Dental insurance we accept

Insurance plans we accept in Walnut Creek

We proudly accept Delta Dental and Medi-Cal Dental (Denti-Cal) for families across Walnut Creek and the surrounding East Bay, and we also work with most major PPO dental plans. Whether you have coverage through your employer, a plan you purchased on your own, or state coverage for your child, there's a good chance we can help. The plans we work with most often include:

• Cigna
• United Healthcare
• Aetna
• Anthem Blue Cross
• Guardian
• United Concordia
• DenteMax
• Humana
• GEHA
• TriStar
• Unum
• Ameritas
• Principal
• Sun Life

Here's how it works once you're with us. After you book, we'll collect your insurance details and verify your child's benefits before the appointment—checking things like co-pays, deductibles, annual maximums, and which services are covered. On the day of your visit, just bring your insurance card (or your child's Benefits Identification Card for Medi-Cal Dental) and a photo ID. In most cases, we file claims directly with your plan, so you won't have to chase paperwork or submit forms yourself.

If part of a treatment isn't fully covered, we'll always explain the cost before moving forward and walk you through flexible payment options that keep care affordable. And don't worry if you don't see your plan on the list above—coverage and in-network status can vary by specific plan and tier, so reach out and we'll confirm exactly what your benefits look like before your appointment.

What does pediatric dental insurance cover?

Knowing which plans we accept is one piece of the puzzle — the other is understanding what your plan actually pays for. Coverage varies from plan to plan, but most pediatric dental insurance follows the same general structure. Here's what families in Walnut Creek can typically expect.

Preventive care — usually covered at 80–100%

Preventive services are the best-covered category because they keep small issues from becoming expensive ones. On most plans, these are covered at a high percentage, often with no deductible:

• Routine exams, usually twice per year
• Professional cleanings
• Dental X-rays at appropriate intervals
• Fluoride treatments
• Dental sealants (some plans have age or frequency limits)

At Tooth + Tongue, these preventive visits are also when we evaluate jaw development, tongue function, and breathing — all within the same appointment your plan already covers.

Basic restorative care — usually covered at 50–80%

When a cavity or minor issue needs treatment, most plans help with the cost after your deductible is met:

• Tooth-colored (composite) fillings
• Simple extractions
• Pulp therapy when decay reaches the nerve
• Space maintainers after early loss of a baby tooth
• Stainless steel crowns

Major restorative care — often covered around 50%

More involved treatment is typically covered at a lower percentage and counts toward your annual maximum. For children, this usually means crowns for significantly decayed teeth.

Annual maximums and deductibles

Most dental plans include an annual maximum — a cap on what the plan pays in a calendar year — and a deductibleyou meet before coverage begins. Once the annual maximum is reached, additional treatment is the family's responsibility until the plan renews. This is a big reason preventive care matters so much: staying ahead of problems helps you avoid hitting that limit.

Orthodontic coverage for children

Orthodontic benefits vary more than any other category. Some plans include a lifetime orthodontic benefit for children under 18; others exclude it or cover it only in specific cases. When it is included, expect a lifetime maximum, possible age limits, and waiting periods.

If you're considering early orthodontic care — palatal expanders, pediatric aligners, or the Vivos Airway Growth and Development Program — it's worth verifying your orthodontic benefit early, since some treatments may require prior authorization.

What insurance may not fully cover

Some of the care that makes our approach different can fall outside standard coverage or require prior authorization, depending on your plan:

• Tongue tie evaluation and laser frenectomy (coding varies by plan — sometimes medical rather than dental)
• Advanced imaging such as CBCT scans for airway and jaw assessment
• Airway-focused orthodontics and growth-guidance programs
• Certain biocompatible or specialty materials

Whenever a recommended treatment isn't fully covered, we explain the cost and your options before moving forward — never after.

How to get the most from your benefits

• Schedule preventive visits consistently to catch issues early
• Complete recommended treatment before your annual maximum resets
• Verify orthodontic benefits early if early treatment may be needed
• Understand any waiting periods on a new policy

Not sure how your specific plan handles any of this? Call us at (925) 949-8427 — our Walnut Creek team will verify your child's benefits and walk you through exactly what to expect before the first visit.