Please be aware that most participating Delta dentists are located in New York and New Jersey. Information on dentists participating with the HMO is available from Delta on their website (Select network for DeltaCare USA) or by phone (1-80). The HMO program is sponsored by Delta Dental and called DeltaCare USA. There is no annual or lifetime limit on services.Įnrollment in the Delta program is available each year and coincides with the City-wide open enrollment period. Unlike traditional insurance, there are no claims to complete or reimbursement to await. Members will pay for dental services in accordance with a copay schedule that Delta has negotiated with the dentists. (Once enrolled, you have the opportunity to switch to another participating Delta dentist by calling 80.) That dentist will be responsible for all dental care including referral to specialists as necessary. DeltaCare USA will assign a primary care dentist for members upon enrollment. This is a dental Health Maintenance Organization. There are also procedural limitations by frequency or age. Treatment exclusions often involve technical matters. Box 981572 El Paso, TX 79998-1572 What is not covered by my Guardian Dental Plan?Ĭoverage is not provided for certain types of care. Guardian Forms have the mailing address on them. How do I file an out-of-network dental claim?Ĭlaim forms are available on the Forms page or from participating providers, by mail from Guardian and through the Guardian Website. Forms are available at participating dentist offices or from Guardian. Access forms and materials related to your coverageĮach plan participant is entitled to be informed by Guardian of the total cost, plan reimbursement and out-of-pocket costs associated with a course of dental treatment.Check status of evidence of insurability.Find dental cost estimates and educational information.View EOB for all of your dental services.Submit claims and track status including receiving email alerts when dental claims are paid. Services available to you on Guardian Anytime Create a username and password, click Submit, and you’re done.Īlready registered? Log in to your account anytime.Fill in your member information and Group ID Number, 381084.Please note, for Dependent User Role registration, you will need the Member’s Group ID Number, 381084, and Social Security Number. Go to the self-registration page and choose Member as your User Role.In addition, the explanation of benefits (EOB) on dental claims will now be delivered electronically using Guardian Anytime. In response to the coronavirus, Guardian is working to minimize service disruption that could include longer wait times and delays. Guardian will no longer issue EOBs by U.S. For Guardian EOBs You Must Register Online Information on participating dentists is available from Guardian on their website or by phone (1-80).įrequency Limits: Standard prophylactic care (cleaning and necessary x-rays) is covered once every four months. The provider panel maintained by Guardian Life is Dental Guard Preferred. Also, non-participating dentists are not eligible for the higher Welfare Fund rate paid to participating dentists. Plan participants may use any licensed dentist to provide services, although non-participating dentists are not required to charge the reduced fees, thereby reducing the value of the benefit. There are no annual or lifetime maximum payment limitations. A higher Welfare Fund rate paid to participating dentists (according to the Guardian Fee Schedule)īenefits include most standard dental procedures.Access to a panel of dental providers who charge reduced fees.This is a “preferred provider” (PPO) program with two components:
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