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Title 8: Medicaid Page 51 Iowa Department of Health and Human Services Employees’ Manual Chapter E: Income Non-MAGI-Related In-Kind Income Revised May 22, 2026 In-Kind Support and Maintenance (ISM)

1. Mr. G, a Medicaid member, lives with his friend, Mr. F, in a home owned by Mr. F. Mr. G has Social Security income of $500 but does not contribute any of his income towards the household’s operating expenses. Mr. F provides Mr. G with all of his meals. Mr. G is not paying a pro rata share of the monthly household operating expenses, so he is considered to be living in the home of another. Since Mr. F provides all Mr. G’s meals, he is receiving ISM income that should be valued according to the VTR method. The IM worker determines that Mr. G has countable in-kind support and maintenance income of $331.33 (one-third of the SSI benefit rate). 2. Mr. S, a Medicaid member, lives with his adult son in a home owned by his son. Mr. S’s pro rata share of the household’s operating expenses is $200. However, Mr. S contributes only $100 per month towards the household’s operating expenses. Although Mr. S is contributing towards the household expenses, he is not paying a pro rata share. Therefore, he is considered to be living in another person’s household. His son also provides Mr. S’s meals. Mr. S is receiving the in-kind support and maintenance that is valued according to the VTR method. This means that he has countable in- kind support and maintenance income of $331.33. 3. Same as Example 2, except that Mr. S’s son does not provide his meals Because his son is not providing his meals, the VTR method does not apply. Mr. S’s in-kind support and maintenance is valued according to the PMV method. When to Apply the Presumed Maximum Value Rule (PMV) Legal reference: 20 CFR 416.1140 Whenever a person receives in-kind support and maintenance that must be counted, but the one-third-reduction rule does not apply, use the presumed maximum value (PMV) rule. Under the PMV method, the maximum in-kind support and maintenance amount is presumed to be $351.33 (one-third of the SSI benefit rate plus $20).