USC PPO

COVID-19 update for USC PPO members

  • Screening and Testing – The health plan will pay 100% for only medically necessary screening and testing of COVID-19 (coronavirus).
  • 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 the latest more information, please visit the CDC website for the latest COVID-19 information.

The USC PPO offers the most freedom to choose where you go for care, including non-network providers. See PPO factsheet. The USC PPO has three provider coverage tiers, and includes international coverage – see the international coverage factsheet.

Provider coverage tiers

Tier 1 (USC providers):

  • Keck Medicine of USC physicians (available at UPC, HSC, and numerous other locations around L.A.)
  • Keck Hospital of USC
  • USC Norris Comprehensive Cancer Center
  • USC Verdugo Hills Hospital

Tier 2: All Anthem Blue Cross 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 to age 18, Tier 2 services are available at Tier 1 costs.

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, or $10 office copay discount with designated Primary Care Physician $125 individual/$375 family $1500 individual/$4500 family PPO pays 100% of hospital room/board charges for maternity delivery at USC Verdugo Hills Hospital (only Tier 1 provider for hospital delivery)
Tier 2 $40 office visit/no charge for most preventive or well child visits, or $10 office copay discount with designated Primary Care Physician $275 individual/$825 family $2500 individual/$7500 Hospital room/board charges at Good Samaritan Hospital are covered at a $100 copay when delivery is performed by a USC Care Medical Group obstetrician
Tier 3 For office visits, preventive care and well child visits, PPO pays half of “usual, customary and reasonable” charges; you pay the rest $600 individual/$1800 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 userguide.

Tier 1 providers – Keck Medicine of USC

To find Tier 1 providers call Keck at (833) KECK USC/(833) 532-5872 or

  1. Go to http://www.keckmedicine.org/
  2. From the tool bar, select Medical Professionals
  3. Click on Doctor Directory
  4. In the “How may we help you today?” box, you may search for a provider by name, specialty, department or condition

Tier 2 providers – Anthem Blue Cross Prudent Buyer (Large Group) Network

To find Tier 2 providers anywhere in the US, call (800) 888-8288 or

  1. Go to www.anthem.com/ca and click Find a Doctor / Find Care on the top of the home page. Click on Guests, then follow the steps below.
  2. Under What type of care are you searching for?” select Medical
  3. Under “What state do you want to search in?” select the name of your state.
  4. Under “What type of plan do you want to search with?” select Medical (Employer-Sponsored)
  5. Under “Select a plan/network,” if you reside in California select “Blue Cross PPO (Prudent Buyer) – Large Group”, or if you reside outside of California select “National PPO (BlueCard PPO)”, then click on Continue.
  6. You must input your city, county, or zip code where you are seeking care before filling in “search for care by specialty, name, NPI or license number” or clicking a link under the Common Searches area.

Tier 3 providers

You may also access Non-Network Tier 3 providers for medical 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 $30 copay ($20 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

Plan members have additional access to behavioral health benefits with Lyra Health. Lyra provides care for mental/emotional health at no cost to you. Whether you’re feeling stressed, anxious, or depressed, short-term support from Lyra’s top therapists and coaches can get you “unstuck” with research-backed therapeutic methods as well as a suite of online tools.

  • Find personalized recommendations for top providers, just for you
  • Meet with a therapist or coach in person, via live video, or tap into self-care apps on the go
  • No copays or paperwork
  • Sessions for you, your partner and your dependents are covered
  • Schedule appointments online
  • More details HERE

Get started at https://usc.lyrahealth.com/ or contact them at care@lyrahealth.com or (844) 495-7094.

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 Guests, then follow the steps below. (For participating locations elsewhere in the U.S., call BlueCard at (800) 810-2583.)

  1. Under “What type of care are you searching for?” select Medical
  2. Under “What state do you want to search in?”select the name of your state.
  3. Under “What type of plan do you want to search with?” select Medical (Employer-Sponsored)
  4. Under “Select a plan/network,” if you reside in California select “Blue Cross PPO (Prudent Buyer) – Large Group”, or if you reside outside of California select “National PPO (BlueCard PPO)”, then click on Continue.
  5. You must input your city, county, or zip code where you are seeking care before selecting “Urgent Care” under the Common Searches

Providers outside the U.S.

See this information on Blue Cross Blue Shield international care.

Visit Blue Cross Blue Shield Global Core or call (800) 810-2583:

  1. Read the Site Use Agreement and check the I accept terms box
  2. Enter TRJ as the three ID letters under the Identification Number field and click on Go
  3. 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)
  4. Enter the CountryCity and Range – example: “Bahamas”, “Freeport”, “10 miles”
  5. 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 BlueCard Worldwide network. See more BlueCard Worldwide information.

If you designate a primary care physician for yourself and each of your covered dependents, 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 primary care physician 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 at the HealthComp site (you may also wish to consult this helpful guide to designating a primary care physician). You may change your primary care physician 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 PPO 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 PPO formulary. Some medications may also require a clinical prior authorization, step therapies or specific quantity limits.

Our 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

EPO members have free access to diabetes management benefits through Livongo. Livongo combines advanced technology with coaching to support you and/or family members with diabetes. Benefits include:

  • Connected, real-time meter that uploads your blood glucose readings
  • Personalized insights with each reading
  • Coaches - certified diabetes educators - available via phone, text and mobile app to offer nutrition and lifestyle guidance
  • Unlimited strips and lancets at no cost to you
  • Enroll now and have a welcome kit shipped to your door at no cost
  • More details HERE

Register at: http://www.join.livongo.com/USCTROJANS/hi or call (800) 945-4355 with code: USCTROJANS

Questions? Contact Livongo at membersupport@livongo.com or (800) 945-4355.

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:

HealthComp claim form

Submit claim forms along with copies of bills and receipts for documentation in one of three ways:

  1. Scan and email to scanform@healthcomp.com– be sure you fill in the subject line with: ATTN: Claims
  2. Fax to (559) 499-2464
  3. Mail to: HealthComp Administrators, PO Box 45018, Fresno, CA 93718-5018

USC Premier Care is a free service for plan participants with one simple goal - to make your health care easier, more convenient, and more personal. Your physician can refer you to the program, or you may contact them directly at (833) 726-8773 (M-F, 8am-5pm). 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:

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.

Plan documents

PPO welcome brochure
2020 PPO Summary Plan Description
Notice of Privacy Practices
2021 USC PPO Plan – Summary of Benefits and Coverage
PPO fact sheet
PPO international travel fact sheet

Contact information

USC PPO | USC Health Plans (213) 740-0035 or healthplans@usc.edu

Claim, eligibility or plan coverage questions
HealthComp | www.healthcomp.com
(855) 727-5267

Medical prior authorizations
Anthem Blue Cross
(800) 274-7767

Questions? Please contact USC Health Plans at healthplans@usc.edu, or (213) 740-0035.