Table D: Specified Low-Income Medicare Beneficiary: SLMB, SLMB135, and SLMB175 SR 05-10, 04/05 (AAM-A)

Assistance Group Size

Monthly Net Income Limits

OÚ?Ü

>100% but <120%

>120% but <135%

1

$798.01 - $957

$957.01 - $1,077

2

$1,070.01 - $1,283

$1,283.01 - $1,444

3

$1,341.01 - $1,609

$1,609.01 - $1,811

4

$1,613.01 - $1,935

$1,935.01 - $2,177

5

$1,885.01 - $2,261

$2,261.01 - $2,544

6

$2,156.01 - $2,587

$2,587.01 - $2,911

7

$2,428.01 - $2,913

$2,913.01 - $3,278

8

$2,700.01 - $3,239

$3,239.01 - $3,644

9

$2,971.01 - $3,565

$3,565.01 - $4,011

10

$3,243.01 - $3,891

$3,891.01 - $4,378

11

$3,515.01 - $4,217

$4,217.01 - $4,745

12

$3,786.01 - $4,543

$4,543.01 - 5,111

For each additional person add:

$272 - $326

$326 - $367