RUSD EPO & PPO Plans

Riverside USD offers 4 self-insured health plans that are administered by Lucent Health.  Each plan offers comprehensive coverage, allows self-referral services, access to Narus Health Nurse health line and telehealth services through PlushCare.   

RUSD EPO MEDICAL PLAN (IN-NETWORK ONLY)- CALIFORNIA ONLY

(Eligible and covered dependents residing out of coverage area will receive medical emergency coverage ONLY)

*Prudent Buyer CA Only*

The RUSD EPO (Exclusive Provider Organization) health plan is administered by Lucent Health and offers members access to medical care through a select number of medical groups, specialists, and facilities "in-network" throughout SOUTHERN CALIFORNIA.  

Local medical groups include, but not limited to: 

*This listing is subject to change without notice due to contracts between the provider's office and Lucent Health. Always verify if your provider or referral is "in-network*

The RUSD EPO health plans give you the flexibility to choose your doctor, specialists and facilities that are approved health care professionals participating in the Anthem Blue Cross PPO (Prudent Buyer) Large Group Network (only).  This is an in-network only plan.  While there is freedom to choose your own in-network personal doctor or doctors to help coordinate your care, if services are rendered with a provider that is not in the network, your care will not be covered except in emergencies and you will be responsible for 100% of the cost.  Therefore, employees must be diligent to research and ensure the provider and referrals are in-network providers.  

This is a "No referral specialists care" plan that allows you to see any provider or specialist without a referral as long as the provider participates in the Anthem Blue Cross PPO (Prudent Buyer) Large Group Network (only). Pre-certification may be necessary for hospitalizations and certain types of outpatient care. 

Please be sure to verify and confirm that the doctor or specialist that you wish to see is in-network by calling Lucent Health directly at (888) 650-6566 or refer to instructions by clicking on How to Find a Provider.  

This plan has a calendar year deductible of $100 for individual and $300 for family.   

RUSD EPO HIGH DEDUCTIBLE MEDICAL PLAN (IN-NETWORK ONLY)- CALIFORNIA ONLY

(Eligible and covered dependents residing out of coverage area will receive medical emergency coverage ONLY)

*Prudent Buyer CA Only*

The RUSD HDHP EPO (High Deductible Health Plan Exclusive Provider Organization) Plan, administered by Lucent Health offers members access to medical care through a number of medical groups "in-network" throughout CALIFORNIA

This health plan gives you the flexibility to choose your doctor, specialists and facilities that are approved health care professionals participating in the Prudent Buyer CA Only (only).  This is an in-network only plan.  While there is freedom to choose your own in-network personal doctor or doctors to help coordinate your care, if services are rendered with a provider that is not in the network, your care will not be covered except in emergencies and you will be responsible for 100% of the cost.  Therefore, employees must be diligent to research and ensure the provider and referrals are in-network providers.  

This is a "No referral specialists care" plan that allows you to see any provider or specialist without a referral as long as the provider participates in the Prudent Buyer CA Only (only). Pre-certification may be necessary for hospitalizations and certain types of outpatient care. 

Please be sure to verify and confirm that the doctor or specialist that you wish to see is in-network by calling Lucent Health directly at (888) 650-6566 or refer to instructions by clicking on How to Find a Provider.  

While this plan offers the EXACT same benefits and coverage as the RUSD EPO plan, the MAIN difference and most notable is that this plan has a calendar year deductible of $2,500 for individual and $2,500 for family. This plan is meant to provide employees at 70% employment, an opportunity to enroll in an affordable health plan. Please be sure to recognize the high deductible on this plan and make the best decision for you and your family.

