES
Learn more about Oxford’s various wellness resources, such as our Healthy BonusSM program and Self-Help Library,SM by logging on to our Member web site and clicking on the Wellness Resources section.
OO X F O R D C O N T A C T I N F O
