The USC PPO is a high-quality medical plan that offers the most freedom to choose where you go for care, including non-network providers. See PPO fact sheet. The USC PPO has three provider coverage tiers that include access to Keck Medicine of USC providers, nationwide and worldwide Anthem providers (see the international coverage fact sheet), and non-network provider coverage.
Learn more about the plan by reading about the following plan details:
- Provider coverage tiers
- Finding a provider
- Designating a primary care physician
- Getting prescriptions
- Claims, billing, and reimbursement
- USC Premier Care
- Your plan ID card
- COVID-19 resources
- Plan documents
- Contact information
Provider coverage tiers
Tier 1: USC providers
- Keck Medicine of USC physicians (available at UPC, HSC, and numerous other locations around Southern California)
- Keck Hospital of USC
- USC Arcadia Hospital
- USC Norris Comprehensive Cancer Center
- USC Verdugo Hills Hospital
Tier 2: All Anthem Prudent Buyer and BlueCard providers
At this tier level you may also access LiveHealth Online for online primary care physician visits; see details below. For all covered individuals up through age 18, Tier 2 services are available at Tier 1 copays/coinsurance benefits.
Tier 3: All other (out-of-network) providers
| TIER COVERAGE COMPARISON | Office visit copay/preventive and well child visits | Annual medical deductible | Annual medical out-of-pocket max for individual/family (3 or more in same family) | Maternity |
| Tier 1 | $25 office visit/no charge for most preventive or well child visits, $10 office copay discount with designated Primary Care Physician | $125 individual/$375 family | $1,500 individual/$4,500 family | PPO pays 100% of hospital room/board charges for maternity delivery at USC Arcadia Hospital |
| Tier 2 | $40 office visit/no charge for most preventive or well child visits, $10 office copay discount with designated Primary Care Physician | $300 individual/$900 family | $3,000 individual/$9,000 | |
| Tier 3 | For office visits, preventive care, and well child visits, PPO pays half of “usual, customary, and reasonable” charges; you pay the rest | $750 individual/$2,250 family | $12,500 individual/$37,500 family |
PPO members may also access HCOnline – the consolidated member health site – to search for providers, compare medical plans, and more. For help, see the HCOnline user guide.
Finding a provider
Tier 1 providers – Keck Medicine of USC
To find Tier 1 providers call Keck at 833-KECK USC/833-532-5872 or
- Go to http://www.keckmedicine.org/.
- Click the“Find a Provider” box, and on the next page you may search for a provider by name, specialty, department, or condition.
Tier 2 providers – Anthem Prudent Buyer Network
To find Tier 2 providers anywhere in the US, call 800-888-8288 or
- Go to www.anthem.com/ca/find-care and click on “Basic search as a guest,” then follow the steps below.
- Under “Select the type of plan or network” select “Medical Plan or Network.”
- Under “Select the state where the plan is offered” select “California”.
- Under “Select how 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 searching for the care provider type, you’re interested in
Tier 3 providers – Non-network providers
You may also access Tier 3 Non-Network providers for medically necessary covered services. You’ll receive the lowest level of benefits, and your out-of-pocket costs will be higher than if you accessed care through Tier 1 or Tier 2 In-Network providers.
Telemedicine providers
USC PPO 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 physicians are considered Tier 2 providers so your online consultation will involve a $40 copay ($30 if you are under age 19). 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
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 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 “Medical Plan or Network” select the name of your state.
- Under “Medical Plan or Network” 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.”
Providers outside the U.S.
See this information on the USC PPO Plan International Providers Fact Sheet.
Visit Blue Cross Blue Shield Global Core or call 800-810-2583:
- Read the Site Use Agreement and check the I accept terms box.
- Enter TRJ as the three ID letters under the Identification Number field and click on “Go.”
- Under Select a Provider Type choose what type of provider you want – example: “Hospital/Inpatient” (NOTE: Pharmacy and Dentists are NOT part of the USC PPO – do not search for this type of provider).
- Enter the Country, City, and Range – example: Bahamas, Freeport, 10 miles.
- Click on “Search.”
Your Tier 2 international provider results will be displayed. Remember when making an appointment with a provider, always verify with their office that they continue to participate in the Blue Cross Blue Shield Global Core network. See more Blue Cross Blue Shield Global Core information.
Designating a primary care physician
If you designate a primary care physician (PCP) for yourself, you receive a $10 discount on your copay 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 PCP 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.
Getting prescriptions
The USC PPO plan’s prescription drug formulary is designed to provide a wide range of medications while helping keep costs down. Be sure to verify your medications are covered under the USC PPO drug formulary. Some medications may also require a clinical prior to 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 PPO 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.
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 fact sheets below:
- USC Premier Care introduction
- USC Premier Care – primary care
- USC Premier Care – cancer screening
- USC Premier Care – hypertension
- USC Premier Care – diabetes
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 into 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.
COVID-19 resources
Screening and testing – The health plan will pay 100% for only medically necessary screening and testing of COVID-19. Members can 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, 2024.
- 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 including those from non-network pharmacies and non-pharmacy locations. The COVID-19 OTC Test Claim Form is available for download at www.navitus.com/members.
For more detailed information, please see the COVID OTC Testing FAQs.
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.
Plan documents
- USC PPO Welcome Brochure
- Notice of Privacy Practices
- USC PPO Fact Sheet
- USC PPO International Travel Fact Sheet
- USC PPO Summary Plan Description
- ERISA Summary Plan Description
- Nurturing Together – Prenatal program
- USC PPO Plan – Summary of Benefits and Coverage (2024)
Contact information
USC PPO | USC Health Plans (213) 740-0035 or healthplans@usc.edu
Claim, eligibility, or plan coverage questions
HealthComp | hconline.healthcomp.com/usc
855-727-5267 or hconline@healthcomp.com
Medical prior authorizations
Anthem Blue Cross
(800) 274-7767
Questions? Please contact USC Health Plans at healthplans@usc.edu or (213) 740-0035.