Exchange Commission Schedule rev 921

Claims & Predeterminations

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Covered Benefit

Major Services

Orthodontic Services

Preventive Care

Restorative Services

Benefits Dates & Co-insurance

Member Benefits and Eligibility

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Dental Benefits

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Remember! To use your dental coverage, you must select a Primary Care Dentist (PCD).

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Search by keyword and topic on the Guardian Marketplace Exchange website. Find answers and content to meet your dental insurance coverage needs.

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Once registered, a Member can access information about Eligibility, Benefit Details, Claims, Notice of Authorization, Forms, Grievance forms and can print or request copies of ID Cards.

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The maximum payment your dental plan will make within a given time period. Some plans have no maximum. Some maximums apply to the lifetime of the benefit plan; others apply to a particular time period (calendar year, benefit year, etc.) or to particular services (such as a separate maximum for orthodontic benefits).

The total amount (usually expressed as an annual figure) enrollees must pay toward treatment before their health benefits are paid. The deductible plus the copayment and amount over the annual maximum are often referred to as the enrollee’s out-of-pocket costs. Under Delta Dental benefit plans, diagnostic and preventive services are often exempt from a deductible.

The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance for in-network care and services, your health plan pays 100% of the costs of covered benefits.

Services related to misaligned teeth and/or jaws.

A request for verification of benefits before rendering services.

The remaining payment your your dental plan will make within a given time period.

The remaining amount you have to pay in order to reach your maximum out of pocket expense for covered services.

Basic services (fillings) and diagnostic services.

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Find a Guardian dental insurance plan in your state. We offer plans directly or through the healthcare marketplace that fit your budget and coverage needs.

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Get answers to Frequently Asked Questions (FAQs) at Guardian for your dental insurance needs. We provide answers for individuals, families, agents, brokers and dental practice providers to commonly asked questions.

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Get Great Dental Coverage On The Exchange - Guardian Exchange

