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Title 8: Medicaid Page 53 Iowa Department of Health and Human Services Employees’ Manual Chapter E: Income Non-MAGI-Related In-Kind Income Revised April 11, 2025 In-Kind Support and Maintenance (ISM)

2. Mr. S, a Medicaid member, lives with his adult son in a home owned by his son. Mr. S purchases and eats his meals separately from his son. Mr. S’s pro rata share of the household’s $400 operating expenses is $200. Mr. S’s actual contribution towards the household’s operating expenses is $75 per month. Although Mr. S is not paying a pro rata share of the household expenses, his son is not paying for or providing his meals. Therefore, Mr. S’s ISM is valued according to the PMV method. The actual value of Mr. S’s ISM is $125 ($200 minus $75). Because this is less than the presumed maximum value, the countable ISM income is $125. 3. Ms. L, a Medicaid member, lives alone in her own home. Her father helps her by paying her gas and electric bill of $80 per month. (Payments are made directly to the utility company.) Because Ms. L lives in her own home, the PMV method of determining in-kind income (for the payment of utilities) is used. Because the actual value of the in-kind support and maintenance received is less than the presumed maximum value, the countable in- kind support and maintenance income is $80. Non-MAGI-Related Self-Employment Income This section describes:  How to determine whether a client’s employment is self-employment.  How to consider income from self-employment. Determining if a Client is Self-Employed Legal reference: 20 CFR 416.1110, 20 CFR 416.1111 “Self-employment” is defined as providing income directly from one’s own business, trade, or profession. If it is unclear whether a person’s employment is self-employment, ask if the person files an income tax return as a self-employed person on form SE, Social Security Self-Employment Tax or if the person is subject to a self-employment tax. If the person files form SE or is subject to self-employment tax, consider the person’s self-employment verified, unless the situation has changed.