Guardian Dental PPO insurance Orthodontics coverage - Hardy Pediatric Dentistry & Orthodontics

Guardian dental PPO cover for Orthodontics

Guardian Dental has the following dental Orthodontics coverage plans available: Achiever and Diamond.
 


 

Guardian dental coverage plans for Orthodontics

Guardian dental plans feature a wide range of orthodontic providers that allow you to “shop around” and visit out-of-network orthodontists. However, you often pay less and don’t have to file claims when you stay in-network.

Guardian Dental Achiever

Orthodontic care is estimated to be 50% covered for members under the age of 19. The waiting period is 12 months. The Dental Achiever plan has an annual maximum of $500 and a lifetime maximum of $1,000 for orthodontic services.

Guardian Dental Diamond

For members under 19 years old, orthodontic services have an estimated 50% coverage with a waiting period of 12 months. The Diamond plan has a yearly maximum of $500 and a lifetime maximum of $1,000 for orthodontic care services.

Are you looking for an Orthodontist that takes Guardian Dental? We accept Guardian Dental.

Guardian dental covers Retainers?

Guardian top-tier dental insurance plan will pay for one retainer per lifetime if needed. Note that contracted orthodontists can bill above their contracted fee schedule for optional materials, such as Invisalign retainers. Contact your insurer to determine whether retainers are included in your insurance plan coverage. You can also give us a call to find out what might be covered for your specific situation. Source

Guardian Dental Lingual Braces cost coverage?

Orthodontic care services like lingual braces have an estimate of 50% coverage. The waiting period is 12 months. This is limited to covered dependent children who are under 19 years old when the active orthodontic appliance is first placed. The Dental Achiever plan has an annual maximum of $500 and a lifetime maximum of $1,000 while the Diamond plan has an annual maximum of $500 and a lifetime maximum of $1,000. Note that contracted orthodontists can bill above their contracted fee schedule for optional materials, such as lingual brackets. Guardian’s fee schedule allowance is based on standard (metal) braces. Source

Does Guardian dental cover X-Rays?

Guardian dental offers an estimate of 80%-100% coverage for diagnostic and preventive care services such as bitewing x-rays. Limited to either a maximum of 4 bitewing images or vertical bitewing images, in a visit, once in a 12-month period. Source

Guardian Dental covers Braces?

Orthodontic services, such as braces, are estimated to be 50% covered with a waiting period of 12 months. This coverage is limited to covered dependent children who are under 19 years old when the active orthodontic appliance is first placed. The Dental Achiever plan has a yearly maximum of $500 and a lifetime maximum of $1,000 while the Diamond plan has a yearly maximum of $500 and a lifetime maximum of $1,000.

Is Invisalign covered by Guardian Dental?

Guardian dental considers clear aligners like Invisalign to be orthodontic care and not cosmetic dentistry. Orthodontic care such as Invisalign has an estimated 50% coverage and a 12 month waiting period. This is limited to covered dependent children who are under the age of 19 when the active orthodontic appliance is first placed. The Dental Achiever plan has an annual maximum of $500 and a lifetime maximum of $1,000 while the Diamond plan has an annual maximum of $500 and a lifetime maximum of $1,000. Source

How much does Guardian dental cover for Clear Braces?

Guardian dental provides an estimated 50% coverage for orthodontic services such as clear braces with a 12 month waiting period. This coverage is limited to covered dependent kids who are under the age of 19 when the active orthodontic appliance is first placed. The Dental Achiever plan has a yearly maximum of $500 and a lifetime maximum of $1,000 while the Diamond plan has an annual maximum of $500 and a lifetime maximum of $1,000. Note that contracted orthodontists can bill above their contracted fee schedule for optional materials, such as clear or ceramic brackets. Guardian’s fee schedule allowance is based on standard (metal) braces.

For latest information, please visit: https://assets.ctfassets.net/gau1nv66ynug/2yMU6I9wNWnNwkGSNlWzac/4b2f100a4fe3aeedca6038d058e05cee/SDBC-CA_Direct_Achiever_Enrollment_v2.pdf or https://assets.ctfassets.net/gau1nv66ynug/791PzttSwtvyV4F2HhlS1H/d3b9b24a16269563a27234a3865958cf/SDBC-CA_Direct_Diamond_Enrollment_v2.pdf for more details.

DISCLAIMER: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information, please see the insurance company’s website or call the customer service or member services number listed on most insurance ID cards. Updated as of 3/27/2023. The above logo & trademarks are property of Guardian Dental.