Keck Medicine of USC Community PPO

The USC Verdugo Hills medical insurance plan is administered by HealthComp. See the summary plan description and the summary of benefits and coverage.

Click here for more information about costs, covered items, and services.

Medical benefits

Browse the various medical and infertility treatment benefits to understand the difference between the two tiers.

MEDICAL
BENEFITTIER 1TIER 2
USC VHH/Keck Medicine of USC/ USC Care Medical GroupAnthem Blue Cross Prudent BuyerNetwork/ BlueCard® Providers
Deductible: Individual / FamilyNone$500/$750
Out-of-pocket maximum (medical)$5,000 individual/$10,000 employee and all covered dependents combined
 Physician office visitPlan pays 100% after $10 copay(USC Care Medical Group only)Plan pays 100% after $25 copay(deductible waived)
Preventive care (adult and child)Plan pays 100%Plan pays 100% (deductible waived)
Child immunizations (through age 18)Plan pays 100%Plan pays 100% (deductible waived)
 Maternity – physician office visitPlan pays 100% after $10 copay(USC Care Medical Group only)Plan pays 100% after $25 copay(deductible waived)
Maternity – physician deliveryPlan pays 100%Plan pays 70%
Maternity – hospital chargesPlan pays 100%Plan pays 70%
(up to 120 days /calendar year)
 Home health carePlan pays 70%
(up to 50 days /calendar year)
Durable medical equipmentPlan pays 90%Plan pays 70%
Hospice carePlan pays 80%
Mental health/substance abuse –Inpatient room and board Plan pays 100% Plan pays 70%
Mental health/substance abuse –OutpatientPlan pays 100% after $10 copay(USC Care Medical Group only)Plan pays 100% after $25 copay(deductible waived)
    Prescription drugsUSC VHH Pharmacies(90-day supply) Generic: You pay 10% up to $5 max Brand Name: You pay 20% Non-Formulary: You pay 30%Navitus Pharmacies(30-day supply) Generic: You 20% up to $10 max Brand Name: You pay 30% Non-Formulary: You pay 50%
Out-of-pocket maximum Prescription: Individual/Family $1,600 individual / $3,200 employee and all covered dependents

Infertility Treatment
TIER 1TIER 2
 USC VHH/Keck Medicine of USC/USC Care Medical GroupAnthem Blue Cross Prudent Buyer Network/ BlueCard®  Providers
Medical – Lifetime Maximum$10,000 lifetime maximum
Physician Office Visit$10 copay$25 copay
Artificial Insemination20% coinsurance
Invitro Fertilization (IVF)20% coinsurance
Physician Services20% coinsurance
Imaging, Tests and Lab Work20% coinsurance

COVID-19 resources

  • Screening and testing – The health plan will pay 100% for only medically necessary screening and testing of COVID-19. Beginning Saturday, Jan. 15, 2022, members covered by private health insurance or a group health plan are now able to purchase over-the-counter (OTC) COVID-19 tests authorized by the U.S. Food and Drug Administration (FDA) at no cost without a prescription. The reimbursement of OTC COVID-19 tests will remain in effect until the Public Health Emergency (PHE) is rescinded.
    • COVID-19 test kits can be purchased at network pharmacies at $0 member out-of-pocket, with a quantity limit of eight tests per covered individual every 30 days. This eight-test limit does not apply to such test kits ordered with a prescription. COVID-19 tests kits must be purchased at the pharmacy counter with your medical/rx insurance card to ensure that they are processed properly. View Navitus’ list of network pharmacies.
    • Members can also submit a claim for reimbursement for COVID-19 OTC test kits purchased on or after Jan. 15, including those from non-network pharmacies and non-pharmacy locations. The COVID-19 OTC Test Claim Form is also available for download at navitus.com/members. For more detailed information, please view the COVID OTC Testing FAQs.
  • Please see the Coronavirus FAQ and the Coronavirus member information.
  • Your Anthem health plan will cover the care you receive if you’re diagnosed with COVID-19. Anthem will also waive out-of-pocket expenses for the focused test used to diagnose COVID-19.
  • Visit anthem.com/ca/blog or the CDC website at cdc.gov/coronavirus to learn more.

Contact information

HealthComp | www.healthcomp.com

(800) 442-7247

Navitus | www.navitus.com (prescriptions)

(855) 673-6504