Table C: Qualified Medicare Beneficiary (QMB) SR 22-14 Dated 03/22 (MAM-A)

Assistance Group Size

Monthly Net Income

<100%

1

$1,133

2

$1,526

3

$1,920

4

$2,313

5

$2,706

6

$3,100

7

$3,493

8

$3,886

9

$4,280

10

$4,673

11

$5,066

12

$5,460

For each additional person add:

$394