Complete Guide to Guardian Dental PPO Insurance Orthodontics Coverage at Hardy Pediatric Dentistry & Orthodontics

Are you looking for a trusted orthodontist in Erie, CO that accepts Guardian Dental PPO insurance? At Hardy Pediatric Dentistry & Orthodontics, we proudly accept Guardian Dental insurance plans and work with families to maximize their benefits. Our team of specialists, led by board-certified orthodontist Dr. T.C. Hardy, is committed to providing exceptional orthodontic care while helping you navigate your insurance coverage.

Guardian Dental PPO plans offer valuable orthodontic benefits that can significantly reduce your out-of-pocket expenses for braces, Invisalign, and other orthodontic treatments. This comprehensive guide will help you understand your Guardian Dental PPO orthodontic coverage options and how our team at Hardy Pediatric Dentistry & Orthodontics can help you achieve a beautiful, healthy smile.

 

Guardian Dental PPO Orthodontic Coverage Plans

Guardian Dental offers several PPO plans that include orthodontic coverage. The two primary plans that provide orthodontic benefits are the Achiever and Diamond plans. Understanding the specifics of these plans can help you make informed decisions about your orthodontic treatment.

Guardian Dental Achiever Plan

The Guardian Dental Achiever Plan provides substantial coverage for orthodontic treatments with the following benefits:

  • Coverage Percentage: Approximately 50% coverage for orthodontic care for members under 19 years of age
  • Waiting Period: 12-month waiting period before orthodontic benefits begin
  • Annual Maximum: $500 per year for orthodontic services
  • Lifetime Maximum: $1,000 lifetime maximum for orthodontic treatments
  • Provider Network: Freedom to choose in-network or out-of-network orthodontists, with greater savings when staying in-network

The Achiever Plan is an excellent option for families planning orthodontic treatment for children or teenagers. By choosing Hardy Pediatric Dentistry & Orthodontics as your in-network provider, you can maximize your benefits and reduce your out-of-pocket costs.

Guardian Dental Diamond Plan

The Guardian Dental Diamond Plan offers similar orthodontic coverage with the following benefits:

  • Coverage Percentage: Approximately 50% coverage for orthodontic care for members under 19 years of age
  • Waiting Period: 12-month waiting period before orthodontic benefits begin
  • Annual Maximum: $500 per year for orthodontic services
  • Lifetime Maximum: $1,000 lifetime maximum for orthodontic treatments
  • Provider Network: Access to an extensive network of orthodontists, including Hardy Pediatric Dentistry & Orthodontics

Both the Achiever and Diamond plans provide significant benefits for orthodontic treatment, helping to make braces, Invisalign, and other orthodontic services more affordable for families.

Guardian Dental Coverage for Different Orthodontic Treatments

Understanding how Guardian Dental PPO plans cover specific orthodontic treatments can help you plan for your orthodontic care. Here’s a breakdown of coverage for various orthodontic services available at Hardy Pediatric Dentistry & Orthodontics.

Braces Coverage

Guardian Dental PPO plans provide coverage for traditional metal braces with the following details:

  • Estimated 50% coverage for braces treatment
  • 12-month waiting period before coverage begins
  • Limited to covered dependent children under 19 years old when orthodontic treatment starts
  • Annual maximum of $500 and lifetime maximum of $1,000 for both Achiever and Diamond plans

At Hardy Pediatric Dentistry & Orthodontics, Dr. T.C. Hardy offers traditional braces along with various customization options to suit your child’s preferences and needs. Our team works directly with Guardian Dental to streamline the claims process, making it easier for you to focus on your child’s treatment rather than paperwork.

Clear Braces Coverage

Guardian Dental plans also cover clear braces (ceramic brackets) with specific considerations:

  • Estimated 50% coverage for clear braces
  • 12-month waiting period before coverage begins
  • Limited to covered dependents under 19 years of age
  • Annual maximum of $500 and lifetime maximum of $1,000 for both plan types
  • Important Note: Contracted orthodontists can bill above the contracted fee schedule for optional materials like clear or ceramic brackets, as Guardian’s fee schedule allowance is based on standard (metal) braces

Dr. T.C. Hardy at Hardy Pediatric Dentistry & Orthodontics offers high-quality clear braces that provide effective treatment while being less noticeable than traditional metal braces. Our team can help explain any additional costs that may apply for clear braces compared to traditional options.

