Table D: Specified Low-Income Medicare Beneficiary (SLMB) and SLMB135 SR 15-14, 03/15 (MAM-A) |
Assistance Group Size |
Monthly Net Income Limits |
||
|
SLMB > 100% but < 120% |
|
SLMB135 > 120% but < 135% |
1 |
$981 - $1,177 |
|
$1,177 - $1,325 |
2 |
$1,328 - $1,593 |
|
$1,593 - $1,793 |
3 |
$1,675 - $2,009 |
|
$2,009 - $2,261 |
4 |
$2,021 - $2,425 |
|
$2,425 - $2,729 |
5 |
$2,368 - $2,841 |
|
$2,841 - $3,197 |
6 |
$2,715 - $3,257 |
|
$3,257 - $3,665 |
7 |
$3,061 - $3,673 |
|
$3,673 - $4,133 |
8 |
$3,408 - $4,089 |
|
$4,089- $4,601 |
9 |
$3,755 - $4,505 |
|
$4,505 - $5,069 |
10 |
$4,101 - $4,921 |
|
$4,921 - $5,537 |
11 |
$4,448 - $5,337 |
|
$5,337 - $6,005 |
12 |
$4,795 - $5,753 |
|
$5,753 - $6,473 |
For each additional person add: |
$347 - $416 |
|
$416 - $468 |
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)