The PPO offers the most provider choice, but highest cost.
- Tier 1 – Keck Medicine of USC providers
- Tier 2 – Anthem Blue Cross Prudent Buyer/BlueCard providers (nationwide and international)
- Tier 3 – Out of network (non-contracted providers)
- See our printable factsheet with everything you need to know about the PPO, including rates for this plan – PPO factsheet.
- Visit the Employee Gateway PPO page.
NEW prescription formulary for PPO
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. Most of the changes can be grouped into one of these categories:
- High-cost multi-source drugs: high-cost branded or generic products will not be 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 will not be covered
- Over the counter: Drugs for which over-the-counter options are available will not be covered
- Me-too drugs: medicines which might be similar but cost many times more
These changes will take effect January 1, 2020. During the open enrollment period, the PPO pharmacy benefit manager, MedImpact, will notify any member currently taking one of the drugs affected by the implementation of the formulary. This correspondence will also include information about Integrity Pharmaceutical Advisors (IPA), a group of independent pharmacists that USC is providing as an additional resource to affected members and their prescribing physicians. IPA will be available to answer any questions about the affected medications and offer alternatives. This service is completely confidential and free.
Please verify whether your medications are covered under the PPO formulary – some medications may also require a clinical prior authorization, step therapies or have specific quantity limits. For more detailed prescription coverage information, including an estimated copay, visit www.mp.medimpact.com/usc. Login under User Name: USCPPO2020 and Password: Password1. Once logged in, select “Drug Price Check” and enter your medication name.
All members affected by their medication not being part of the new formulary will be granted at least a 90-day grace period (as of January 2020) to continue to fill their excluded drug while they consult with their prescribing physician about alternative medications.
Questions? Please contact USC Health Plans at email@example.com, or (213) 740-0035.
Extras for PPO members
PPO members may access their dedicated member portal to compare plans and find providers.
In addition, 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
Coverage across the country and around the world