Page 13 - Burnham BG 2018-19 v4

HEALTH BENEFITS: TIPS HEALTH BENEFITS: DENTAL PLAN

Guardian PPO Dental Plan

The Guardian Preferred Provider Organization (PPO) Dental plan covers a wide range of dental services. You may
visit a PPO dentist and benefit from the negotiated rate or visit a non-network dentist. When you utilize a PPO
dentist, your out-of-pocket expenses will be less. You may also obtain services using a non-network dentist;
however, you will be responsible for paying the difference between the covered amount and the actual charges
and you may be responsible for filing claims.

To find in-network providers, visit www.guardiananytime.com or call 800-541-7846 (refer to the “DentalGuard
Preferred PPO” network).
Guardian PPO Dental Plan
In-Network Non-Network
Plan Provisions
Calendar Year Maximum Benefit $1,500

Annual Deductible
Individual $50 $75
Family 3 Per Family 3 Per Family
Dental Coverage
Preventive Services (Plan Pays) 100% 100%
Deductible Waived Yes No
Cleaning Frequency Once Every 6 Months

Basic Services (Plan Pays 80% 80%
Major Services (Plan Pays) 50% 50%
Orthodontia (Adult & Child) 50%; $1,500 Lifetime Maximum

Tips on Getting the Most from Your Dental Benefits

1. Dental ID cards are not required to obtain dental services.

When visiting a Guardian DentalGuard Preferred PPO dentist, simply provide your social security
number. The dental office can use that information to verify your eligibility and benefits.
2. Utilize contracted network providers when possible.
Contracted network providers have rate agreements with insurance companies for services rendered.
If you use a non-network provider, your out-of-pocket expenses will be higher and you may be subject
to balance billing.
3. Ask for a predetermination of benefits.
Ask your dentist for a predetermination if total charges are expected to exceed $300. Predetermination
enables you and your dentist to know in advance what the payment will be for any service that may be
in question.
4. Have dental checkups regularly.

Routine dental visits not only preserve your smile, but they can provide an opportunity for the early
detection of serious diseases such as diabetes.

13