Figuring out whether your dental insurance is accepted at a specific practice — and what it actually covers — can feel more complicated than it should be. This guide is designed to give Concord parents a clear, practical picture of how dental insurance works for children and how to get the most out of your coverage at Hopscotch Children’s Dentistry.

The short answer

Hopscotch Children’s Dentistry works with a wide range of dental insurance plans, including many of the most common plans used by families in the Concord and Contra Costa County area. The best way to confirm whether we accept your specific plan is to call our office directly — our team can verify your coverage quickly and let you know what to expect before your child’s visit.

📞 925-254-4777

How pediatric dental insurance generally works

Most dental insurance plans divide covered services into three tiers, each covered at a different percentage:

  • Preventive care (exams, cleanings, X-rays, fluoride): typically covered at 80–100%, with little or no out-of-pocket cost for the patient
  • Basic restorative care (fillings, simple extractions): typically covered at 70–80%
  • Major restorative care (crowns, root canals, space maintainers): typically covered at 50%

For children specifically, most plans are more generous with preventive benefits than they are for adults. This reflects the insurance industry’s recognition that prevention is significantly less expensive than treatment — and that investing in children’s preventive care reduces long-term costs for everyone.

What most plans cover for children

While specific coverage varies by plan, the following services are covered at least partially by the vast majority of pediatric dental plans:

Some plans also cover silver diamine fluoride (SDF) as a cavity-arresting treatment, though coverage varies more widely for this service.

What is an annual maximum — and why it matters

Most dental insurance plans have an annual maximum benefit — the most the insurance company will pay toward dental care in a calendar year. For pediatric plans, this typically ranges from $1,000 to $2,000 per child per year.

For a child who only needs routine preventive care, the annual maximum is rarely a factor — preventive visits cost well under that threshold. However, if a child needs restorative treatment such as multiple fillings or a crown, the annual maximum can come into play.

Because of this, it is worth understanding your plan’s annual maximum before your child’s visit — particularly if significant treatment is anticipated. Our team can help you plan treatment timing to make the most of your available benefits within the calendar year.

The use-it-or-lose-it reality of dental benefits

One of the most important things Concord parents should know about dental insurance: most plans reset on January 1st, and unused benefits do not roll over. If your child has remaining annual maximum benefits in November or December, scheduling a visit before year-end ensures those benefits are used rather than lost.

This is especially relevant if your child has a filling or other treatment pending that has been put off. Completing it before December 31st allows you to apply your current year’s benefits — and start the new year with a fresh maximum.

In-network vs. out-of-network: the practical difference

When a dental practice is in-network with your insurance plan, it means the practice has agreed to a pre-negotiated fee schedule with that insurer. As a result, your co-pays and out-of-pocket costs are lower and more predictable.

When a practice is out-of-network, your insurance may still pay a portion of the cost — but typically at a lower reimbursement rate, and you may owe the difference between the practice’s fee and what the insurer pays.

Hopscotch Children’s Dentistry is in-network with a number of major insurance providers. To confirm whether we are in-network with your specific plan, call our office or ask our front desk team when you arrive. We can run a benefits check and give you a clear picture of your coverage before any treatment begins.

Denti-Cal (California Medicaid dental benefits)

California’s Medicaid dental program — Denti-Cal — provides comprehensive dental coverage for eligible children at no cost to the family. Covered services include preventive care, X-rays, fillings, crowns, extractions, and more.

Hopscotch Children’s Dentistry accepts Denti-Cal. If your child is enrolled in Medi-Cal, their dental benefits are handled through the Denti-Cal program. If you are unsure whether your child is enrolled or what their benefits include, you can contact the Denti-Cal program directly or call our office — our team is experienced in working with Medi-Cal families and can help you navigate the process.

Covered California dental plans

If you purchase health insurance through Covered California, pediatric dental coverage is embedded in all plans for children under 19 — it is not optional or add-on coverage. This means children in families who use Covered California plans are automatically covered for dental care.

Standalone pediatric dental plans are also available through Covered California for families who need dental coverage but do not need to change their health plan.

What to bring to your child’s first visit

To make the insurance verification process as smooth as possible, bring the following to your child’s appointment:

  • Your dental insurance card (front and back)
  • The name of the insurance company and your plan name or group number
  • Your member ID number
  • The name of the primary insured person on the plan

If you have multiple insurance plans — for example, coverage through both parents’ employers — bring both cards. In some cases, secondary insurance can cover costs that the primary plan does not, reducing your out-of-pocket expense further.

What if I do not have dental insurance?

If your family is currently uninsured, you still have options for accessing quality pediatric dental care in Concord. Our team is happy to discuss the cost of services before your visit so there are no surprises. We can also point you toward Denti-Cal eligibility screening or other resources that may be available to your family.

The most important thing is not to delay your child’s care because of uncertainty about cost. A conversation with our front desk team can clarify exactly what to expect — and we will work with you to find a path forward.

Pediatric dental services in Concord

Ready to verify your insurance or book a visit?

Our team at Hopscotch Children’s Dentistry in Concord is happy to answer any questions about coverage, costs, or scheduling.

📞 925-254-4777
📧 hello@hopscotchdental.com
🌐 hopscotchdental.com

Your child’s dental care should be one less thing to stress about. Let us help make it simple. 💙