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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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Samantha B
6/19/2019
Currently very unsatisfied with this insurance. My whole bill was submitted for review and they came back saying most of it wasn't need and they would not cover it. My dentists is currently appealing them. So far my experience with them has been awful.


R
Roberts-Pearson
6/14/2019
Guardian plans are a rip off, we pay into it guardian through our company and when ever a service is submitted by our dentist, guardian sends it to review by some supposedly dental-dentist and it gets refused. It took more than a year to get repayment from guardian which are thieves. It happens every time! We get the run around through your customer service when we call inquiring about any question as to why it is refused. Same thing happens with guardian vision. THIS IS HOW GUARDIAN INSURANCE STAYS FAT CAT RICH BY CHEATING PEOPLE!


hgghy098y
5/29/2019
Had decay on a tooth, it needed to be crowned. Dentist took Xrays of the decay. Guardian refused to cover it even after appeals by my dentist, claiming there wasn’t decay. X-ray clearly showed decay and this is after 3 separate dentists reviewed the X-rays at different practices. Garbage insurance, happy my employer replaced them.


sharrongrover78
5/15/2019
In March, I had an entire distal portion of my molar break off after eating a popcorn kernel. I went to my dentist and he took an x-ray and used an intra-oral camera to submit to Guardian. Guardian ended up paying for a 3 surface amalgam instead of the crown. I'm not sure how the dentist was supposed to completely rebuild half a tooth with amalgam, but apparently Guardian feels that would have been the better treatment option. What a joke. Now I'm responsible for almost the entire crown out of pocket.


J
jill_rapier
5/3/2019
Guardian is terrible at processing appeals. I have patiently waited weeks and weeks promised that the appeal will be processed. I completed online form, and received confirmation it was received. I called weeks later to find it had not been received although I had proof it was. I emailed in the info directly to the agent and was promised it would be rushed and processed. Weeks later, not processed or even found. I have every call reference number and emails sent. NO apologies and endless hold times! Still no decision!!


L
Linda
4/28/2019
Terrible insurance. Premiums are way too high for the services you receive. No decent dentists accept it, which means you have to go to a clinic with questionable practices. Their website shows you the bare minimum information on a claim and you can't download the EOB. My recommendation is that you find ANY other dental insurance company. You can get individual plans with other insurers that cover more and are less costly.


Michael N
4/6/2019
I have Guardian dental for the past two years and just now tried to contact them regarding a claim. They have an 800 number but you cannot zero out and speak to a live person. I tried three times and each time ended up in voicemail jail and finally hung up. I called my insurance person and he gave me the same 800 number with no alternate way to contact them.


D
Debbie R
3/27/2019
Guardian was once a fairly good company. Sadly, the past few years have proven they are one of the worst! I am an insurance coordinator at a dental office and just received a denial for one of our patients that was unacceptable or should I say unbelievable! Our patient had an open margin with recurrent MLB decay under a 15 year old crown. We sent pre-op photos & x-ray to show the open margin. We also sent pre-op photos to show the extent of the recurrent decay once the old existing crown was removed. Photos of the prep showing the amount of missing & compromised structure were included with the claim along with a photo of the BU and an x-ray of the final crown seated. A LOT of... Read More


Karen M
3/13/2019
Not happy with guardian Dental I was burned twice by the in network dentist. First one gave me a price for a crown which I had to pay for up front and then 6 months later I was sent a bill for 75.00 more because it was a cosmetic crown instead of a regular crown. I stated they gave me a price we agreed that is what it would cost and I paid for the crown they should not be able to come back six months later and ask for me to pay more. I filed a complaint with Guardian and have heard nothing back. My second incident happened when I moved and again looked up an in network dentist on the web called to verify that they were good go with and went to the dentist for my teeth cleaning and was... Read More


E
e c
3/5/2019
I have been calling Guardian for months regarding a claim from 11/29/18. Never get any concrete answers. Finally had a "supervisor" call me back and leave me a message that I was receiving $600 back ..... just got letter in the mail that I'm not. THIS COMPANY IS THE WORST!!!!



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