At Hardy Pediatric Dentistry & Orthodontics in Erie, CO, we understand that navigating dental insurance for your child can be overwhelming. As a Guardian Dental PPO provider, we’re committed to helping families maximize their benefits while providing exceptional pediatric dental care. Our team of specialists, led by board-certified pediatric dentist Dr. Namrata Hardy and orthodontist Dr. T.C. Hardy, works with Guardian Dental to ensure your child receives the best possible care with the most comprehensive coverage available.
Guardian Dental PPO plans offer flexibility, allowing you to choose from in-network and out-of-network providers. However, staying in-network with our practice typically results in lower out-of-pocket costs and eliminates the need to file claims yourself. Let’s explore the various Guardian Dental plans and what they cover for your child’s dental needs.
Guardian Dental PPO Plans for Pediatric Dentistry
Guardian Dental offers four main plans that cover pediatric dental services with varying levels of coverage. Each plan is designed to meet different family needs and budgets, with options ranging from basic preventive care to comprehensive orthodontic treatment.
Guardian Dental Starter Plan
The Guardian Dental Starter plan provides essential coverage for your child’s basic dental needs:
- Preventive Care: 100% coverage for oral exams, cleanings, and X-rays with no waiting period
- Basic Dental Services: 50% coverage for simple extractions and tooth fillings with a 6-month waiting period
- In-Network Benefits: Lower out-of-pocket costs when visiting Hardy Pediatric Dentistry & Orthodontics
The Starter plan is ideal for families seeking affordable coverage for essential preventive care and basic dental services. This plan ensures your child receives regular check-ups and cleanings without any waiting period, establishing good oral health habits from an early age.
Guardian Dental Core Plan
The Guardian Dental Core plan offers more comprehensive coverage for children’s dental needs:
- Preventive Care: 80% coverage for oral exams, cleanings, and X-rays with no waiting period
- Basic Dental Services: 50% coverage for fillings and simple extractions with no waiting period
- Major Dental Services: 50% coverage for crowns, complex extractions, endodontic treatments, and root canals with a 12-month waiting period
This mid-tier plan eliminates waiting periods for basic services, making it an excellent choice for families whose children may need immediate attention for cavities or minor dental issues. The added coverage for major dental work provides peace of mind for more extensive treatment needs.
Guardian Dental Achiever Plan
The Guardian Dental Achiever plan provides enhanced coverage for comprehensive pediatric dental care:
- Preventive Care: 100% coverage for dental exams, cleanings, and X-rays with no waiting period
- Basic Dental Services: 70% coverage for fillings and simple extractions with no waiting period
- Major Dental Services: 50% coverage for crowns, complex extractions, endodontic treatments, and root canals with a 12-month waiting period
- Orthodontic Coverage: 50% coverage for members under 19 years old with a 12-month waiting period
This plan is particularly valuable for families considering orthodontic treatment for their children, as it includes coverage for braces and other orthodontic services. The increased coverage percentage for basic services also reduces out-of-pocket expenses for common childhood dental needs.
Guardian Dental Diamond Plan
The Guardian Dental Diamond plan offers the most comprehensive coverage for your child’s dental health:
- Preventive Care: 100% coverage for oral exams, cleanings, and X-rays with no waiting period
- Basic Dental Services: 80% coverage for fillings and simple extractions with no waiting period
- Cosmetic Services: 50% coverage for teeth whitening with a 6-month waiting period
- Major Dental Services: 50% coverage for crowns, complex extractions, endodontic treatments, and root canals with a 12-month waiting period
- Orthodontic Coverage: 50% coverage for members under 19 years old with a 12-month waiting period
As Guardian’s premium plan, the Diamond plan provides the highest coverage percentages across all service categories and includes cosmetic services like teeth whitening. This plan is ideal for families seeking the most comprehensive dental coverage for their children’s overall oral health and aesthetic needs.
What Guardian Dental Covers for Common Pediatric Dental Needs
Understanding exactly what’s covered for specific pediatric dental services can help you make informed decisions about your child’s oral health care.
Preventive Care Coverage: X-Rays and Cleanings
Guardian Dental plans offer generous coverage for preventive pediatric dental services:
- X-Rays: 80-100% coverage for diagnostic X-rays, including bitewing X-rays (limited to a maximum of 4 bitewing images or vertical bitewing images per visit, once in a 12-month period)
- Dental Cleanings: 80-100% coverage with no waiting period (limited to 1 prophylaxis or periodontal maintenance in a 6-month period)
- Oral Exams: 80-100% coverage for routine check-ups with no waiting period
At Hardy Pediatric Dentistry & Orthodontics, we emphasize preventive care as the foundation of excellent pediatric dental health. Regular cleanings and X-rays help us detect issues early, preventing more serious problems and reducing the need for invasive treatments.
Restorative Treatment Coverage: Fillings and Major Work
Guardian Dental provides varying levels of coverage for restorative dental treatments:
- Tooth Fillings: 50-80% coverage depending on your plan (with either no waiting period or a 6-month waiting period)
- Multiple Fillings: Considered as one restoration when on one surface
- Replacement Fillings: Covered if 12 months have passed since the previous restoration for children under 19
- Major Dental Work: 50% coverage for crowns, complex extractions, and root canals (with a 12-month waiting period)
All Guardian plans include coverage for bonding agents, liners, bases, polishing, and local anesthetic when receiving fillings or other restorative treatment at our office.
