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Guardian Direct® Dental Insurance Review


ConsumersAdvocate.org Rating: 4.9 / 5 (Excellent)
159 Customer Comments & Reviews - see all comments
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Guardian Direct is a division of Guardian Life Insurance Company of America, which is among the largest mutual insurance companies in the nation. Founded in 1860 and headquartered in New York, Guardian offers a wide array of products, including dental insurance. Guardian employs numerous agents across the country and holds a superior rating with the BBB and excellent ratings for financial stability.

Guardian Direct® Dental Insurance - Overview

Guardian Direct's dental insurance is part of a series of comprehensive individual insurance products offered on guardiandirect.com, including accident, critical illness, vision and pet insurance. 

Guardian Direct dental insurance plans can cover regular exams, cleanings, x-rays, root canals, crowns, implants, and braces. Consumers can choose from a number of Preferred Provider Organization (PPO) plans or a Dental Health Maintenance Organization (DHMO) plan based on their needs, budget, and state.  


 

Qualification

Consumers interested in dental insurance from Guardian Direct can enroll immediately through their fast, safe and secure website guardiandirect.com.  Guardiandirect.com also provides a provider lookup to help find a dentist in the Guardian network or confirm their existing dentist is a part of the network. 

After providing their zip code, applicants are shown the plans that are available for them in their area.  To purchase, they need only enter who needs to be covered, home address, phone number, gender, birthdate and email address along with a valid form of payment.  


Plans

Through Guardian Direct, consumers have access to three tiers of PPO dental insurance plans. The first, Bronze, is for people who are only expecting to get cleanings and the occasional filling. The second, Silver, works best for those who anticipate needing dental work beyond the occasional filling. And the third, Gold, is best suited for people who want the maximum amount of coverage possible. In the states of FL, IL, NY, and TX, DHMO plans are also available. The PPO plan tiers' offering is as follows:

Coverage

Preventive services include the most routine dental services, such as oral exams, cleanings, and X-rays.

Basic services include dental services, such as fillings and simple extractions.

Major services include more complex dental services such as crowns, oral surgery, and implants.

 

GUARDIAN DIRECT PAYS

PLAN BENEFITS

GOLD ADVANTAGE

SILVER ADVANTAGE

BRONZE ADVANTAGE

Preventive Services

100%, No Waiting Period

80%, No Waiting Period

100%, No Waiting Period

Basic Services

70%, After 6 Month Waiting Period

50%, After 6 Month Waiting Period

50%, After 6 Month Waiting Period 

Major Services

50%, After 12 Month Waiting Period

50%, After 12 Month Waiting Period 

0% (Not Covered)

Implants

50%, After 12 Month Waiting Period

50%, After 12 Month Waiting Period

0% (Not Covered)

Child (under 19) Orthodontia

50%, After 12 Month Waiting Period

0% (Not Covered)

0% (Not Covered) 

DEDUCTIBLES

 

 

 

Preventive Services

$0 In-Network

$50 Out-of-Network

$0 In-Network

$50 Out-of-Network

$0 In-Network

$50 Out-of-Network

All Other Dental Services 

$50

$50

$50

MAXIMUM PAYOUTS

 

 

 

Total Benefit Maximum

1st Year Max: $500

2nd Year Max: $750

3rd Year Max: $1,000

4th Year & Beyond Max: $1,500

1st Year Max: $500

2nd Year Max: $750

3rd Year Max: $1,000

4th Year & Beyond Max: $1,000

1st Year Max: $1,000

2nd Year Max: $1,250

3rd Year Max: $1,500

4th Year & Beyond Max: $1,000

Implant Maximum

Lifetime Max: $1,000

Lifetime Max: $700

Not Covered

Child (under 19) Orthodontia Maximum

Yearly Max: $500

Lifetime Max: $1,000

Yearly Max: $500

Lifetime Max: $1,000

Not Covered

Dental Insurance at Guardian Direct

Guardian Direct's easy online enrollment process, comprehensive plan breakdown, and supplementary research material all make for a solid choice of dental insurance. After consumers answer a few questions designed to determine which plans best suit them, they can begin the enrollment process. Since Guardian Direct is highly rated by the BBB, consumers should have confidence that the company can meet their dental insurance needs.


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159 Customer Comments & Reviews

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M
Mark
9/6/2018
Worst coverage plan I've ever been a part of. Seems to have a scenario for every reason not to pay on a claim. Weasels.