2022 PPO Wisconsin Select for Families and Individuals

2022 PPO Wisconsin Essentials for Families and Individuals

2022 PPO Wisconsin Basics for Families and Individuals

2022 PPO Wisconsin Preventive Plus for Families and Individuals

2022 PPO Virginia Select for Families and Individuals

2022 PPO Virginia Essentials for Families and Individuals

2022 PPO Virginia Basics for Families and Individuals

2022 PPO Virginia Preventive Plus for Families and Individuals

2022 PPO Utah Choice for Families and Individuals

2022 PPO Utah Essentials for Families and Individuals

2022 PPO Utah Preventive Plus for Families and Individuals

2022 DHMO Texas Managed DentalGuard

2022 PPO Texas Choice for Families and Individuals

2022 PPO Texas Essentials for Families and Individuals

2022 PPO Texas Basics for Families and Individuals

2022 PPO Texas Preventive Plus for Families and Individuals

2022 PPO Tennessee Select for Families and Individuals

2022 PPO Tennessee Essentials for Families and Individuals

2022 PPO Tennessee Basics for Families and Individuals

2022 PPO Tennessee Preventive Plus for Families and Individuals

2022 PPO South Carolina Select for Families and Individuals

2022 PPO South Carolina Essentials for Families and Individuals

2022 PPO South Carolina Basics for Families and Individuals

2022 PPO South Carolina Preventive Plus for Families and Individuals

2022 PPO Pennsylvania  Select for Families and Individuals

2022 PPO Pennsylvania  Essentials for Families and Individuals

2022 PPO Pennsylvania  Basics for Families and Individuals

2022 PPO Pennsylvania  Preventive Plus for Families and Individuals

2022 PPO Oklahoma Select for Families and Individuals

2022 PPO Oklahoma Essentials for Families and Individuals

2022 PPO Oklahoma Basics for Families and Individuals

2022 PPO Oklahoma Preventive Plus for Families and Individuals

2022 PPO Ohio Select for Families and Individuals

2022 PPO Ohio Essentials for Families and Individuals

2022 PPO Ohio Basics for Families and Individuals

2022 PPO Ohio Preventive Plus for Families and Individuals

2022 PPO North Carolina Select for Families and Individuals

2022 PPO North Carolina Essentials for Families and Individuals

2022 PPO North Carolina Preventive Plus for Families and Individuals

2022 PPO North Carolina Basics for Families and Individuals

2022 DHMO New York Managed DentalGuard Child Essentials

2022 DHMO New York Managed DentalGuard Family Plan

2022 PPO New York Pediatric Essentials

2022 PPO New York Family Essentials

2022 PPO New York Basics for Families and Individuals

2022 PPO New York Preventive Plus for Families and Individuals

2022 PPO New Jersey Preferred for Families and Individuals

2022 PPO New Jersey Select for Families and Individuals

2022 PPO New Jersey Essentials for Families and Individuals

2022 PPO New Jersey Basics for Families and Individuals

2022 PPO New Jersey Preventive Plus for Families and Individuals

2022 PPO Nebraska Select for Families and Individuals

2022 PPO Nebraska Essentials for Families and Individuals

2022 PPO Nebraska Basics for Families and Individuals

2022 PPO Nebraska Preventive Plus for Families and Individuals

2022 PPO Missouri Essentials for Families and Individuals

2022 PPO Missouri Basics for Families and Individuals

2022 PPO Missouri Preventive Plus for Families and Individuals

2022 PPO Mississippi Essentials for Families and Individuals

2022 PPO Mississippi Basics for Families and Individuals

2022 PPO Mississippi Preventive Plus for Families and Individuals

2022 PPO Michigan Select for Families and Individuals

2022 PPO Michigan Essentials for Families and Individuals

2022 PPO Michigan Preventive Plus for Families and Individuals

2022 PPO Louisiana Essentials for Families and Individuals

2022 PPO Louisiana Basics for Families and Individuals

2022 PPO Louisiana Preventive Plus for Families and Individuals

2022 PPO Kansas Select for Families and Individuals

2022 PPO Kansas Essentials for Families and Individuals

2022 PPO Kansas Basics for Families and Individuals

2022 PPO Kansas Preventive Plus for Families and Individuals

2022 PPO Indiana Select for Families and Individuals

2022 PPO Indiana Essentials for Families and Individuals

2022 PPO Indiana Basics for Families and Individuals

2022 PPO Indiana Preventive Plus for Families and Individuals

2022 DHMO Illinois Managed DentalGuard 

2022 PPO Illinois Select for Families and Individuals

2022 PPO Illinois Essentials for Families and Individuals

2022 PPO Illinois Basics for Families and Individuals

2022 PPO Illinois Preventive Plus for Families and Individuals

2022 PPO Georgia Essentials for Families and Individuals

2022 PPO Georgia Basics for Families and Individuals

2022 PPO Georgia Preventive Plus for Families and Individuals

2022 PPO Florida Select for Families and Individuals

2022 PPO Florida Essentials for Families and Individuals

2022 PPO Florida Basics for Families and Individuals

2022 PPO Florida Preventive Plus for Families and Individuals

2022 PPO Arizona Choice for Families and Individuals

2022 PPO Arizona Essentials for Families and Individuals

2022 PPO Arizona Basics for Families and Individuals

2022 PPO Arizona Preventive Plus for Families and Individuals

2022 PPO Alabama Essentials for Families and Individuals

2022 PPO Alabama Basics for Families and Individuals

2022 PPO Alabama Preventive Plus for Families and Individuals

2022 DHMO Florida Managed DentalGuard

undefined PPO Texas Choice for Families and Individuals

undefined PPO New Jersey Preferred for Families and Individuals

undefined PPO Oklahoma Select for Families and Individuals

undefined PPO Arizona Choice for Families and Individuals

undefined PPO Wisconsin Basics for Families and Individuals

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