The USC Trojan Care EPO is a high-quality, affordable medical plan especially designed for USC employees, with access to Keck Medicine of USC providers and other select Anthem providers within six Southern California counties.
How it works
You must use USC Trojan Care EPO network providers; there is no out-of-network coverage (except for urgent care and emergencies). When you need care, your only out-of-pocket cost for a physician visit is a $20 copay. For most other services, you only pay a 10% coinsurance after you meet your annual deductible ($100 for an individual, $300 for family coverage).
Your $20 copay is reduced to $10 for primary care physician (PCP) visits or behavioral health visits when you designate a PCP ahead of time – see information on designating a primary care physician below. You are not required to obtain a referral from your PCP before seeing a specialist.
See the USC Trojan Care EPO fact sheet.
Browse the following list to get more details on the EPO plan, including contact information and features.
- Finding a provider
- Designating a primary care physician
- Getting prescriptions
- Claims, billing and reimbursement
- Your plan ID card
- USC Premier Care
- COVID-19 resources
- Plan documents
- Contact information
Finding a provider
You can access quality care from these providers in the Trojan Family:
- Keck Medicine of USC physicians (available at UPC, HSC, and numerous other locations in Southern California)
- Keck Hospital of USC
- USC Norris Comprehensive Cancer Center
- USC Verdugo Hills Hospital
- USC Arcadia Hospital
To find providers call Keck at (833) KECK USC/(833) 532-5872 or visit http://www.keckmedicine.org/.
To ensure your access to a full range of services, the EPO network also includes a wide selection of carefully chosen providers and facilities that meet USC quality standards, which you can find online at HCOnline, the consolidated member site. Note you do not have to log in as a member to use the “find a provider” feature. However, EPO members – as well as anyone in your family – can log in to the site to find providers, compare medical plans, and more.
USC Trojan Care EPO participants may access LiveHealth Online, where a primary care physician visit can be conducted online via two-way video consultation. Physicians can answer questions, make a diagnosis and even prescribe basic medication if needed. LiveHealth Online consultation will involve a $10 copay. Physicians are available year-round, 24/7. This service is only available within the United States. Visit www.livehealthonline.com for information on system requirements and supported mobile devices. Note that you will need your subscriber ID which begins with NP followed by the 7 digits of your employee ID number (NPXXXXXXX). Be sure you select “Anthem Blue Cross and Blue Shield” when asked which insurance you have. Employees and their spouses will need to create their own LiveHealth account to access a doctor visit; children can be seen using the employee’s account, but you will need to create a profile for each child.
Lyra Health providers
Refer to the Other health and wellness programs page for information on the behavioral health benefits with Lyra Health.
Urgent care providers
Save time and money by using a participating urgent care center if you don’t have a life-threatening emergency but have a condition that requires prompt medical attention – an urgent care copay is only $35. Find a participating urgent care center in CA by clicking here. Click on Basic search as a guest, then follow the steps below. (For participating locations elsewhere in the U.S., call BlueCard at (800) 810-2583.)
- Under “Select the type of plan or network” select “Medical Plan or Network.”
- Under “Select the state where your plan is offered” select “California”.
- Under “How do you get health insurance” select “Medical (Employer-Sponsored).”
- Under “Select a plan/network,” if you reside in California, select “Prudent Buyer PPO/EPO.” Or, if you reside outside of California, select “National PPO (BlueCard PPO),” then click on “Continue.”
- You must input your city, county, or zip code where you are seeking care before clicking “Urgent Care.”
Designating a primary care physician
If you designate a primary care physician (PCP) for yourself, you receive a $10 discount on your copay amount each time you visit the physician’s office (excluding visits to a specialist). While not required, in addition to the savings you receive, designating a PCP gives you someone who will have the “big picture” of your health and who can monitor any changes. The same goes for your covered dependents. To designate a primary care physician for you and each of your covered dependents, register as a member at the HealthComp site (you may also wish to consult this helpful guide to designating a PCP). You may change your PCP designation at any time. Changes made on or before the 15th day of the month will be effective on the first day of the following month.
