What you need to know
Here’s a reason to show off those pearly whites: You have two dental plans to choose from, both through Guardian. The main difference between the Base and Buy-Up plan is that the Buy-Up plan covers—brace yourself!—orthodontia. Both plans allow you to visit any dentist you like, but you’ll save money when you use a DentalGuard Preferred Network provider.
Highlights
- The Base plan is free for you and your dependents, and covers preventive care, including regular checkups, as well as fillings, bridges, crowns and other dental services (orthodontia not covered).
- You can elect the Buy-Up plan, which covers the same services as the Base plan plus orthodontia. The Buy-Up plan features a higher annual benefit maximum and covers certain services (cleanings; crown, denture and bridge replacements) more often.
- With both plans, you must first meet the annual deductible before services are covered (except preventive care).
- Both plans cover in-network services (providers accept Guardian’s benefits as payment in full) and out-of-network services (you’ll be responsible for what a provider charges above what Guardian reimburses them).
Need another reason to smile? Both plans will roll over a portion of your unused annual maximum into a special account that you can use in future years. Each enrolled family member is eligible for the rollover.
Dental plans at a glance
| Base | Buy-Up | |
|---|---|---|
| Individual deductible | $50 | $50 |
| Family deductible | $150 | $150 |
| Annual maximum benefit (excludes orthodontia) | $1,500 per person | $2,500 per person |
| Preventive and diagnostic care | $0 | $0 |
| Basic care (fillings, space maintainers, sealants, extractions, oral surgery, endodontics, periodontics, emergency exams) | In-network: You pay 10% after deductible Out-of-network: You pay 20% after deductible (UCR)* | In-network: You pay 10% after deductible Out-of-network: You pay 20% after deductible (UCR)* |
| Major care (inlays, onlays, crowns, bridgework, dentures, repairs, implants, occlusal guards) | In-network: You pay 40% after deductible Out-of-network: You pay 50% after deductible (UCR)* | In-network: You pay 40% after deductible Out-of-network: You pay 50% after deductible (UCR)* |
| Orthodontia** | Not covered | 50%, lifetime maximum of $2,500 |
* The amount the plan pays for out-of-network care is based on what the customary and reasonable amount for the service is in the geographical area. You’ll be responsible for what a provider charges above what Guardian reimburses them.
** 24-month treatment fee. Additional fees will apply for pre-orth visits and treatment, records and retention, and banding.
Please refer to the plan and policy documents for additional details on the plans, including exclusions, limitations and eligibility.