Table D: Specified Low-Income Medicare Beneficiary (SLMB) and SLMB135 SR 13-14, 03/13 (AAM-A)

Assistance Group Size

Monthly Net Income Limits

+ 

5ó#

Ô

> 100% but < 120%

> 120% but < 135%

1

$958 - $1,149

$1,149 - $1,293

2

$1,293 - $1,551

$1,551 - $1,745

3

$1,628 - $1,953

$1,953 - $2,198

4

$1,963 - $2,355

$2,355 - $2,650

5

$2,298 - $2,757

$2,757 - $3,102

6

$2,633 - $3,159

$3,159 - $3,554

7

$2,968 - $3,561

$3,561 - $4,007

8

$3,303 - $3,963

$3,963 - $4,459

9

$3,638 - $4,365

$4,365 - $4,911

10

$3,973 - $4,767

$4,767 - $5,363

11

$4,308 - $5,169

$5,169 - $5,816

12

$4,643 - $5,571

$5,571 - $6,268

For each additional person add:

$335 - $402

$402 - $453