USC PPO

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.

Provider coverage tiers

Tier 1: USC providers

  • Keck Medicine of USC physicians (available at UPC, HSC, and numerous other locations around in Southern California)
  • Keck Hospital of USC
  • USC Norris Comprehensive Cancer Center
  • USC Verdugo Hills Hospital
  • As of July 1, 2022: USC Arcadia 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, 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 user guide.

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 “Find a Provider” box, you may search for a provider by name, specialty, department, or condition.

Tier 2 providers – Anthem 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 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 “Prudent Buyer PPO/EPO.” 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 Tier 3 Non-Network 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 $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

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 "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 “Prudent Buyer PPO/EPO.” 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 USC PPO Plan International Providers Fact Sheet.

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 Blue Cross Blue Shield Global Core network. See more Blue Cross Blue Shield Global Core information.

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.

The 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 PPO 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.

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. 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.
  2. Fax to (559) 499-2464
  3. 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 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:

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.

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 the Public Health Emergency (PHE) is rescinded.

  • 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.

Plan documents

USC PPO Welcome Brochure
Notice of Privacy Practices
USC PPO Fact Sheet
USC PPO International Travel Fact Sheet
Sydney Health Mobile App
USC PPO Summary Plan Description
USC PPO Plan – Summary of Benefits and Coverage

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.

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