Specialized Pediatric Dental Procedures Coverage
For specialized pediatric dental procedures, Guardian offers variable coverage:
- Frenectomy (Tongue-Tie/Lip-Tie): May be covered under major services/oral surgery depending on your specific plan
- Laser Dentistry: Coverage varies by plan and procedure
- Orthodontic Treatment: 50% coverage for members under 19 with select plans (12-month waiting period applies)
- Retainers: Guardian’s top-tier plans may cover one retainer per lifetime if needed
At Hardy Pediatric Dentistry & Orthodontics, we specialize in pediatric procedures like laser dentistry and frenectomy. Dr. Nam Hardy is currently the only dentist in Colorado offering advanced laser treatment that allows for cavity procedures without drills or shots in 99% of cases.
Why Choose Hardy Pediatric Dentistry & Orthodontics for Guardian Dental Patients
As a Guardian Dental PPO provider, Hardy Pediatric Dentistry & Orthodontics offers several advantages for families with Guardian insurance:
- In-Network Benefits: Lower out-of-pocket costs and simplified billing
- Specialized Pediatric Care: Board-certified specialists focused exclusively on children’s dental needs
- Advanced Technology: State-of-the-art equipment including laser dentistry, iTero scanners, digital X-rays, and 3D printing
- Comprehensive Services: Complete pediatric dental and orthodontic care under one roof
- Patient-Centered Approach: Kid-friendly environment and compassionate care philosophy
Our Erie, CO practice combines specialized pediatric dental expertise with cutting-edge technology to provide exceptional care for children with Guardian Dental insurance. We work directly with Guardian to maximize your benefits and minimize paperwork.
Frequently Asked Questions About Guardian Dental Coverage at Hardy Pediatric Dentistry
Does Guardian Dental cover pediatric dental exams and how often?
Yes, Guardian Dental covers pediatric dental exams at 80-100% depending on your specific plan. Most Guardian plans cover two preventive exams per year with no waiting period. These regular check-ups are essential for monitoring your child’s oral development and catching potential issues early. At Hardy Pediatric Dentistry, Dr. Nam performs comprehensive exams that include checking for proper jaw and tooth development, evaluating oral hygiene, and screening for potential orthodontic needs—all covered by your Guardian plan.
How does Guardian Dental coverage work for emergency pediatric dental visits?
Guardian Dental typically covers emergency pediatric dental visits, though coverage percentages vary based on the specific treatment needed. Diagnostic X-rays are usually covered at 80-100%, while treatments like emergency extractions or pain relief procedures may fall under basic or major services with corresponding coverage levels. At Hardy Pediatric Dentistry, we prioritize emergency cases and work directly with Guardian to expedite claims for urgent care. We recommend calling both our office and Guardian’s customer service line when facing a dental emergency to verify specific coverage details.
What orthodontic benefits does Guardian Dental provide for children?
Guardian’s Achiever and Diamond plans offer 50% coverage for orthodontic treatment for members under 19 years old, subject to a 12-month waiting period. Coverage includes traditional braces, clear braces, and in some cases, Invisalign Teen. Most plans have a lifetime maximum benefit for orthodontics, typically ranging from $1,000 to $2,000. At Hardy Pediatric Dentistry & Orthodontics, Dr. T.C. Hardy offers comprehensive orthodontic evaluations and creates personalized treatment plans that maximize your Guardian benefits while achieving optimal results for your child’s smile.
Does Guardian Dental cover specialized pediatric services like frenectomy and laser dentistry?
Guardian Dental may cover specialized procedures like frenectomy (tongue-tie/lip-tie correction) under major services or oral surgery classifications, with coverage typically at 50% after applicable waiting periods. Laser dentistry coverage varies by specific procedure and plan. At Hardy Pediatric Dentistry, Dr. Nam specializes in laser frenectomy procedures that offer faster healing and less discomfort than traditional methods. Our office staff can perform a pre-treatment benefit verification to determine your exact coverage for these specialized services under your Guardian plan.
How can I maximize my child’s Guardian Dental benefits at Hardy Pediatric Dentistry?
To maximize your Guardian Dental benefits at our practice, we recommend scheduling preventive services like cleanings and exams at regular six-month intervals as these typically have the highest coverage percentage (80-100%) with no waiting period. For procedures requiring waiting periods, we can help develop a treatment timeline that aligns with your coverage effective dates. Our office also offers cost-saving strategies like bundling certain procedures when possible and providing clear cost estimates before treatment. We work directly with Guardian to ensure you receive all eligible benefits and can help you understand how to best utilize your annual maximum across the calendar year.
Visit Hardy Pediatric Dentistry & Orthodontics – Your Guardian Dental Provider in Erie, CO
We’re proud to accept Guardian Dental insurance and are committed to helping your family maximize their benefits while receiving exceptional pediatric dental care. Our team specializes in making dental visits positive experiences for children while ensuring parents understand their insurance coverage.
📍 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.