Guardian Life Dental Benefits

There is an annual deductible of $50.00 per calendar year for single coverage, and two individual deductibles for family coverage.

There are three payments levels, as listed below:

• Preventive services (exams, cleanings, fluoride treatments, x-rays, etc.)
  • 100% of the Usual Customary (U C) fee
• Primary services (fillings, extractions, oral surgery, etc.)
  • 80% of the U C fee
• Major services (Inlays, Onlays, Crowns, bridgework, dentures, etc.)
  • 50% of the U C fee

The annual maximum benefit is $1500.00

Orthodontic Services

• Benefit is 50% of the U C fee with a lifetime maximum of $1000.00

Pre-Treatment Review

When the cost of a proposed course of treatment is expected to exceed $300, ask your dentist to submit a treatment plan to guardian which includes the services to be done and the cost of each service. Guardian will review the treatment plan and send you and the dentist an estimate of what we will pay. Emergency treatment, oral exams, x-rays, and cleanings can be performed before the treatment plan is submitted.

Please refer to your employee benefits handbook for a more detailed description of benefits or check this web site: http://www.GuardianLife.com