Guardian Dental has the following Pediatric dental coverage plans available: Starter, Core, Achiever, and Diamond.
Guardian dental coverage plans for Pediatric Dentistry
Guardian dental plans feature a wide range of pediatric service providers that allow you to “shop around” and visit out-of-network pediatric dentists. However, you often pay less and don’t have to file claims when you stay in-network.
Guardian Dental Starter
Guardian Dental Starter plan covers an estimate of 100% for preventive care services including oral exams, cleanings, and X-rays with no waiting period for you and your dependent. Basic dental care is estimated to be 50% covered for children and has a 6 month waiting period. These basic services include simple extractions and tooth fillings.
Guardian Dental Core
With Guardian Dental Core, there’s an estimated 80% coverage for you and your dependent’s preventive services like oral exams, dental cleanings, and x-rays with no waiting period. Restorative work like fillings and basic services such as simple tooth extractions are estimated to be 50% covered with no waiting period. Major dental care including crowns, complex extractions, endodontic, and root canals are estimated to be 50% covered with a waiting period of 12 months.
Guardian Dental Achiever
Guardian Dental Achiever includes an estimated 100% coverage for you and your dependent’s dental exams, teeth cleanings, and x-rays with no waiting period. Basic dental care such as teeth fillings and simple extractions are estimated to be 70% covered and have no waiting period. Major dental care including crowns, complex extractions, endodontic, and root canals have an estimate of 50% coverage with a waiting period of 12 months. Orthodontic care is estimated to be 50% covered for members under the age of 19. The waiting period is also 12 months for orthodontic services.
Guardian Dental Diamond
Guardian dental Diamond plan offers an estimated 100% coverage for you and your dependent’s preventive care services such as oral exams, cleanings, and x-rays with no waiting period. When your dependent needs restorative work like fillings and other basic services such as simple extractions, the Diamond plan provides an estimate of 80% coverage with no waiting period. Teeth whitening is also covered under this plan with an estimated 50% coverage and a 6 month waiting period. Major dental services including crowns, complex extractions, endodontic, and root canals are estimated to be 50% covered with a 12 month waiting period. For members under 19 years old, orthodontic services have an estimated 50% coverage with a waiting period of 12 months.
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Guardian dental covers Retainers after Braces for kids?
Guardian top-tier dental insurance plan will pay for one of your child’s retainers per lifetime if needed. Note that contracted orthodontists can bill above their contracted fee schedule for optional materials, such as Invisalign Teen retainers. Contact your insurer to determine whether retainers for kids are included in your dependent’s insurance plan coverage. You can also give us a call to find out what might be covered for your dependent’s specific situation. Source
Does Guardian Dental cover X-Rays for Children?
Guardian dental offers an estimate of 80%-100% coverage for diagnostic and preventive care services for children. These preventive care includes bitewing x-rays. This is limited to either a maximum of 4 bitewing images or vertical bitewing images, in a visit, once in a 12-month period. Source
Does Guardian Dental cover Cleaning and Tooth Fillings for Children?
Guardian dental plans cover an estimate of 80%-100% for preventive care services including dental cleanings for kids with no waiting period. Teeth cleanings are limited to 1 prophylaxis or periodontal maintenance (considered a periodontic service) in a 6 month period. Basic dental services, such as fillings for children, are estimated to be 50%-80% covered. There’s either no waiting period or a 6 month waiting period depending on your dependent’s plan. Multiple fillings on one surface will be considered one restoration. Benefits for the replacement of existing fillings will be considered for payment if 12 months have passed since the previous restoration was placed if the covered person is under age 19. Allowance includes bonding agents, liners, bases polishing and local anesthetic. Source
Are Frenectomy, Tongue Tie and Lip Tie covered by Guardian dental?
Guardian dental plans include coverage for oral surgeries under major services. Oral surgeries such as frenectomy, lip tie surgery, or tongue tie procedure may or may not be covered depending on your dependent’s insurance plan. Allowance includes diagnostic and treatment radiographs, the treatment plan, local anesthetic and post-surgical care. Please contact your insurer to determine whether frenectomy is included in your dependent’s insurance plan coverage. You can also give us a call to find out what might be covered for your dependent’s specific situation.
For latest information, please visit: https://www.guardianlife.com/dental-insurance or https://www.guardianlife.com/dental-insurance/ppo-plans 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.