Table C, TANF Medical Assistance Net Income Limits and Percentages of Poverty Level SR 09-03, 03/09 (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

$903

$1,670

$2,708

2

$675

$1,215

$2,247

$3,643

3

$683

$1,526

$2,823

$4,578

4

$691

$1,838

$3,400

$5,513

5

$698

$2,150

$3,976

$6,448

6

$779

$2,461

$4,553

$7,383

7

$842

$2,773

$5,130

$8,318

8

$935

$3,085

$5,706

$9,253

9

$987

$3,396

$6,283

$10,188

10

$1,064

$3,708

$6,859

$11,123

11

$1,151

$4,020

$7,436

$12,058

12

$1,223

$4,331

$8,013

$12,993

For each additional person add:

$67

$312

$577

$935