Invisalign and Clear Aligners Coverage

Guardian Dental considers clear aligners like Invisalign to be orthodontic care rather than cosmetic dentistry, which means they are covered under orthodontic benefits:

  • Estimated 50% coverage for Invisalign treatment
  • 12-month waiting period applies
  • Coverage limited to dependents under 19 years old at treatment start
  • Annual maximum of $500 and lifetime maximum of $1,000 for both plans
  • Potential additional costs for this specialized treatment option

At Hardy Pediatric Dentistry & Orthodontics, Dr. T.C. Hardy is certified in Invisalign treatment for both teens and adults. Our team can provide detailed cost estimates and help you understand how your Guardian Dental benefits will apply to Invisalign treatment.

Lingual Braces Coverage

Lingual braces, which are placed behind the teeth for a virtually invisible appearance, have specific coverage considerations under Guardian Dental plans:

  • Estimated 50% coverage for lingual braces
  • 12-month waiting period applies
  • Coverage limited to dependents under 19 years old at treatment start
  • Annual maximum of $500 and lifetime maximum of $1,000
  • Important Note: Contracted orthodontists may bill above the contracted fee schedule for lingual brackets, as Guardian’s fee schedule allowance is based on standard (metal) braces

Dr. T.C. Hardy offers InBrace, an advanced lingual braces system, as part of our practice’s commitment to providing diverse treatment options for our patients. Our team can help you understand the additional costs that may apply for this specialized treatment option.

Additional Guardian Dental Coverage for Orthodontic-Related Services

Beyond the primary orthodontic appliances, Guardian Dental plans cover several related services that are important parts of comprehensive orthodontic treatment.

Retainer Coverage

Retainers are essential for maintaining the results of orthodontic treatment. Here’s how Guardian Dental covers retainers:

  • Guardian’s top-tier dental insurance plans pay for one retainer per lifetime if needed
  • Coverage is subject to the same orthodontic benefits limitations
  • Important Note: Contracted orthodontists can bill above their contracted fee schedule for optional materials, such as Invisalign retainers

Our team at Hardy Pediatric Dentistry & Orthodontics can help determine what retainer options are covered under your specific Guardian Dental plan. We offer various retainer types to suit different patient needs and preferences.

X-Ray Coverage

Diagnostic services like X-rays are an important part of orthodontic treatment planning and monitoring. Guardian Dental offers coverage for X-rays:

  • Estimated 80%-100% coverage for diagnostic and preventive care services including bitewing X-rays
  • Limited to either a maximum of 4 bitewing images or vertical bitewing images in a visit
  • Coverage typically limited to once in a 12-month period

At Hardy Pediatric Dentistry & Orthodontics, we use advanced digital X-ray technology that reduces radiation exposure by up to 90% compared to traditional X-rays. Our digital imaging system allows Dr. T.C. Hardy to provide more precise diagnoses and treatment planning.

Why Choose Hardy Pediatric Dentistry & Orthodontics for Guardian Dental Covered Orthodontics

When you’re looking for an orthodontist that accepts Guardian Dental insurance in Erie, CO, Hardy Pediatric Dentistry & Orthodontics offers several advantages:

  • In-Network Provider: We are an in-network provider for Guardian Dental plans, helping you maximize your benefits and minimize out-of-pocket costs
  • Board-Certified Specialists: Dr. T.C. Hardy is board-certified by the American Board of Orthodontics, ensuring the highest level of care
  • Comprehensive Treatment Options: We offer traditional braces, clear braces, Invisalign, InBrace lingual braces, and KLOwen customized braces
  • Advanced Technology: Our practice utilizes cutting-edge technology like iTero digital scanning, 3D printing, and CBCT imaging for precise treatment planning
  • Insurance Expertise: Our team has extensive experience working with Guardian Dental and can help you understand and maximize your benefits

Our dedicated staff works directly with Guardian Dental to verify benefits, file claims, and ensure you receive the coverage you’re entitled to under your plan.

