Table D: Specified Low-Income Medicare Beneficiary (SLMB) and SLMB135 SR 16-14, 03/16 (MAM-A)

Assistance Group Size

Monthly Net Income Limits

SLMB

> 100% but < 120%

SLMB135

> 120% but < 135%

1

$990 - $1,188

$1,188 - $1,337

2

$1,335 - $1,602

$1,602 - $1,803

3

$1,680 - $2,016

$2,016 - $2,268

4

$2,025 - $2,430

$2,430 - $2,734

5

$2,370 - $2,844

$2,844 - $3,200

6

$2,715 - $3,258

$3,258 - $3,666

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