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Title 8: Medicaid Page 52 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) Situations in which the PMV method is used include:  A client living in another person’s household, but the household does not pay for or provide all their meals.  A client living in the client’s own household and receiving in-kind support and maintenance. Give clients an opportunity to show that the actual market value of their support and maintenance is less than the presumed maximum value. The actual market value is the client’s pro rata share of household expenses minus the client’s actual contribution. If the client verifies that the actual market value is less than $351.33, use the actual market value as the monthly income. In-kind support and maintenance received by an SSI recipient that is valued according to the PMV rule is reflected under unearned income as income type “H.”

1. Mr. G, a Medicaid member, lives with his friend, Mr. F. Mr. G has Social Security income of $700 but does not contribute any of his income towards the household’s operating expenses. Mr. F provides Mr. G with shelter, but Mr. G provides his own food. The household’s expenses, other than food, total $800. Because Mr. F does not pay for or provide all of Mr. G’s meals, the in-kind support and maintenance income received is valued according to the PMV method and not the VTR method. (Mr. G’s pro rata share of the household’s operating expenses (not including food) is $400.) The difference between Mr. G’s pro rata share ($400) and his contribution ($0) is greater than the presumed maximum value amount of $351.33. The IM worker uses countable in-kind support and maintenance income of $351.33 (one-third of the SSI benefit rate + $20) to determine Mr. G’s Medicaid eligibility.