- Medicaid co-pay is $3.00 and is due in full at the time of the visit.
- If you do not have insurance, we ask that you pay in full for services that day. (We do accept VISA and MasterCard)
- Any outstanding balances on the account MUST be paid in full before the patient will be seen.
- Please turn cell phones to silent while in exam rooms.
- There will be a $30.00 fee for returned checks.
- Any person who is more than 15 minutes late for their scheduled appointment will need to be rescheduled.
- We accept medicaid for children and adults and follow the Federal Poverty Guidelines for our uninsured patients.
|
2011 HHS Poverty
Guidelines
|
|
Persons
in Family
|
48 Contiguous
States and D.C.
|
Alaska
|
Hawaii
|
|
1
|
$10,890
|
$13,600
|
$12,540
|
|
2
|
14,710
|
18,380
|
16,930
|
|
3
|
18,530
|
23,160
|
21,320
|
|
4
|
22,350
|
27,940
|
25,710
|
|
5
|
26,170
|
32,720
|
30,100
|
|
6
|
29,990
|
37,500
|
34,490
|
|
7
|
33,810
|
42,280
|
38,880
|
|
8
|
37,630
|
47,060
|
43,270
|
|
For each additional
person, add
|
3,820
|
4,780
|
4,390
|
SOURCE: Federal Register, Vol. 76, No. 13, January 20, 2011, pp.
3637-3638
- A parent or guardian must give consent to dental care for minors under age 19, or no care will be provided.
Please feel free to contact the Dental Coordinator at (308) 696-1201 ext. 254 with any questions that you may have. Our goal is to make quality dental care obtainable for all. We look forward to working with you!
West Central District Health Department & Dental Clinic Staff.
|