Advantage Gold
Frequently Asked Questions


Q: How many times a year can I have my teeth cleaned?
One cleaning every 6 months up to two times per calendar year.
Q: What is a pre-existing condition? Is it covered?
A pre-existing condition is an oral health condition, which existed before your enrollment in a dental program. Pre-existing conditions are excluded from the Plan.
Q: What is work in progress? Is it covered?
Work in progress is any oral health procedure that is started and not completed prior to your enrollment in a dental program. The Plan does not cover any expenses prior to the date you are covered under the Plan.
Q: Are cosmetic procedures covered? If so, what procedures?
Only as listed in the schedule of benefits and exclusions and limitations.
Q: Is Orthodontia Covered? What are the Orthodontia benefits?
This Plan provides benefits for orthodontic services for covered dependent children who are under 19 years old when the active orthodontic appliance is first placed. For more details, refer to Your Schedule of Benefits.
Q: Do I need to obtain claim forms?
If the dentist does not file the claim, the member must obtain a claim form and file the claim themselves. One is available online at MyDental.GuardianLife.com.
Q: Is there a waiting period?
There is a 12 month waiting period on this Plan for any Major Services, Orthodontia, and Implant Services. There is a 6 month waiting period for Basic Services. There is no waiting period for Preventative Services. You must have had dental coverage with Your prior employer and must enroll in this Plan on a timely basis. You and Your dependents are eligible for dental benefits under this Plan after You and Your dependents complete the service waiting period. Service waiting periods are shown in the Schedule of Benefits.
Q: Is this insurance?
Yes.
Q: Can I change my dentist once I am in the plan
Yes, you may change your dentist at any time
Q: My dentist isn’t currently in the directory. What can I do?
Fill out a Provider Nomination form obtained from MyDental.GuardianLIfe.com. We will contact him/her about becoming a Provider.
Q: How long does it take to process my application?
If the application is submitted by the 15th of the month you will have a 1st of the following month effective date. Application usually processed within 72 hours of submission.
Q: When will I receive my new member kit and what will it include?
You will receive a Member ID card in the mail within 10 business days of your successful payment being processed. Please go online to “MyDental.GuardianLife.com” and register as a new member. Once you have registered you can print out state specific Plan information and the Plan benefit summary.
Q: If I choose to pay by credit card, what will my credit card statement read?
Guardian.
Q: If I choose to pay by Bank Account Draft (ACH), what will my bank statement read?
Guardian.
Q: Is the processing fee billed separately or with the premium?
The processing fee is billed at the same time the premium is billed. However, there will be 2 charges to your account when the initial premium is drafted, one for the processing fee, and one for the premium due.
Q: Can I change my payment type once I am in the plan?
Yes.
Q: If I started with monthly payment, can I change it to annual payment at a later date?
Yes.
Q: Do the applicant name and the billing name need to be the same?
No.
Q: What if I need to change my membership from Individual to Family Coverage?
In order to change coverage during the plan year you will need to have a change in family status or life event. Examples of qualifying life events are changes in employment or changes in your family size (if you marry, divorce, or have a baby). Please call our Eligibility Department for more information at 877-272-0100.
Q: How do I cancel coverage for a dependent?
Cancellation must have been submitted to us in writing or email only 31 days prior to the cancellation date. Cancellation takes place the last day of the month following receipt date of the cancellation request.
Q: If I cancel the Plan, will I receive a refund of the processing fee?
The processing fee is nonrefundable.