Guardian PPO Dental Insurance Exclusions, Limitations, Frequencies, and Missing Tooth Clause
Guardian PPO Dental Insurance plans make it easier for you to achieve and maintain good oral health which contributes to your overall health. Guardian PPO Dental insurance pays for a percentage of your dental treatment. Sunnyvale Dentist Dr. Antonious is a preferred provider for Guardian PPO Dental insurance. He has agreed to accept the lower Guardian PPO Dental fees for patients who have purchased or had provided for them this type of coverage.
Contained in insurance coverage booklets are plan limitations, exclusions, and sometimes a missing tooth clause. These terms can be complicated to understand but it is important to be informed of your individual insurance policy rules. The insurance professionals at Sunnyvale Dental Care will research and help you understand your insurance plan.
Frequency limitations are the number of times a patient is permitted to receive a particular covered service during a certain number of months or years. For example, dental cleanings may be permitted every six months or two times during a plan or calendar year. Limitations may also determine whether bonded tooth colored white composite fillings are paid at the same percentage everywhere in the mouth or just on anterior or front teeth. If coverage for bonded white composite fillings is limited to front teeth, patients wishing to receive them on posterior (back) teeth, instead of silver amalgam fillings would have to pay a higher out of pocket copay for this type of restoration.
Some recommended services may be excluded by your Guardian PPO Dental insurance plan when more cost effective options are available. For many insurance plans, dental implants are one example. Some services such as sealants may be excluded after a patient reaches a set age limit.
If your Guardian PPO Dental insurance contains a missing tooth clause, any tooth that was lost before the insurance coverage start date would not be covered. The full denture, partial denture, implant, or bridge needed to replace the tooth or teeth would have a 100% out of pocket cost to you.
The details of your individual Guardian PPO Dental insurance plan can be accessed by the insurance professionals at Sunnyvale Dental care. They will pay careful attention to any exclusions, limitations, and missing tooth clause contained in your plan and make you aware of them.
Sunnyvale Dentist Dr. Antonious will present to you all available treatment options and together you can select the treatment plan that is best for you.