Does my Dental plan cover Orthodontics?

Bob Gearhart Jr.
Bob Gearhart Jr.
  • Updated

You can verify if your plan has Orthodontic coverage by following these steps in Guardian Anytime.

  1. From the menu options, select Benefits and then Overview.

  2. In the coverage column, click on the Dental hyperlink.

  3. If your plan has Orthodontic coverage it will display on this page.

Example

My Benefits tab listing the orthodontic coverage

Terms and definitions are provided below.

 

Terms

Definitions

Orthodontic Coverage                 

The benefit percentage applied to covered services

Orthodontic Deductible

Your financial responsibility before the orthodontic coverage is applied; Unless otherwise noted, this deductible is separate from the deductible applied to Preventative, Basic, and/or Major services.

Individual Lifetime Ortho Max

The maximum benefit the plan will pay

Orthodontics Age Limit

Age 19:

  • Orthodontics are covered on dependent children up to the age of 19; their teeth must be banded prior to their 19th birthday.

  • For dependent children banded prior to their 19th birthday and remaining covered under the plan, payments will continue beyond age 19 until the lifetime maximum is reached, they are no longer eligible, or their treatment ends.

  • Any treatment, or additional stage of treatment, that starts after age 19 is not covered.

Age 99:

  • Orthodontics are a covered benefit for all eligible members and dependents.  

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