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Guardian Direct® Dental Insurance Review


ConsumersAdvocate.org Rating: 4.9 / 5 (Excellent)
157 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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157 Customer Comments & Reviews

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Lee S
1/28/2019
Guardian dental appears to be a scam. I cracked a tooth and was in severe pain. My dentist had to put on a crown because the crack split my tooth to the root. Guardian paid a licensed doctor to state it could have been repaired with a filling. This too had no decay whatsoever. I bit down hard on a piece of bone or something. They denied the dentist resumbitted all requested documentation as well as a letter detailing the situation and it was denied again. I called and when the person helping couldn’t explain the denial, he just flat out hung up the phone. I wouldn’t recommend any guardian offerings to anybody. They are not a good faith company, they are a scam.


Danielly A
1/2/2019
My dentist & I have submitted and got rejected to cover the cost of my crown 2 times! Now one year later, the health of the teeth next to the culprit is now degrading. I have yet to see Guardian live up to their name. It's debilitating and embarrassing to know that my insurance carrier is the bain of my existence. I can't wait for this god awful review to meet their eyes. Let's see what more insult they can do for me.


James G
12/26/2018
I was issued a new debit card and after 5 days of non-payment Guardian cancelled my policy with absolutely zero attempts to contact me and let me know that they hadn't received any payment. I automate everything for the exact reason that I don't have to obsess over all of it all the time so I didn't find out until recently, tried to pay and get everything squared away, only to find out I no longer have dental insurance two days before I have an appointment for some fillings/crowns. This is an absolutely disgusting way to do business.


Nicole M
12/4/2018
Guardian denied to pay my claim for a periodontal gum surgery after they said they would pay 70%. They essentially said that my surgery was unnecessary after I was on antibiotics for weeks while waiting for the surgery. Terrible insurance company that will not stick to their word nor reimburse you.


C
Caitlin
11/8/2018
I would give this company 0 stars if it would let me. I'm in the process of dealing with a claim that they are refusing to pay ANYTHING of. It was a deep cleaning that I was told (and my dentist verified) it would be covered. When I got my EOB and saw they denied it, I submitted an appeal. My dentist sent this in TWICE (tried 3 different ways both time: online, faxed, and mailed) and Guardian says they never received it. So I uploaded the narrative myself online and then they magically got it. Took them 28 days to evaluate my appeal only for them to deny me AGAIN. Apparently, my deep cleaning wasn't deemed necessary even when I have 30% bone loss (and sent in the proof) LOL. I told them... Read More


H
Harry D
11/7/2018
Guardian dental insurance coverage is horrible. I enrolled in a PPO plan advertising availabity to see any provider. Only to find if your provider is out of network they pay nothing. Not even what they would pay an in network provider. Very limited provider network. The wait period for basic service is ridiculous. Six months for a newly discovered cavity. There plan literature is purposely obfuscating. There customer service is an exercise in frustration. Better to self pay then pay them, then again for services rendered. Absolutely worse dental plan I have ever had.


L
Lauren
9/16/2018
"Preventive services include the most routine dental services, such as oral exams, cleanings, and x-rays." This is a blatant lie. You list it under preventive services and then insert a note in the coverage information claiming it's Basic so you can stick the patient with the deductible plus added percentage you won't cover. SCAM. "X-Rays RADIOGRAPHIC IMAGES (X-RAYS) ARE CONSIDERED A BASIC CATEGORY SERVICE. BITEWING RADIOGRAPHIC IMAGES ARE LIMITED TO EITHER A MAXIMUM OF 4 FILMS OR A SET OF VERTICAL BITEWINGS, IN ONE VISIT, IN ANY 12 CONSECUTIVE MONTH PERIOD. FULL MOUTH SERIES OR PANORAMIC FILMS ARE COVERED ONCE IN ANY 60 CONSECUTIVE MONTH PERIOD. "


C
carmen
9/13/2018
Carmen I had done a tooth cap end of 2017 for which Guardian did not pay a dime since there were no more money available for that year. So I paid entirely myself 2500$ for the cap. Unfortunately the cap was too short and was impossible to eat on that side so I went to different dentist to re- do the cap. Guardian is refusing to pay for the cap this time because they said it is a replacement of the cap done last year and for which they recognize they did not pay anyway also. Customer service is poor, indifferent and bored to listen to your problem. Hard to give even a star to this rapacious organization.


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



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