Guardian Dental PPO cover in Costa Mesa CA

Guardian Dental has the following dental coverage plans available: Starter, Core, Achiever, and Diamond.

Guardian dental coverage plans

Guardian dental plans feature a wide range of providers that allow you to “shop around” and visit out-of-network 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. Basic dental care is estimated to be 50% covered under this plan and has a 6 month waiting period. These basic services include simple extractions and tooth fillings. Starter plan has an annual maximum of $500 for year 1, $750 for year 2, and $1,000 for year 3 and after.

Guardian Dental Core

With Guardian dental Core, there’s an estimated 80% coverage for 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, oral surgery, implants, periodontal, endodontic, root canals, and dentures are estimated to be 50% covered with a waiting period of 12 months. Dental Core plan has an annual maximum of $500 for year 1, $750 for year 2, and $1,000 for year 3 and after except for some dental services like dental implants (Lifetime max: $700).

Guardian Dental Achiever

Guardian Dental Achiever includes an estimated 100% coverage for 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, oral surgery, dental implants, periodontal, endodontic, root canals, and dentures 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. The Dental Achiever plan has an annual maximum of $1,000 for year 1, $1,250 for year 2, and $1,500 for year 3 and after except for certain services like dental implants (Lifetime max: $1,000) and orthodontics (Yearly max: $500, Lifetime max: $1,000).

Guardian Dental Diamond

Guardian dental Diamond plan offers an estimated 100% coverage for preventive care services such as oral exams, cleanings, and x-rays with no waiting period. When you need 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, oral surgery, dental implants, periodontal, endodontic, root canals, and dentures 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. The Diamond plan has a yearly maximum of $1,500 except for some services like dental implants (Lifetime max: $1,000), orthodontia (Yearly max: $500, Lifetime max: $1,000), and teeth whitening (Yearly max: $500).

Are you looking for a dentist that accepts Guardian Dental or where it’s accepted? Dentistry At Its Finest accepts Guardian Dental.

Guardian Dental tooth extraction cost cover?

Guardian dental covers basic dental care such as simple extractions with an estimate of 50%-80% with either no waiting period or a 6 month waiting period. The waiting period and dental coverage will depend on your PPO plan. Major dental care like complex extractions are estimated to be 50% covered with a waiting period of 12 months. Source

Guardian dental Wisdom teeth removal coverage?

The removal of wisdom teeth is an oral surgery benefit. Oral surgeries are under major dental services and have an estimate of 50% coverage for in-network patients. Please call your insurer to confirm if wisdom teeth removal is covered in your plan. You can also give us a call to find out what might be covered for your specific situation. Source

Does Guardian Dental cover X-Rays service?

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 Braces Coverage?

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. Source

Is Invisalign covered by Guardian dental Insurance?

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

What does Guardian Dental offer for dental implant?

Guardian dental provides an estimated 50% coverage with a 12 month waiting period for major services like dental implants. Dental Core plan has a lifetime maximum of $700 for dental implants. Dental Achiever and Dental Diamond plans have a lifetime maximum of $1,000. Source

Does Guardian Dental cover both the dentures?

Guardian Dental plans offer an estimated 50% coverage for major services like removable partial dentures. The waiting period is 12 months. This is limited to permanent teeth. Dental prosthesis replacement limitation and missing tooth provision applies. Allowance includes adjustments done by the dentist furnishing the denture in the first 6 months after installation and all temporary or provisional dentures. Temporary or provisional full and partial dentures and interim dentures older than one year are considered to be a permanent dental prosthesis. Source

How much does Guardian dental insurance cover for Veneers?

Guardian dental may cover labial veneers. However, this is limited to permanent anterior and bicuspid teeth. Labial veneers are covered when needed because of decay or injury and only when the tooth cannot be restored with amalgam or resin based composite fillings. Dental prosthesis replacement limitation applies. Allowance includes insulating bases, temporary or provisional restorations, local anesthetic and associated gingival involvement. Repairs and maintenance of labial veneers is covered if performed more than 12 months after initial insertion. Please contact your insurer to confirm if your plan covers veneers or not. You can also give us a call to find out what might be covered for your specific situation. Source

Guardian Dental coverage for Gum Grafts?

Guardian dental may cover tissue grafts like gum grafts. This is limited to a total of one graft per tooth or site, in a 36 month period. Tissue grafts are covered when the tooth is present or when dentally necessary as part of a covered surgical placement of a dental implant. Please contact your insurer to determine if your plan covers gum grafts. You can also give us a call to find out what might be covered for your specific situation. Source

Does Guardian Dental plan cover Cleaning and Tooth Fillings?

Guardian dental plans cover an estimate of 80%-100% for preventive care services including dental cleanings 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, are estimated to be 50%-80% covered. There’s either no waiting period or a 6 month waiting period depending on your 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, and 36 months if the covered person is age 19 or older. Allowance includes bonding agents, liners, bases polishing and local anesthetic.

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.

 

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