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Title 8: Medicaid Page 43 Iowa Department of Health and Human Services Employees’ Manual Chapter E: Income Types of Non-MAGI-Related Income Revised May 22, 2026 Social Security Payments

Social Security Payments (Cont.) Mr. A is an applicant for Medicaid. His gross Social Security benefit is $1,182.00. His Medicare premium is $202.90, so Mr. A’s net check is $979.10. If Mr. A is approved, the state will “buy in” and pay his Medicare premium. Once buy-in occurs, Mr. A’s check will increase to $1,182.00. ($979.10 + $202.90 = $1,182.00). In determining Medicaid eligibility for Mr. A, the worker considers income of $1,182.00, so that Mr. A’s eligibility is determined based on the amount of income he will receive once buy-in occurs. In determining client participation, Medically Needy spenddown, or an MEPD premium, the worker uses Mr. A’s income of $1,182.00 to calculate his benefits until after buy- in takes place. Social Services 20 CFR 416.1102, 20 CFR 416.1103, 20 CFR 416.1123; P. L. 103-60 Social services are not considered income. They include services to assist handicapped or disadvantaged people to function in society to the level of a person without the handicap, e.g., vocational rehabilitation. The training allowance issued by the Department of the Blind is considered a social service and is not counted as income.

The following items are not social services:

 Income from a sheltered workshop (see Sheltered Workshop Earnings).

 Financial aid for education and training (see Educational Assistance).

 FIP, SSI, Veterans assistance, or general assistance payments (see Assistance Payments). Strike Pay 20 CFR 416.1102 Count strike pay as earned income if a union member is involved in the strike and the duties involve strike activity. Count all other strike pay as unearned income.