The USC HMO is a low-cost plan designed specifically for USC employees that includes providers in Anthem’s HMO network and other selected providers. While the plan does not allow you to choose a Keck Medicine of USC doctor, some Keck doctors are in the Anthem network.
How it works
You must use network providers; there is no out-of-network coverage (except in an emergency). The plan has two provider tiers, and benefit coverage depends on which tier provider you choose.
|TIER COVERAGE COMPARISON||Office visit copay/preventive and well child visits||Annual medical deductible individual/family (3 or more in same family)||Annual medical out-of-pocket max for individual/family (3 or more in same family)|
|Tier 1||$20 office visit/no charge for most preventive or well child visits||none/none||$1500 individual/$4500 family|
|Tier 2||$40 office visit/no charge for most preventive or well child visits||$300 individual/$900 family (does not apply to services with a flat dollar copay, like office visits)||$2500 individual/$7500 family|
See additional details in the USC HMO Summary Plan Description.
Designating a primary care physician
Upon enrollment in this plan, you must choose a primary care physician for each covered family member from Anthem Blue Cross HMO’s list of affiliated physicians. You must see your primary care physician for a referral to any other Anthem Blue Cross HMO physician and obtain authorization before seeking care outside the HMO.
To find providers in the USC HMO
- Go to www.anthem.com/ca and scroll down the home page to click on Find A Doctor. You may search as a member, or click on Continue under Search as a Guest, then follow the steps below.
- Under How do you get Insurance? select Through my employer.
- Under What state do you want to search in? select the name of your state.
- Under What type of care are you searching for? select Medical.
- Under Select a plan/network, enter USC HMO Plan (Two Tiered Network), then click on Continue.
- Using the drop-down boxes, select what type of doctor, specialty and location you’re looking for, then select Search.
- For more information about a provider, such as skills and training, click on the provider’s name on the screen that appears after you select Search.
- Tier 1 providers are distinguished by a black ribbon next to the provider name. Hover your cursor over the black ribbon to see a “lower copay provider” message – confirming this is a Tier 1 provider. All other providers without a black ribbon are Tier 2.
Accessing urgent care
Follow the directions above for provider search, but choose “Urgent Care” under what type of care you’re searching for.
Your copayment is $10 per prescription for generic drugs, 20% of cost (with a minimum $30 copay and up to a maximum of $125 copay) for brand name formulary drugs, and 45% of the cost for brand name non-formulary drugs (with a minimum of $50 copay and up to a maximum $250 copay) at participating pharmacies. You can find a participating pharmacy near you on the Anthem Blue Cross HMO website or by calling (800) 235-8631.
Claims, billing, reimbursement and ID card information
Available through Anthem directly – access their website portal by creating an account.
Anthem Blue Cross HMO Summary of Benefits and Coverage
Anthem Blue Cross ConditionCare Health Program
Anthem Blue Cross 24/7 NurseLine
Anthem Blue Cross Prescription Formulary List
Anthem Blue Cross Future Moms Information
Anthem Blue Cross Diabetes Information
Anthem Blue Cross Power of Prevention
Anthem Blue Cross Special Discounts
Anthem Blue Cross Website Overview
Anthem Blue Cross Anywhere Mobile App Info
Anthem Blue Cross HMO | www.anthem.com/ca
HMO Member Services