DENTAL

Guardian	In-Network	Non-Network Provider
Annual Deductible	$50 per person $150 per family
Preventive Care Exams and Cleanings (once every 6 months) X-rays	100%	100%
Basic Care Fillings Extraction Repair of crowns, bridges, dentures	80%	80%
Major Care Single crowns Bridges & dentures	50%	50%
Orthodontia	50%	50%
Lifetime Orthodontia Maximum	$1,000	$1,000
Annual Maximum Benefit	$1,500	$1,500