America’s Toothfairy®
…because every child deserves a healthy smile.
Patient Eligibility Criteria
- The teen must be between the ages of 12 and 19.
- The parent or guardian must complete the application if the teen is under 18.
- The teen must complete the Essay.
- The teen must secure a sponsor to provide a letter of recommendation to Tomorrow’s SMILES.
- The teen must sign an agreement confirming participation in the Pay It Forward program component.
- A Media Waiver and Release Form must be completed and signed by the teen and parent/guardian.
- The teen must be enrolled in an accredited middle or high school or high school equivalency program. (Extenuating circumstances may be considered on an individual basis.)
- The teen/family must meet income eligibility criteria (based on the federal poverty guidelines).
Eligibility Determination for Services
In order to determine a family’s eligibility for enrollment into the Tomorrow’s SMILES program, NCOHF has established criteria based on the federal poverty guidelines. Individuals seeking acceptance into the program must live in a household where, for their family size, the household income does not exceed 250% or 2.5 times the income levels as set by the federal government each year. See the current guidelines below.
2011 Federal Poverty Guidelines
| FAMILY SIZE | 100% POVERTY GUIDELINE | 250% POVERTY GUIDELINE |
| 1 | 10,890.00 | 27,225.00 |
| 2 | 14,710.00 | 36,775.00 |
| 3 | 18,530.00 | 46,325.00 |
| 4 | 22,350.00 | 55,875.00 |
| 5 | 26,170.00 | 65,425.00 |
| 6 | 29,990.00 | 74,975.00 |
| 7 | 33,810.00 | 84,525.00 |
| 8 | 37,630.00 | 94,075.00 |
For families with more than 8 members, add $3,820 for each additional person.
