Table C: TANF Medical Assistance Net Income Limits and Percentages of Poverty Level SR 02-01, 01/02 (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

$ 559

$ 716

$1,325

$ 2,148

2

$ 675

$ 968

$1,790

$ 2,903

3

$ 683

$1,220

$2,256

$ 3,658

4

$ 691

$1,471

$2,722

$ 4,413

5

$ 698

$1,723

$3,187

$ 5,168

6

$ 779

$1,975

$3,653

$ 5,923

7

$ 842

$2,226

$4,118

$ 6,678

8

$ 935

$2,478

$4,584

$ 7,433

9

$ 987

$2,730

$5,049

$ 8,188

10

$1,064

$2,981

$5,515

$ 8,943

11

$1,151

$3,233

$5,981

$ 9,698

12

$1,223

$3,485

$6,446

$10,453

For each additional person add:

$ 252

$ 466

$ 755