Table D: Specified Low-Income Medicare Beneficiary (SLMB) and SLMB135 SR 14-14, 03/14 (MAM-A) |
Assistance Group Size |
Monthly Net Income Limits |
||
|
SLMB > 100% but < 120% |
|
SLMB135 > 120% but < 135% |
1 |
$973 - $1,167 |
|
$1,167 - $1,313 |
2 |
$1,311 - $1,573 |
|
$1,573 - $1,770 |
3 |
$1,650 - $1,979 |
|
$1,979 - $2,227 |
4 |
$1,988 - $2,385 |
|
$2,385 - $2,684 |
5 |
$2,326 - $2,791 |
|
$2,791 - $3,140 |
6 |
$2,665 - $3,197 |
|
$3,197 - $3,597 |
7 |
$3,003 - $3,603 |
|
$3,603 - $4,054 |
8 |
$3,341 - $4,009 |
|
$4,009 - $4,511 |
9 |
$3,680 - $4,415 |
|
$4,415 - $4,967 |
10 |
$4,018 - $4,821 |
|
$4,821 - $5,424 |
11 |
$4,356 - $5,227 |
|
$5,227 - $5,881 |
12 |
$4,695 - $5,633 |
|
$5,633 - $6,338 |
For each additional person add: |
$339 - $406 |
|
$406 - $457 |
References: 42 CFR 407, Section 1902(a)(10)(E)(iii)-(iv) of the Social Security Act (SSA), 42 USC 1396a(a)(10)(E)(iii)-(iv), 42 USC 9902(2)