Maximizing Your Guardian Dental Orthodontic Benefits

To get the most value from your Guardian Dental orthodontic coverage, consider these helpful tips:

Benefit Maximization Strategy Description
Start planning early Since Guardian Dental plans have a 12-month waiting period for orthodontic services, enroll in coverage at least a year before anticipated treatment
Schedule a consultation Visit Hardy Pediatric Dentistry & Orthodontics for a free orthodontic consultation to understand treatment options and costs
Verify your benefits Our team can help verify your specific Guardian Dental coverage before treatment begins
Understand annual vs. lifetime maximums Plan treatment timing to take advantage of both annual and lifetime maximums
Ask about payment plans We offer flexible payment plans that work with your insurance coverage to make treatment more affordable

At Hardy Pediatric Dentistry & Orthodontics, we believe that financial considerations shouldn’t be a barrier to achieving a healthy, beautiful smile. We work with each family individually to create a financial plan that fits their budget while maximizing their insurance benefits.

Frequently Asked Questions About Guardian Dental PPO Orthodontic Coverage

Does Guardian Dental PPO cover adult orthodontics?

Guardian Dental PPO plans typically limit orthodontic coverage to dependents under 19 years of age. However, adults can still receive orthodontic treatment at Hardy Pediatric Dentistry & Orthodontics. While your Guardian plan may not provide coverage for adult orthodontics, our office offers flexible payment plans and financing options to make treatment affordable. Dr. T.C. Hardy has extensive experience treating adult patients with various orthodontic needs and provides treatment options like Invisalign and clear braces that are discreet and compatible with professional settings.

How is the orthodontic benefit paid out by Guardian Dental?

Guardian Dental typically pays orthodontic benefits differently than regular dental procedures. Rather than paying a lump sum at the beginning of treatment, Guardian often distributes the benefit throughout the treatment period. For example, if your child has a 24-month orthodontic treatment plan, Guardian may divide the lifetime maximum benefit of $1,000 into installments over that period. At Hardy Pediatric Dentistry & Orthodontics, our insurance coordinators can explain exactly how your benefits will be applied and help you plan for your financial responsibility throughout treatment.

What happens if I change insurance during orthodontic treatment?

If you change from Guardian Dental to another insurance provider during orthodontic treatment, the situation can become complex. Generally, Guardian will stop making payments once your coverage ends. Your new insurance may or may not cover ongoing orthodontic treatment, and many plans won’t cover treatment that began before you were enrolled. At Hardy Pediatric Dentistry & Orthodontics, we recommend discussing any potential insurance changes with our office as early as possible. Our team can help you understand how a change might impact your coverage and work with you to adjust your financial plan if needed.

Are there alternatives if my Guardian Dental plan doesn’t cover the orthodontic treatment I need?

Yes! At Hardy Pediatric Dentistry & Orthodontics, we offer several options for patients whose Guardian Dental plan doesn’t fully cover their desired treatment. We provide in-house membership plans that include discounts on orthodontic services, flexible payment plans with low or no interest, and third-party financing options. Dr. T.C. Hardy also works with each patient to find the most cost-effective treatment approach that will achieve their goals. During your consultation, we’ll discuss all available options and help you find a solution that fits both your orthodontic needs and your budget.

How does Guardian Dental handle orthodontic coverage for treatments that started before I had insurance?

Guardian Dental typically doesn’t provide coverage for orthodontic treatment that began before your insurance plan took effect. This is why it’s important to have your insurance in place before starting treatment. However, if you’re transferring to our practice mid-treatment and already have Guardian Dental coverage, we can help you understand what portion of your remaining treatment may be covered. At Hardy Pediatric Dentistry & Orthodontics, we work with many families in various situations and can help navigate complex insurance scenarios to maximize your benefits.

Ready to Start Your Orthodontic Journey with Guardian Dental Coverage?

At Hardy Pediatric Dentistry & Orthodontics, we make it easy to begin your orthodontic treatment with Guardian Dental insurance. Our team of specialists is committed to providing exceptional care while helping you maximize your insurance benefits.

📍 Visit Us: 3200 Village Vista Dr., Suite 110, Erie, CO 80516
📞 Call: (720) 764-6158
📩 Or Request an Appointment Online Today

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 April 28, 2025. The above logo & trademarks are property of Guardian Dental.