SSA does not apply in-kind support and maintenance (ISM) rules when determining Retirement, Survivors, and Disability Insurance (RSDI) benefits. ISM is an SSI-specific income methodology used only to determine eligibility, and payment amounts under the Supplemental Security Income (SSI) program.

RSDI benefits are based on a person’s earnings record and benefit status under Title II of the Social Security Act, not on need-based income or living arrangement rules. Because ISM is not part of the RSDI methodology, SSA does not calculate or code ISM for RSDI determinations.

KEY POINTS:

“In-kind income” is used by the Social Security Administration for determining eligibility and payment amounts for Supplemental Security Income.

SSA counts “in-kind support and maintenance” (ISM), which is a type of unearned income that can reduce the SSI payment.

The In-kind income rule generally does not apply to:

• Social Security retirement benefits
• SSDI (Social Security Disability Insurance)
• Survivor benefits

Those programs are based on work credits, not need based.

** For any client receiving Supplemental Security Income (SSI), workers must follow the Social Security Administration’s determination. Medicaid eligibility workers are not to separately calculate or code in-kind income.

 Example 1:

Rose Tyler applies for ABD-related benefits. SDX shows the following:

• SSI: $307,67
• RSDI: $660
• In-kind: $46.33

Source: Use the SDX income shown in Block 006: Gross Income and for SSA use income shown in Block 009.

Calculations: This figure already accounts for all deductions applied by SSA/SSI.

ANSWER:

Ms. Tyler’s countable income is SSI $307.67 (308.00) + SSA $660.00= $968.00.  The client will be eligible for the full amount of SSP as the income is less than the standard.  In addition, she is also eligible for Title XIX Medicaid and QMB if applicable.

*** The worker will only need to code the SSI gross income from block 006 ($308.00) and the SSA income shown in block 009 ($660.00). SSA has already used the in-kind income to determine the SSI payment amount; therefore, it is not to be coded on the case in the income tab received from another household member.

Example 2:

Darla receives $870 in RSDI. She is currently living in an apartment with her boyfriend. Here mother helps her monthly by purchasing groceries and paying her utility bills, electric, water and trash. Darla stated her utility bills normally run between $250 and $300 a month, and her mother brings groceries over every week.

What would be the best choice for Darla? Do we count the presumed value or actual value as our in-kind income?

What is Darla’s countable income for ABD Related Benefits?

What benefit would Darla be eligible to receive?

ANSWER:

Darla’s income award is not counted under the in-kind income or presumed value rules. Even though her income is below the SSI limit and she might qualify for a small SSI payment, in June 2025 CMS ruling removed the requirement to apply for other benefits under §§ 435.608 and 436.608.  *OHCA policy updates are forthcoming.

Per policy 340:15-1-4 (10), Darla is eligible for the full amount of SSP as the income is less than the standard.  In addition, she is also may be eligible for Title XIX Medicaid and QMB if applicable.

The worker will only need to code the SSA income shown on the BEN screen $870.  No need to address the living arrangement shelter expenses for Medicaid purposes as Darla does not receive SSI income.

NOTE :

Medicaid eligibility staff are encouraged to inform SSI recipients to report any changes in their living arrangements to the Social Security Administration (SSA) so their SSI benefits can be updated.

For information regarding in-kind income and the Child Care & SNAP program, refer to policy 340:40-7-12 and 340:50-7-22.