Table C: TANF Medical Assistance Net Income Limits and Percentages of Poverty Level SR 00-13, 04/00 (FAM-A)

Assistance Group Size

PIL

QMB <100%

MCPW/

EMA/ Healthy Kids -Gold: age 0-19 <185%

Healthy Kids -Gold: Infants age 0-1 > 185% & <300%

1

$ 526

$ 696

$1,288

$ 2,088

2

$ 675

$ 938

$1,735

$ 2,813

3

$ 683

$1,180

$2,182

$ 3,538

4

$ 691

$1,421

$2,629

$ 4263

5

$ 698

$1,663

$3,076

$ 4,988

6

$ 779

$1,905

$3,523

$ 5,713

7

$ 842

$2,146

$3,970

$ 6,438

8

$ 935

$2,388

$4,417

$ 7,163

9

$ 987

$2,630

$4,864

$ 7,888

10

$1,064

$2,871

$5,312

$ 8,613

11

$1,151

$3,113

$5,759

$ 9,338

12

$1,223

$3,355

$6,206

$10,063

For each additional person

Add $242

Add $448

Add $725