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 A$1520% Level B$3040% Level C$4560% Level D$6080% Level E$75100% Level F
  From To From To From To From To From To  
1 $0
$12,140
$12,141
$15,175
$15,176
$18,210
$18,211
$21,245
$21,246
$24,280
Income over guideline OR Proof of income not provided
2 $0
$16,460
$16,461
$20,575
$20,576
$24,690
$24,691
$28,805
$28,806
$32,920
3 $0
$20,780
$20,781
$25,975
$25,976
$31,170
$31,171
$36,365
$36,366
$41,560
4 $0
$25,100
$25,101
$31,375
$31,376
$37,650
$37,651
$43,925
$43,926
$50,200
5 $0
$29,420
$29,421
$36,775
$36,776
$44,130
$44,131
$51,485
$51,486
$58,840
6 $0
$33,740
$33,741
$42,175
$42,176
$50,610
$50,611
$59,045
$59,046
$67,480