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

$851

$1,575

$2,553

2

$675

$1,141

$2,111

$3,423

3

$683

$1,431

$2,648

$4,293

4

$691

$1,721

$3,184

$5,163

5

$698

$2,011

$3,721

$6,033

6

$779

$2,301

$4,257

$6,903

7

$842

$2,591

$4,794

$7,773

8

$935

$2,881

$5,330

$8,643

9

$987

$3,171

$5,867

$9,513

10

$1,064

$3,461

$6,403

$10,383

11

$1,151

$3,751

$6,940

$11,253

12

$1,223

$4,041

$7,476

$12,123

For each additional person add:

$67

$290

$537

$870