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. The USC PPO has three provider coverage tiers, and includes international coverage.
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||$20 office visit/no charge for most preventive or well child visits, or $10 office copay discount with designated Primary Care Physician||$100 individual/$300 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||$30 office visit/no charge for most preventive or well child visits, or $10 office copay discount with designated Primary Care Physician||$250 individual/$750 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|
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/
- From the tool bar, select Medical Professionals
- Click on Doctor Directory
- 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
- 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 “BlueCross PPO (Prudent Buyer – Large Group)” if you reside in California or
“National PPO (BlueCard PPO)” if you reside outside of California, 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 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.
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.
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 – then just enter your zip code in the “Located near” field, and search. For participating locations elsewhere in the U.S., call BlueCard at (800) 810-2583.
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:
- 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 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 prescription drug formulary is designed to provide a wide range of medications while helping keep the PPO plan costs low – eliminating drugs that are more expensive but may not provide greater clinical value when compared to less expensive but similarly effective medications, including:
- High-cost multi-source drugs: high-cost branded or generic products are not covered if less expensive generics are available
- Fixed-dose combination drugs (“combo drugs”): drugs with two or more active ingredients in one pill costing substantially more than the individual ingredients in separate pills are not covered
- Over the counter: Drugs for which over-the-counter options are available are not covered
- Me-too drugs: medicines which might be similar but cost many times more
To learn coverage details about your medication under the PPO, including an estimated copay, visit the MedImpact site. Login under user name: USCPPO2020 and password: Password1!. Once logged in, select “Drug Price Check” and enter your medication name.
Some of the PPO's network pharmacies include:
- USC Pharmacy
- USC Medical Plaza Pharmacy
- USC Verdugo Hills Professional Pharmacy
- Rite Aid
- Payless Drugs
Some small independent pharmacies are also in-network. Call USC Health Plans at (213) 740-0035 to verify pharmacy participation.
For prescriptions filled at non-network pharmacies, the PPO will reimburse a member for 50% of the PPO's MedImpact contracted rate (not 50% of the cost). You must pay in full for the prescription at the pharmacy, and then submit a reimbursement claim form to MedImpact within 60 days of your fill via:
Email - Claims@Medimpact.com
Fax - (858) 549-1569
MedImpact Healthcare Systems, Inc.
PO Box 509098
San Diego, CA 92150-9098
Your member ID card also includes the phone number and link for MedImpact - (844) 401-2054 or mp.medimpact.com.
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 the HealthComp online instructions. You can also sign up to receive Explanation of Benefits (EOB) statements online only - see the HealthComp electronic EOB statement instructions.
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:
- Scan and email to firstname.lastname@example.org– be sure you fill in the subject line with: ATTN: Claims
- Fax to (559) 499-2464
- Mail to: HealthComp Administrators, PO Box 45018, Fresno, CA 93718-5018
USC PPO 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.
PPO 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 – see the Lyra mental health factsheet
PPO members also 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
- See the Livongo Diabetes factsheet
USC Premier Care is a free service for PPO patients 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:
The PPO prescription drug formulary is designed to provide a wide range of medications while helping keep the PPO plan costs low – eliminating drugs that are more expensive but may not provide greater clinical value when compared to less expensive but similarly effective medications.
Questions? Please contact USC Health Plans at email@example.com, or (213) 740-0035.