Table D: Specified Low-Income Medicare Beneficiary (SLMB) and SLMB135 SR 23-14 Dated 03/23

Assistance Group Size

Monthly Net Income Limits

SLMB

> 100% but < 120%

SLMB135

> 120% but < 135%

1

$1,215 - $1,458

1,458 - $1,641

2

$1,644 - $1,972

$1,972 - $2,219

3

$2,072 - $2,486

$2,486 - $2,797

4

$2,500 - $3,000

$3,000 - $3,375

5

$2,929 - $3,514

$3,514 - $3,954

6

$3,357 - $4,028

$4,028 - $4,532

7

$3,785 - $4,542

$4,542 - $5,110

8

$4,214 - $5,056

$5,056 - $5,688

9

$4,642 - $5,570

$5,570 - $6,267

10

$5,070 - $6,084

$6,084 - $6,845

11

$5,499 - $6,598

$6,598 - $7,423

12

$5,927 - $7,112

$7,112 - $8,001

For each additional person add:

$429 - $514

$514 - $579