Table C, TANF Medical Assistance Net Income Limits and Percentages of Poverty Level SR 11-14, 03/11 (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

$908

$1,679

$2,723

2

$675

$1,226

$2,268

$3,678

3

$683

$1,545

$2,857

$4,633

4

$691

$1,863

$3,446

$5,588

5

$698

$2,181

$4,035

$6,543

6

$779

$2,500

$4,624

$7,498

7

$842

$2,818

$5,213

$8,453

8

$935

$3,136

$5,802

$9,408

9

$987

$3,455

$6,391

$10,363

10

$1,064

$3,773

$6,980

$11,318

11

$1,151

$4,091

$7,569

$12,273

12

$1,223

$4,410

$8,157

$13,228

For each additional person add:

$67

$319

$589

$955