Guardian dental insurance ppo coverage
As a member, you can view your PPO Dental benefits by following these steps in Guardian Anytime .
- From the menu options, select Benefits and then Overview to view your enrolled benefits. Note: If a message displays requesting you to call, the benefits are not available in Guardian Anytime. Call the number mentioned in the message for benefits.
- Locate the Coverage column and click the Dental hyperlink. The View Benefits - Dental Eligibility page displays the following sections.
- Effective Dates of Coverage (by Service Category). If an effective date is not listed for a service, the service is not covered.
- Plan Information
- Coverage Information for Preventative, Basic, Major, TMJ and Cosmetic services.
- Accumulator and Deductible Summary
- Max Rollover Summary (If your plan does not have this feature, this section won’t display.)
- Orthodontic (If your plan does not have Orthodontic coverage, this section won’t display.)
Benefit Detail Descriptions Field | Description |
Deductible Waived | Indicates if the deductible is waived for this type of service. |
Last Eligible Service | The last time you had this service. (It can be used to calculate your eligibility for frequently used services.) |
Individual Deductible | The amount you must pay on your claims before your coverage percentage is applied. (Refer to your Certificate Booklet for your plan's frequency.) |
Individual Dental max | The maximum Guardian will pay in a calendar/policy year, per person. |
Maximum Met to Date for Benefit Period | The amount of the Individual Dental max you have used to date. |
Deductible Met to Date for Benefit Period | The amount of the Individual Deducible you have satisfied. |
Note: For more information regarding plan limitations and exclusions, review your certificate booklet. For instructions, refer to How do I find my certificate booklet?
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