Table C: TANF Medical Assistance Net Income Limits and Percentages of Poverty Level SR 03-07, 04/03 (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

$ 566

$ 749

$1,385

$ 2,245

2

$ 675

$1,010

$1,869

$ 3,030

3

$ 683

$1,272

$2,353

$ 3,815

4

$ 691

$1,534

$2,837

$ 4,600

5

$ 698

$1,795

$3,321

$ 5,385

6

$ 779

$2,057

$3,805

$ 6,170

7

$ 842

$2,319

$4,289

$ 6,955

8

$ 935

$2,580

$4,773

$ 7,740

9

$ 987

$2,842

$5,258

$ 8,525

10

$1,064

$3,104

$5,742

$ 9,310

11

$1,151

$3,365

$6,226

$10,095

12

$1,223

$3,627

$6,710

$10,880

For each additional person add:

$ 67

$ 262

$ 485

$ 785