Guardian managed dental care plan

Fillings: $28 for Amalgam filling-one surface, primary or permanent
$36 for (white filling) Resin-based composite-one surface, anterior
$56 for (white filling) Resin-based composite-one surface, posterior

Extractions: $35 for (Simple) Extraction, erupted tooth or exposed root Crowns: $430 for crown-porcelain fused metal
$450 for crown – porcelain/ceramic

Root Canals: $260 for endodontic (root canal) therapy-anterior
$400 for endodontic (root canal) therapy-molar

Dentures: $580 for complete denture (maxillary)
$580 for complete denture (mandibular) Deep Cleanings: $32 for Periodontal maintenance Implants: No coverage

Braces / Orthodontia: $2,800 for comprehensive orthodontic treatment of the adult dentition
$2,500 for comprehensive orthodontic treatment of the adolescent dentition

Teeth Whitening: $165 external bleaching – per arch Additional Network Information:

With Guardian Managed DentalGuard HMO plan, you must select a Primary Care Dentist to receive benefits. You can select your PCD during the online enrollment process or can call customer service for assistance.

The benefits shown are performed as deemed appropriate by the assigned Primary Care Dentist subject to the limitations and exclusions of the program. You should discuss all treatment options with your PCD prior to services being rendered.

Specialty services require prior authorization from the Plan. A referral must be submitted to the Plan by your Primary Care Dentist for approval.

Can I change my dentist once I am in the plan?

You may change your selected Primary Dentist every month while you are covered under the plan by contacting Customer Service by the 15th of the month; your change will be made effective the first of the following month.

What is a pre-existing condition versus work-in-progress? Is it covered?

A pre-existing condition is an oral health condition, which existed before your enrollment in a dental program. The plan does not include an exclusion for pre-existing conditions. However, expenses for the replacement of teeth that were lost or extracted prior to the policy effective date will not be covered.

Work in progress is any oral health procedure that is started and not completed prior to your enrollment in a dental program. The plan does not cover any expenses prior to the date you are covered under the Policy.

What provider options do I have?

With Guardian Managed DentalGuard HMO plan, you must select a Primary Care Dentist to receive benefits. You can select your PCD during the online enrollment process or can call customer service for assistance.

When can I start using my Plan?

You can start using your plan once it goes into effect - usually the 1st of the month following your enrollment (as long as the enrollment and payment is received within the enrollment deadline). Incomplete enrollment forms or failure to submit the required initial premium amount may cause an initial delay in issuance of insurance. Do not cancel any other insurance or assume you are insured under the Plan until you receive your certificate of insurance.

When will I receive my new member kit and what will it include?

You will receive a Member ID card in the mail within 10 business days of your successful payment being processed. Please go online to "MyDental.GuardianLife.com" and register as a new member. Once you have registered you can print out state specific policy information and the plan benefit summary.

Who can enroll in this plan?

Coverage is offered to individuals and their dependents residing in the coverage area. Dependent Child benefits are different from Adult benefits and include additional covered services and limitations.

As long as you meet the plan’s general eligibility requirements and pay the applicable premium, your acceptance is automatic.

Can I change my dentist once I am in the plan?

You may change your selected Primary Dentist every month while you are covered under the plan by contacting Customer Service by the 15th of the month; your change will be made effective the first of the following month.

What is a pre-existing condition versus work-in-progress? Is it covered?

A pre-existing condition is an oral health condition, which existed before your enrollment in a dental program. The plan does not include an exclusion for pre-existing conditions. However, expenses for the replacement of teeth that were lost or extracted prior to the policy effective date will not be covered.

Work in progress is any oral health procedure that is started and not completed prior to your enrollment in a dental program. The plan does not cover any expenses prior to the date you are covered under the Policy.

What provider options do I have?

With Guardian Managed DentalGuard HMO plan, you must select a Primary Care Dentist to receive benefits. You can select your PCD during the online enrollment process or can call customer service for assistance.

When can I start using my Plan?

You can start using your plan once it goes into effect - usually the 1st of the month following your enrollment (as long as the enrollment and payment is received within the enrollment deadline). Incomplete enrollment forms or failure to submit the required initial premium amount may cause an initial delay in issuance of insurance. Do not cancel any other insurance or assume you are insured under the Plan until you receive your certificate of insurance.

When will I receive my new member kit and what will it include?

You will receive a Member ID card in the mail within 10 business days of your successful payment being processed. Please go online to "MyDental.GuardianLife.com" and register as a new member. Once you have registered you can print out state specific policy information and the plan benefit summary.

Who can enroll in this plan?

Coverage is offered to individuals and their dependents residing in the coverage area. Dependent Child benefits are different from Adult benefits and include additional covered services and limitations.

As long as you meet the plan’s general eligibility requirements and pay the applicable premium, your acceptance is automatic.

Guardian Life Insurance Company of America
P.O. Box 981569
El Paso, TX 79998-1569 Disclaimers & Disclosures

This website provides a very brief description of some of the important features of this plan. It is not the insurance contract, nor does it represent the insurance contract. A full description of benefits, exclusions and limitations is contained in the Schedule of Benefits and your policy.

Rates shown are based upon the information you provided, and are subject to change based on the dental and/or vision plan's underwriting practices and your selection of available optional benefits, if any. Final rates and effective dates are subject to underwriting and are always determined by the dental insurance and/or vision insurance company. To be considered for reimbursement, expenses must qualify as covered expenses.

This site was designed to provide you with a general description of the plans you requested. Keep in mind that it does not include all the benefits and limitations outlined in the policies -- it is the insurance contract, not the general descriptions on this website, which forms the contract between you and the insurance company.

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