Income is anything an individual receives in cash or in kind that can be used to meet
his or her needs for food or shelter. In-kind income is not cash, but is actually
food or shelter, or something that can be used to get one of these. Income can be
earned income or unearned income. In-kind support and maintenance (ISM) is countable
as income for Extra Help applications effectively filed December 31, 2009, or earlier.
NOTE: Public Law 110-275 (The Medicare Improvements for Patients and Providers Act of 2008)
changes the rules for counting in-kind support and maintenance (ISM) as income for
Medicare Part D Extra Help applications. ISM will not be counted as income for: applications
effectively filed on or after January 1, 2010; and initial determinations that do
not become effective before January 1, 2010. An example of an initial determination
that becomes effective on or after January 1, 2010 is a periodic or cyclical redetermination
initiated in August 2009.