Table C, TANF Medical Assistance Net Income Limits and Percentages of Poverty Level SR 06-04, 03/06 (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

$591

$817

$1,511

$2,450

2

$675

$1,100

$2,035

$3,300

3

$683

$1,384

$2,560

$4,150

4

$691

$1,667

$3,084

$5,000

5

$698

$1,950

$3,608

$5,850

6

$779

$2,234

$4,132

$6,700

7

$842

$2,517

$4,656

$7,550

8

$935

$2,800

$5,180

$8,400

9

$987

$3,084

$5,705

$9,250

10

$1,064

$3,367

$6,229

$10,100

11

$1,151

$3,650

$6,753

$10,950

12

$1,223

$3,934

$7,277

$11,800

For each additional person add:

$67

$284

$525

$850