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Guardian Essentials for Families and Individuals
Healthcare.gov Individual Dental Plan Finder
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Guardian Essentials for Families and Individuals

Overview
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Guardian Essentials for Families and Individuals is an individual dental health plan issued by The Guardian Life Insurance Company and is available for the year 2019. This dental plan is offered by the federal government through HealthCare.gov and the Affordable Care Act (ACA).

Do I Need to Buy a Dental Plan?

Some but not all health plans offer dental coverage. If your health plan does not include dental coverage, you can purchase a stand-alone dental plan.

However, you cannot buy a dental plan from the government healthcare marketplace, unless you are also buying a health plan at the same time.

Where Do I Need to Live to Quality for this Plan?

This plan is available for qualifying individuals who live in Knox county, Illinois.

What Type of Dental Plan Is This?

This plan is a PPO plan, which is also known as a "Preferred Provider Organization." In this type of insurance plan, you can choose to receive care from doctors, hospitals, and other providers who are in-network or out-of-network. You pay less if you use in-network providers. In a PPO plan, you can visit any doctor without getting a referral.

This is a lower premium, higher copay and deductible plan. This means you pay less every month, but you will pay more when you use dental services. This plan is better for those who plan to use a lot of dental services.

Where Can I Buy This Plan?

You can purchase this plan at HealthCare.gov.

About
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Issuer
The Guardian Life Insurance Company
Plan ID
85099IL0210001
Coverage area
Knox County, Illinois
Phone
Local Phone: 1-844-561-5600
Toll-Free: 1-844-561-5600
TTY:
Plan type
PPO
Coverage type
Low
Child only option
Allows Adult and Child-Only
Deductible
$75
Out-of-Pocket Maximum
$350
Coverage
Adult Dental Coverage
Child Dental Coverage
Deductible
Dental Deductible (Individual) $75
Dental Maximum Out of Pocket (Individual) $350
Dental Deductible (Family) See Plan Brochure
Dental Maximum Out of Pocket (Family) $700
Routine Dental Services (Adult) No Charge after Deductible
Basic Dental Care (Adult) 50% Coinsurance after deductible
Major Dental Care (Adult) 50% Coinsurance after deductible
Adult Orthodontics Not Covered
Dental Check-Up for Children No Charge after Deductible
Basic Dental Care (Child) 50% Coinsurance after deductible
Major Dental Care (Child) 50% Coinsurance after deductible
Orthodontia (Child) 50%
Premium Rates
Premium Child Age 0-14 21
Preimum Child Age 18 21
Premium Adult Individual Age 21 20
Premium Adult Individual Age 27 20
Premium Adult Individual Age 30 20
Premium Adult Individual Age 40 20
Premium Adult Individual Age 50 20
Premium Adult Individual Age 60 20
Premium Couple 21 41
Premium Couple 30 41
Premium Couple 40 41
Premium Couple 50 41
Premium Couple 60 41
Couple+1 child, Age 21 62
Couple+1 child, Age 30 62
Couple+1 child, Age 40 62
Couple+1 child, Age 50 62
Couple+2 children, Age 21 84
Couple+2 children, Age 30 84
Couple+2 children, Age 40 84
Couple+2 children, Age 50 84
Couple+3 or more Children, Age 21 105
Couple+3 or more Children, Age 30 105
Couple+3 or more Children, Age 40 105
Couple+3 or more Children, Age 50 105
Individual+1 child, Age 21 42
Individual+1 child, Age 30 42
Individual+1 child, Age 40 42
Individual+1 child, Age 50 42
Individual+2 children, Age 21 63
Individual+2 children, Age 30 63
Individual+2 children, Age 40 63
Individual+2 children, Age 50 63
Individual+3 or more children, Age 21 84
Individual+3 or more children, Age 30 84
Individual+3 or more children, Age 40 84
Individual+3 or more children, Age 50 84
Reference
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  • HealthCare.gov. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/
  • What You Should Know about Provider Networks. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://marketplace.cms.gov/outreach-and-education/what-you-should-know-provider-networks.pdf
  • Dental coverage in the Marketplace. U.S. Centers for Medicare & Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/coverage/dental-coverage/