Table C: Qualified Medicare Beneficiary (QMB) SR 14-14, 03/14 (MAM-A)

Assistance Group Size

Monthly Net Income

<100%

1

$973

2

1,311

3

1,650

4

1,988

5

2,326

6

2,665

7

3,003

8

3,341

9

3,680

10

4,018

11

4,356

12

4,695

For each additional person add:

$339

References: 42 CFR 406, Section 1905(p)(1) & (p)(2)(C) of the Social Security Act (SSA), 42 USC 1396d(p)(2)(C), 42 USC 9902(2)