Dental
Taking care of your oral health is not a luxury; it is a necessity for long-term optimal health. With a focus on prevention, early diagnosis, and treatment, Dental insurance can greatly reduce your costs when it comes to restorative and emergency procedures.
When you visit a dentist in the network, you will maximize your savings. These dentists have agreed to reduced fees, which means you won’t get charged more than your expected share of the bill.
Guardian Dental PPO
Plan Information
Plan Name: Guardian Dental PPO
Policy Number: 394693
Effective Date: 01/01/2025
Network: Guardian
In-Network Benefit Highlights
In-Network
Deductible (Per Individual)
$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Basic Services
$XX
Major Procedures
$XX
Orthodontia (Adults and Children)
$XX
Provider Network
Deductible (Per Individual)
$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Basic Services
$XX
Major Procedures
$XX
Orthodontia (Adults and Children)
$XX
Out-of-Network
Deductible (Per Individual)
$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Basic Services
$XX
Major Procedures
$XX
Orthodontia (Adults and Children)
$XX
Benefit Highlights
In-Network
Deductible (Individual/Family)
$50/$150
Plan Maximum
$2,000 (combined with out-of-network)
Preventive Care
$0 (coverage limited to 1 per 6 consecutive months)
Basic Services
10% after deductible
Major Procedures
40% after deductible
Orthodontia (Children up to 26)
50%
Lifetime Maximum
$2,500 (combined with out-of-network)
Out-of-Network
Deductible (Individual/Family)
$50/$150
Plan Maximum
$2,000 (combined with-in-network)
Preventive Care
$0 (coverage limited to 1 per 6 consecutive months)
Basic Services
20% after deductible
Major Procedures
50% after deductible
Orthodontia (Children up to 26)
50%
Lifetime Maximum
$2,500 (combined with out-of-network)
Plan Documents
Year Carrier Document Name
Contact Information
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
In-Network
Deductible (Individual/Family)
$50/$150
Plan Maximum
$2,000 (combined with out-of-network)
Preventive Care
$0 (coverage limited to 1 per 6 consecutive months)
Basic Services
10% after deductible
Major Procedures
40% after deductible
Orthodontia (Children up to 26)
50%
Lifetime Maximum
$2,500 (combined with out-of-network)
Out-of-Network
Deductible (Individual/Family)
$50/$150
Plan Maximum
$2,000 (combined with-in-network)
Preventive Care
$0 (coverage limited to 1 per 6 consecutive months)
Basic Services
20% after deductible
Major Procedures
50% after deductible
Orthodontia (Children up to 26)
50%
Lifetime Maximum
$2,500 (combined with out-of-network)
Plan Documents
Year Carrier Document Name