The EPO does not have a referral system, so you can make an appointment to see any provider you wish without obtaining a referral from your PCP. Note that it is your responsibility to determine what level of coverage you have with any provider before your visit. If a provider is not contracted with the EPO, benefits are not covered under the plan.
The EPO plan’s prescription drug formulary is designed to provide a wide range of medications while helping keep the EPO a low-cost plan. Be sure to verify your medications are covered under the EPO drug formulary. Some medications may also require a clinical prior authorization or step therapies or have specific quantity limits.
The plan’s pharmacy benefits manager is Navitus. Our exclusive specialty pharmacy network includes Lumicera, USC Pharmacies, and Keck Specialty Pharmacy. Mail order service is available through Costco Mail Order Pharmacy (Costco membership not required).
Visit the Navitus USC site now to learn more about your medications in the formulary and search for a contracted pharmacy.
Livongo diabetes care
Refer to the Other health and wellness programs page for information on the diabetes management benefits through Livongo.
Claims, billing and reimbursement
The USC Trojan Care EPO Plan is administered by HealthComp. Call (855) 727-5267 with questions about plan benefits, bills, or claims. You can view your paid claims information on the HealthComp site, but you must first register as a member – see Registering on HealthComp. You can also sign up to receive Explanation of Benefits (EOB) statements online only – see Understanding your EOB.
Medical claim forms can be downloaded from the same site; a PDF version is posted here for your convenience:
Submit claim forms along with copies of bills and receipts for documentation in one of three ways:
- Submit your medical claims electronically to HealthComp at HCOnline (Recommended for faster processing and tracking.)
Instructions on how to submit a claim.
Instructions on how to register for HealthComp.
- Fax to (559) 499-2464
- Mail to: HealthComp Administrators, PO Box 45018, Fresno, CA 93718-5018
Note: Please keep copies of all documents mailed and faxed to HealthComp for your records.
Your plan ID card
Medical plan identification cards are issued by HealthComp. HealthComp automatically sends two ID cards to subscribers with family coverage. If you need an extra card, log in to the the HealthComp site or call (855) 727-5267. Cards take about two weeks to arrive, or you can download a HealthComp Digital ID Card on that site.
USC Premier Care
USC Premier Care is a free care management service for plan participants who use Keck Medicine of USC providers. Your physician can refer you to the program, or you may contact them directly at (833) 726-8773 (M-F, 8 a.m.-5 p.m.). The Premier Care team tailors services to each patient, collaborating with your physician and clinical staff to help you reach important health milestones. They also help with scheduling appointments, wellness services, medical management, community services support, health education, and care transitions when you are hospitalized, as well as annual cancer screening and clinical programs for issues like hypertension and diabetes. Learn more with the factsheets below:
- USC Premier Care introduction
- USC Premier Care – primary care
- USC Premier Care – cancer screening
- USC Premier Care – hypertension
- USC Premier Care – diabetes
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 December 31, 2023.
- 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 www.navitus.com/members.
For more detailed information, please see the COVID OTC Testing FAQs.
LiveHealth Online – Primary care physician and mental health visits can be conducted online where physicians can answer questions, make a diagnosis, and even prescribe basic medication if needed. For more information visit livehealthonline.com.
Lyra mental health – Lyra provides care for mental/emotional health at no cost to you. Whether you’re feeling stressed, anxious, or depressed, short-term support is available from Lyra’s top therapists, coaches, and online tools. For more information visit lyrahealth.com or see Coping with the Coronavirus Epidemic.
For more information, please visit the CDC website for the latest COVID-19 information.
Members of this plan also have access to other health and wellness offerings, such as online health visits and mental health support. Visit Other health and wellness programs for details.
USC Trojan Care EPO | USC Health Plans (213) 740-0035 or email@example.com
Medical prior authorizations
Anthem Blue Cross
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