Table C: Qualified Medicare Beneficiary (QMB) (AAM)

SR 11-14 Dated 03/11

Previous Policy

Assistance Group Size

Monthly Net Income

<100%

1

$908

2

1,226

3

1,545

4

1,863

5

2,181

6

2,500

7

2,818

8

3,136

9

3,455

10

3,773

11

4,091

12

4,410

For each additional person add:

$319