Not all school districts offer the NY44 Health Benefits Trust dental plan. If you are unsure whether you have this plan please ask your benefits administrator.
Guardian will bring access to a larger selection of in-network dentists along with new value-added benefits, all while keeping the same great dental plan that you are used to having.
FINDING AN IN-NETWORK PROVIDER IS EASY!
Guardian has a large provider network–so chances are your dentist is already part of the Guardian network. You can check to see if your dentist participates or to find a dentist near you by visiting the Guardian website HERE.
You and your covered members will have access to Guardian’s Value Added benefits such as:
• Annual Maximum Rollover Benefit
• byte at-home orthodontic treatment
Best Dental Plans For Savings
Resources
Coverage
For schools covered by this insurance, the Plan pays 100% of the cost of many dental services when the services are provided by an in-network provider. The Plan pays up to an annual maximum amount.
Resources
Contact your district’s Benefits Administrator if you want to confirm your school’s participation in the Dental Plan.
Click Here to find an in-network dental service provider with Guardian
Guardian Pre-Determination
If your services will be exceeding $300 or more, we strongly suggest you ask your provider to request a pre-determination through Guardian. This will tell you, as well as the provider, if the service is covered or not and what out-of-pocket amount (such as a copayment) will be owed.
In-Network Providers
Your plan is geared for in-network providers. At time of service, even If you checked the website or PPO list, please ask at the provider’s office if they are participating with our Guardian PPO Plan. Please don’t ask them if they “take” it. They all “take” our insurance, but you may be left with a large out-of-pocket expense if they are not in-network. When you go to an in-network provider, you may only pay a copay and no other out-of-pocket costs. You will only pay out-of-pocket costs if a service is ineligible, meaning not covered under your plan, or if you have already reached the maximum benefit for the plan year.
Referrals to Other Providers
Check the locations of your providers and if they do participate with Guardian’s PPO dental network. Should your provider recommend someone to do a root canal, oral surgery or orthodontics, they may not realize the kind of plan you have, so verify the name of the provider they may be referring you to, so that you can confirm they participate in your plan.
