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 $11,670 $11,671 $14,588 $14,589 $17,505 $17,506 $20,423 $20,424 $23,340 Income over guideline OR Proof of income not provided
2 $0 $15,730 $15,731 $19,663 $19,664 $23,595 $23,596 $27,528 $27,529 $31,460
3 $0 $19,790 $19,791 $24,738 $24,739 $29,685 $29,686 $34,633 $34,634 $39,580
4 $0 $23,850 $23,851 $29,813 $29,814 $35,775 $35,776 $41,738 $41,739 $47,700
5 $0 $27,910 $27,911 $34,888 $34,889 $41,865 $41,866 $48,843 $48,844 $55,820
6 $0 $31,970 $31,971 $39,963 $39,964 $47,955 $47,956 $55,948 $55,949 $63,940