K
Kathleen o
8/23/2018
I have been with guardian with my company for so many years, I can't remember. I recently changed to policy on my own, due to possible retirement. Waiting period was waved. I have nothing but problems since 2017. Still has not paid on tooth no. 30, crown was gold, early 1970, was replaced. Still no payment, I still have the gold for proof. Since January of 2018, wAiting on approval of 28 & 29. Crowns were put in the 1990's. I can't tell you how many X-rays I have had done. They denied, need submission of diagnostic quality X-rays. Submitttted X-rays are not diagnostic, therefore the plan is unable to approve this procedure. Please submit with diagnostic quality X-rays.... Read More


N
Nicole
7/25/2018
Guardian has not paid out my reimbursement in full. They have only paid me for a portion of the reimbursement and it has been extremely difficult to receive the rest of the money. I got the dental treatment done in February and paid the dentist in FULL and it is now July 25th, still waiting for the rest of my reimbursement. When I filed the claim, the ADA form clearly said "the patient paid in full" and therefore all benefits should have been sent to me (the patient). Guardian ignored this instruction and sent the check to the wrong party. Then they refused to write me a new check even though they failed to follow directions. This delayed my partial reimbursement until end of April.... Read More


Analeise M
7/13/2018
My review is the same as all the reviews below, horrible experience and delays after delays. I have been attempting to process a claim for dental work only to be given the runaround. Requests for the same documents 4 times. I have also spoken to a rep twice to provide this information over the phone. It appears this company is not able to process claim information, by fax, their dashboard or phone, leading me to wonder where my information is going. The best part of this all is that they do not have a complaints department and will not let you escalate or speak to a manager. This is a horrible dental provider and should not be in the business of insurance if they do not intend to actually... Read More


C
Clint
5/30/2018
Sorry excuse for dental care insurance. I upgraded my coverage to their 'High Plan' with the belief that would help ensure reasonable coverage for any issues I might have. I have since discovered that GDI actively works to deny claims, in full or partial, in an apparent effort of cut costs on their side. You are then required to work through a poor automated phone service to access customer service only to be given hoop after hoop to gain reconsideration. It is an unreasonable burden on the patient/planholder and their medical/dental provider to have to spend so much time justifying and rejustifying only to be pushed back the appeals process again. Make no mistake, this is not good... Read More


R
rey
5/16/2018
I signed up for dental insurance at the beginning of 2018 (Guardian Advantage PPO Silver) and went to the dentist and got a deep cleaning of my entire mouth. When reaching out to guardian to follow up on my claim after the work was completed, I was told that a deep cleaning is different from a regular cleaning. A regular cleaning is considered as preventive work but a deep cleaning is considered major dental work and is not covered under my policy until after being enrolled for one entire year. I don't know how they get away with this, I opted for a deep cleaning as preventive measure, I do not have any cavities and i don't understand the difference between a deep cleaning and regular... Read More


B
Bruce B
5/12/2018
I've submitted two claims. I've submitted the paperwork for both claims twice. The first claim was denied because they sent additional paperwork, which was completed and returned not once, but twice. They state they've never received the additional paperwork. The paperwork for the second claim was submitted twice, each time separated by one month. Two months later, they have yet to acknowledge it. I'm cancelling our coverage. The choice of participating dentists in our area is not very good.


M
Maureen
4/25/2018
I find it extremely hard to believe that this is a 'Top rated" insurance company. After having to deal with them over the last 2 months, I feel the need to warn people, if they are given a choice. Understandably, you have to go with the insurance offered by your company. I have spent over 2 hours on 4 separate calls to give them the information they keep telling my Dr they need. They claim that I am the only one who can give them this information, not the Dr. office. I have called numerous times to give them this information, each time they say they do not need it & do not know why the Dr. tells me this. During this time I also received a letter from Guardian asking for this same... Read More


D
DJ
3/23/2018
Unfortunately I've had bad experience with GDI but thing are getting better. One example is trying to get a replacement bridge approved. My Dentist sent 2 requests with x-rays to Guardian and did not receive any response. I took the reins and called Guardian one day. The rep told me there was no record of for a bridge replacement. She but me on hold, got back to me and said the request was waiting approval. I replied, "I thought your records showed not requests." She said it was seen further down the document she was reading and Guardian would call me back in two hours to let me know the results. Yes, guessed it, I did not receive a telephone call. I called back the next day, got the... Read More


R
Ripped c
3/16/2018
Dont ever take this insurance. Lot of dental providers within their network refuse to accept them initially. Their co-pays are so high that I was able to get cash price (w/o insurance) on almost all their services equal to their total co-pay. So why should we get their insurance. So effectively, I have gotten my dental care done with cash without insurance. I just keep paying their premium. Just cancelled their insurance. The biggest gotcha....they keep deducting your monthly premium silently. They said and and so did marketplace, that if you dont pay next premium due, the insurance will cancel automatically. I used a debit card to pay their one month premium for one month without... Read More



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