Table C: Qualified Medicare Beneficiary (QMB) SR 04-15, 04/04 (AAM-A)

Assistance Group Size

Monthly Net Income

<100%

1

$776

2

1,041

3

1,306

4

1,571

5

1,836

6

2,101

7

2,366

8

2,631

9

2,896

10

3,161

11

3,426

12

3,691

For each additional person add:

$265