RUSD PPO MEDICAL PLAN - NATIONWIDE

(If obtaining services outside of California, Out-of-Network Coverage Available ONLY)

*Prudent Buyer CA Only*

The RUSD PPO (Preferred Provider Organization) Plan, administered by Lucent Health offers members access to medical care through any recognized provider or hospital. Each time you need care under one of the RUSD PPO Plans you can choose the doctors, specialists and other health professionals and facilities from the providers in the Anthem Blue Cross PPO (Prudent Buyer) Large Group Network to ensure the least out-of pocket expenses. Unlike, the EPO Plans, the PPO plans allow you the freedom to visit doctors or use facilities that are not part of the PPO network and still receive a benefit. However, your costs will be higher and you may need to file a claim The PPO plan is a California only plan but allows active employees the flexibility for covering themselves or a dependent while out of state.  Out of state costs would fall under the out of network co insurance costs unless stated as a true emergency. 

This is a "No referral specialists care" plan that allows you to see any provider or specialist without a referral! Pre-certification may be necessary for hospitalizations and certain types of outpatient care. You are your own personal health advocate and are not assigned to a Primary Care Provider/Physician (PCP). You have the freedom to choose your own in-network and out-of-network personal doctor or doctors to help coordinate your care. Again, if you choose to see a provider that is not in the network, your out-of-pocket costs will be higher and you may need to file a claim.

For more information on coverage or plan information, please contact Lucent Health at (888) 650-6566 or refer to How to Find a Provider.  

This plan has a calendar year deductible for "In-Network" of $300 for individual and $600 for family and "Out-of-Network" of $500 for individual and $1,000 for family.

RUSD HIGH DEDUCTIBLE PPO MEDICAL PLAN -NATIONWIDE 

(If obtaining services outside of California, Out-of-Network Coverage Available ONLY)

*Prudent Buyer CA Only*

The RUSD HDHP PPO (High Deductible Preferred Provider Organization) Plan, administered by Lucent Health offers members access to medical care through any recognized provider or hospital. Each time you need care under one of the RUSD PPO Plans you can choose the doctors, specialists and other health professionals and facilities from the providers in the Anthem Blue Cross PPO (Prudent Buyer) Large Group Network to ensure the least out-of pocket expenses. Unlike, the EPO Plans, the PPO plans allow you the freedom to visit doctors or use facilities that are not part of the PPO network and still receive a benefit. However, your costs will be higher and you may need to file a claim.

How is the HDHP PPO Plan Different? By introducing a high deductible for hospital and outpatient services, this plan maintains a very comprehensive coverage and same access to providers as the PPO plan but at a more affordable cost. This plan offers the EXACT same benefits and coverage as the RUSD PPO Plan, the MAIN difference and most notable is that this plan has a calendar year deductible for "In-Network" of $2,500 for individual and $4,000 for family and "Out-of-Network" of $4,000 for individual and $6,000 for family.

For more information on coverage or plan information, please contact Lucent Health at (888) 650-6566 or refer to How to Find a Provider.  

RUSD Health Plan Summary of Benefits and Formulary Information

The Summary of Benefits and Coverage (SBC) document will help you choose and understand your health plan.  The SBC illustrates how you and the plan would share the cost for your covered health care services.  

RUSD EPO   RUSD EPO HD RUSD PPO RUSD PPO HD

                                                                    RUSD SPD January 1, 2024

For more information about your coverage, or to get a copy of the complete terms of coverage call 1-877-789-8488 or to get a copy of the complete terms of coverage visit www.lucenthealth.com.  

Download the Lucent Health Mobile app to gain access to your ID card, view claims history, view your deductible, and more!

RUSD Health Plan Contact Information

Lucent Health Member Services/Claims: 888-650-6566  |  www.lucenthealth.com

Inpatient Hospital Pre-Certification:  800-274-7767

Narus Health Nurse Line & Disease Management:  833-Narus44 (833-627-8744)

CVS CareMark Pharmacy Member Services/Claims:  866-475-0056  | www.caremark.com

Discount Maintenance Medications:  866-440-4429

EPO or PPO Network (Anthem) Online Provider Finder:  Go to www.anthem.com/ca

Vision Service Plan (VSP) Member Services/Claims:  800-877-7195 | www.vsp.com

PlushCare Telehealth Visits:  866-460-6205 | Register Online: www.plushcare.com

How to access your card, claims and more with Lucent Health Instructions on How to Register