Dental Application

INSTRUCTIONS TO APPLY FOR A SENIOR ANSWERS AND SERVICES DENTAL GRANT
PLEASE READ BEFORE FILLING OUT THE ENCLOSED FORM
Call 303-333-3482 or 1-855-293-6911 or 1-855-880-4777 (Spanish) if you have questions.
Download application at senioranswers.org/programs/dental-grants/
FAX COMPLETED FORM TO 303-333-9112


Older adults age 60 and over who live in Adams, Arapahoe, Broomfield, Clear Creek, Delta, Denver, Douglas, Eagle,
Garfield, Gilpin, Jefferson, La Plata, Mesa, Montrose, or Summit. county may apply for a grant for partial assistance
with dental care (including covers exams, x-rays, extractions, fillings, full and partial dentures, relines and cleanings.
The program will not cover crowns, root canals, fixed bridges, and implants. Priority is given to older adults who are in
the greatest economic and social need.
HOW TO APPLY FOR A GRANT:

  1. Complete the attached Application.
  2. Select a dentist. You may select a dentist from the list or you may use your own dentist, but your dentist
    must be willing to accept the grant as payment in full.
  3. Contact the dentist and ask if they will accept you as a patient on the Senior Answers and Services Dental
    Program.
  4. Submit the completed Application to Senior Answers and Services, Dental Program, 1129 Pennsylvania St,
    Denver CO 80203 (Be sure to sign the Application Form and the HIPPA – Disclosure Form) INCOMPLETE
    FORMS WILL BE RETURNED.
  5. You will be placed on the waiting list.
    WHEN YOU ARE SELECTED TO RECEIVE A GRANT:
  6. When funding is available, you will receive an Initial Grant Award Letter to make an appoint for an exam.
  7. After your exam, a treatment plan will be submitted by your dentist for a grant to cover the necessary
    dental services.
  8. When you receive the Final Grant Award Letter, make another appointment with the dentist to get your
    dental work completed. You will have 60 days to complete the work.
  9. The dentist will request payment from Senior Answers.
  10. ANY CHARGES OVER THE AMOUNT APPROVED ARE THE PATIENT’S RESPONSIBILITY.
  11. The Low Income Senior Dental Program is not able to meet emergency needs.
    THINGS TO KNOW:
  12. The Senior Answers program is not insurance.
  13. ALL WORK THAT IS NOT COMPLETED BY JUNE 30, 2020 WILL NOT BE PAID BY THE GRANT.
  14. Grants are for a limited time. All work must be completed within 60 days.
  15. There is no guarantee of a grant, as grants are dependent on funding availability.

Download the application form here!