Income Guidelines

The same income guidelines and proof requirements still apply for the discount program. Acceptable proof of income includes: 30 day paystub, last years taxes, SSI/SSDI benefit letter, child support, and retirement benefits.

These charges will be collected before the visit.

Medical ServicesDental Hygentist ServicesStandard Dental ServicesOral Surgery / Endodontic Services
Level A $15.00 Level A $15.00 Level A $30.00 Level A $60.00
Level B $30.00 Level B $30.00 Level B $60.00 Level B $120.00
Level C $45.00 Level C $45.00 Level C $90.00 Level C $180.00
Level D $60.00 Level D $60.00 Level D $120.00 Level D $240.00
Level E $75.00 Level E $75.00 Level E $150.00 Level E $300.00
Level F Full Charge Level F Full Charge Level F Full Charge Level F Full Charge



Level G $0.00
General Beadle School Patients



Level H $0.00
Homeless Patients

Annual Income Before Taxes

Family Size0% Level A20% Level B40% Level C60% Level D80% Level E100% Level F
  From To From To From To From To From To  
1 $0
$12,490
$12,491
$15,613
$15,614
$18,735
$18,736
$21,858
$21,859
$24,980
Income over guideline OR Proof of income not provided
2 $0
$16,910
$16,911
$21,138
$21,139
$25,365
$25,366
$29,593
$29,594
$33,820
3 $0
$21,330
$21,331
$26,663
$26,664
$31,995
$31,996
$37,328
$37,329
$42,660
4 $0
$25,750
$25,751
$32,188
$32,189
$38,625
$38,626
$45,063
$45,064
$51,500
5 $0
$30,170
$30,171
$37,713
$37,714
$45,255
$45,256
$52,798
$52,799
$60,340
6 $0
$34,590
$34,591
$43,238
$43,239
$51,885
$51,886
$60,533
$60,534
$69,180