Page 12 - Draken Intl. 2022 OE Flipbook

Dental Plan

It’s important to have regular dental exams and cleanings so problems are detected before they become painful — and
expensive. Keeping your teeth and gums clean and healthy will help prevent most tooth decay and is an important part of
maintaining your overall health. We offer a dental plan through Guardian.

Guardian Dental PPO Plan
Plan Provisions In-Network Out-of-Network
Annual Deductible $50/$150 $50/$150
(Individual/Family)
Calendar Year Maximum $2,000 $2,000
Orthodontia Lifetime Maximum Up to $1,500 maximum per lifetime
Diagnostic and Preventive Services Covered 100% Covered 100%
(e.g., X-rays, clean ngs, exams) (deductible waived) (deductible waived)
i
Basic and Restorative Services 80%* 80%*
(e.g., fillings)

Major Services 50%* 50%*
(e.g., dentures, crowns, bridges)
Orthodontia 50%* for children and adults
*After deductible

Using in-network dental providers
With the PPO plan, you can visit any dentist; but you pay less out-of-pocket when you choose an in-network participating
PPO dentist. Out-of-network benefits are limited to Guardian’s PPO fee schedule. Your PPO plan is part of the DentalGuard
Preferred network. Dependents are covered until age 26.

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