Guardian Select for Families and Individuals

55440NC0220006
Low
PPO

Guardian Select for Families and Individuals is a Low PPO plan by Guardian.

Locations

Guardian Select for Families and Individuals is offered in the following counties.

Plan Overview

This is a plan overview for 2025 version of Guardian Select for Families and Individuals 55440NC0220006.
Insurer: Guardian
Network Type: PPO
Metal Type: Low
HSA Eligible?:
Plan ID: 55440NC0220006

Cost-Sharing Overview

Guardian Select for Families and Individuals offers the following cost-sharing.

Notes:

  • Some plans have separate cost-sharing for medical and drugs, while other plans offer combined cost-sharing. The cost-sharing amounts above are combined medical and drug costs unless otherwise noted.
  • You are viewing the standard version of this plan. Your costs may be lower depending on your income. Use the “get a quote” button below to see your estimated premium and out-of-pocket costs after assistance.
Ready to sign up for Guardian Select for Families and Individuals?

Click or call to enroll online, get a quote, or find out if you qualify for assistance.
Get Help from a licensed agent. 1-877-668-0904

Plan Features

Guardian Select for Families and Individuals offers the following features and referral requirements.

Wellness Program:
Disease Program:
Notice Pregnancy:
Referral Specialist:
Specialist Requiring Referral:
Plan Exclusions:
Child Only Option?: Allows Adult and Child-Only

Network Details

The following network details will help you understand what Guardian Select for Families and Individuals covers when you are out of the service area or out of the country.

Out of Country Coverage: No
Out of Country Coverage Description:
Out of Service Area Coverage: Yes
Out of Service Area Coverage Description: Coverage is provided outside of the Service Area.
National Network: Yes

Additional Benefits and Cost-Sharing

Guardian Select for Families and Individuals includes the following benefits at the cost sharing rates listed below.

Service In-Network
Copay / Coinsurance
Out-of-Network
Copay / Coinsurance
Limits and Explanation
Routine Dental Services (Adult)
Covered
Not Applicable No Charge after deductibleNot Applicable 30.00% Coinsurance after deductible An annual deductible and maximum apply to adult services.
Dental Check-Up for Children
Covered
Not Applicable No Charge after deductibleNot Applicable 10.00% Coinsurance after deductible2.0 Visit(s) per Benefit Period
Basic Dental Care – Child
Covered
Not Applicable 50.00% Coinsurance after deductibleNot Applicable 60.00% Coinsurance after deductible
Orthodontia – Child
Covered
Not Applicable 50.00%Not Applicable 70.00%
Major Dental Care – Child
Covered
Not Applicable 50.00% Coinsurance after deductibleNot Applicable 60.00% Coinsurance after deductible
Basic Dental Care – Adult
Covered
Not Applicable 40.00% Coinsurance after deductibleNot Applicable 60.00% Coinsurance after deductible An annual deductible and maximum apply to adult services. A 6-month waiting period applies to Basic Dental Care for adults.
Orthodontia – Adult
Major Dental Care – Adult
Covered
Not Applicable 50.00% Coinsurance after deductibleNot Applicable 70.00% Coinsurance after deductible An annual deductible and maximum apply to adult services. A 12-month waiting period applies to Major Dental Care for adults.
Accidental Dental

Free Preventive Services

There is no copayment or coinsurance for any of the following Guardian Select for Families and Individuals preventive services. This is true even if you haven’t met your yearly deductible.

Please note, these services are free only when delivered by a doctor or other provider in your plan’s network.

Additional Resources

Below are additional resources for Guardian Select for Families and Individuals including the Summary of Benefits & Coverage (SBC), plan brochure, formulary link, and a link to the website to pay your monthly premium after you enroll.

Summary of Benefits: Summary of Benefits Link
Plan Brochure: Plan Brochure Link
Formulary: Formulary Link
Premium Payment Website: Premium Payment Link
Ready to sign up for Guardian Select for Families and Individuals?

Click or call to enroll online, get a quote, or find out if you qualify for assistance.
Get Help from a licensed agent. 1-877-668-0904

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