USC PPO

The USC PPO (Preferred Provider Organization) plan offers the most options to choose from in terms of providers. It is a high-quality medical plan offering access to Keck Medicine of USC, other nationwide and worldwide Anthem providers, and out-of-network coverage.

The PPO offers access to the following providers:

  • Tier 1 – Keck Medicine of USC providers
  • Tier 2 – Anthem Blue Cross Prudent Buyer/BlueCard providers (nationwide and international providers). For international coverage, refer to the USC PPO Plan international coverage fact sheet.
  • Tier 3 – Out-of-network (non-contracted providers)

Get the details

Prescription coverage

The PPO drug formulary (a list of prescription drugs preferred by your health plan) is designed to provide a wide range of medications while helping keep PPO care affordable. Be sure to verify your medications are covered under the PPO drug formulary. Some medications may also require a clinical prior authorization, step therapies, or specific quantity limits.

The plan does have an exclusive specialty pharmacy network, meaning those taking medications for certain complex diseases, such as rheumatoid arthritis, multiple sclerosis, cancer, etc., must fill their specialty medications through Keck Medicine of USC Specialty Pharmacy or Optum Specialty Pharmacy.

For those currently enrolled in the USC PPO Plan, here’s what to expect with the change to Optum Rx:

• new drug formulary
• all active drug prior authorizations will be transferred to Optum Rx – no new authorizations required
• exclusive specialty pharmacy Network – Keck Medicine of USC Specialty Pharmacy and Optum Specialty Pharmacy
• members currently filling a specialty drug will receive personalized communication on setting up a pharmacy account
• new Plan ID cards will be issued and mailed to all members
• new mail order service through Optum Home Delivery, and
• minimal retail pharmacy network disruption.

If you are currently taking a medication that will not be covered under the new drug formulary, Optum Rx will be sending you a letter in early January advising you of covered alternatives to discuss with your physician.

If you have questions about the prescription drug formulary, you can make an appointment to speak with a clinical pharmacist by contacting IPA Concierge Services at 855-948-0219 or by making an appointment at https://calendly.com/pharmacy-consulting-teleconference-usc/usc-teleconference.

For prescription drug copay information, refer to the USC PPO Plan fact sheet.

Visit the Optum Rx site to learn more about your medications under the new drug formulary and to search for a contracted retail pharmacy.

Behavioral health benefits with Lyra Health

PPO members have additional access to behavioral health benefits with Lyra Health,  providing care for mental and emotional health.  

  • Find personalized recommendations for top providers.
  • Meet with a therapist or coach, in person or via live video, and tap into self-care apps on the go.
  • PPO Plan members receive 25 no-cost sessions annually. Additional sessions are covered under the PPO medical plan – Tier 2 plan copays apply. 
  • Refer to the Lyra Health fact sheet on page 10 of the 2025 Benefits Guide.

Diabetes management benefits through Livongo

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

  • A 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
  • Free diabetes medications
  • A welcome kit shipped to your door at no cost
  • Refer to the Livongo fact sheet on page nine of the 2025 Benefits Guide.

 Nurturing Together program through Personify Health 

USC has partnered with Personify Health to offer free access to the Nurturing Together program for PPO members. The  Nurturing Together program provides you with access to prenatal nurses and their expertise in the care of women and newborn babies. Your prenatal nurse remains available to you throughout your pregnancy and six weeks postpartum to assist you in obtaining the information and care you need. To learn more: