• Elderly - and elderly (age 60 or older) household member. An individual is considered elderly the month of the individual’s 60th birthday.

• Disabled - a disabled household member to include an individual receiving presumptive SSI.

• Deceased - households with a legal obligation to pay medical expenses for deceased individuals who met the definition of elderly or disabled prior to dying and were SNAP household members at the time of death or at time they entered a hospital or nursing home prior to death.

• Recent Absence - households with a legal obligation to pay medical expenses for elderly or a disabled individual who was a household member immediately prior to entering a hospital or nursing home.

   

Individuals who are not aged (over 60) or disabled receiving social security benefits as a dependent A person who relies on another for support. or survivor are not eligible for the medical expense deduction.

Households are required to report and verify the amount of medical expenses minus any amount paid by a third party at application Filing a signed Application for Assistance via paper application or through the self-service portal of the eligibility system to establish eligibility and assign a review period. and recertification.

• At initial application and review Filing a signed Application for Review via paper review form or through the self-service portal of the eligibility system for SNAP eligibility with the human service zone to determine continuing eligibility and establish a new review period. medical expenses should be averaged from a prior three- month period, if that is indicative of what the household anticipates as ongoing medical expenses in the new review period The period of time a household is approved to participate in SNAP..

• The medical expenses from the three prior months may not be indicative anticipated ongoing medical expenses. The medical expenses must thoroughly be discussed with the household to establish what the household anticipates as ongoing medical expenses.

• In a combination SNAP/Medicaid case, when making a change Information that is different from what is currently used to determine eligibility and/or benefits. for both programs, if the participant A person who is eligible for benefits under SNAP, even if that person is not currently receiving benefits because the amount is too low, or the person is under a sanction or disqualification. share for Medicaid changes and the participant share is being allowed as a medical expense for SNAP purposes, change the amount allowed as an expense for SNAP.

• If the household is only incurring a portion of the participant share and the amount has been averaged, and the income or expenses for this case causes the participant share to change, continue to use the previously averaged amount as a medical expense for SNAP. At review, reaverage using the new participant share.

The eligibility staff member must document Used as a noun, as in documentary evidence indicates a written record of the circumstances of an event or fact. Used as a verb, indicates the act of entering the case file actual proof or statement of proof that the contents of the record are accurate. in case notes the medical expenses allowed for the deduction.

The participant can choose to have current medical expenses, paid or unpaid computed as follows:

• Averaged over the review period at application or recertification or the remainder of the review period for ongoing cases.

• Used as a one-time expense for the next month.

• A monthly installment can be used for the period of time it has been agreed upon for the household to pay the balance. This agreement can be verbal or implied as long as the medical provider is accepting payment, there is an agreement.

• If the averaging or monthly installment computation is used, a one-time expense is treated separately. Do not change the averaged amount currently being used for the review period. Installment payments are allowed only through the month the expense is incurred.

The household must be assisted in deciding which method provides the household with the greater benefit.

Initial Application:

Households with elderly or disabled individuals who are billed and responsible for more than $35 in allowable monthly medical expenses but not greater than $175 can choose the Standard Medical Expense Deduction of $175 per month rather than actual medical expenses. Only one Standard Medical Expense Deduction can be allowed per household.

• The only medical expense that will be allowed in addition to the standard medical expense deduction is when a household is legally responsible for payment of expenses for an individual who was an elderly or disabled SNAP household member immediately prior to dying or entering a hospital or nursing home

• At initial application, verification Third-party information or documentation used to establish the accuracy of statements. of medical expenses is required. If verification of medical expenses is not provided, no expense is allowed. If verification of medical expenses is provided and the total of all allowable monthly medical expenses for all elderly and disabled household members exceeds the $175 Standard Medical Expense Deduction, actual verified expenses are allowed.

Recertificaiton:

At recertification, households will remain eligible for the Standard Medical Expense Deduction if they report and verify the total of all elderly and disabled members allowable medical expenses are greater than $35.

• If a household also reports a one-time medical expense at review, the household can choose to have the one-time expense averaged over the review period or used as a one-time expense. If the household chooses to:

• Average over the review period, the one-time expense is included with other allowable monthly medical expenses in determining entitlement to the Standard Medical Expense Deduction.

• Use as a one-time expense, the one-time expense is included with other allowable monthly medical expenses. If the total is greater than $35 but less than $175, the household can choose the Standard Medical Expense Deduction.

• If the total is greater than $175, the household can choose to use actuals. The actuals must be allowed for the first month of the new review period. The one-time expense must then be removed for the remainder of the new review period. Once removed, if monthly expenses are less than $175, the household can choose the Standard Medical Expense Deduction again for the remainder of the new review period.

   

A household may report changes in medical expenses during its certification period A period of time a household is approved to participate in SNAP.. Verification is required. Changes must be acted on according to the household’s reporting requirements.

• If verification of medical expenses is not provided, no expense is allowed.

• If verification of medical expenses is provided and the total of all allowable monthly medical expenses for all elderly and disabled household members is more than $35 in allowable monthly medical expenses but not greater than $175 can choose the standard Medical Expense Deduction of $175 per month rather than the actual medical expenses.

• If verification of the medical expense provided exceeds the $175 Standard Medical Expense Deduction, actual verified expenses are allowed.

   

Medical expenses cannot be allowed if past due. A bill is considered past due 30 days from the billing date after third party processing. Past due means the payment is overdue to the provider, not overdue at the time of review.

The only time a bill is not considered past due is if the household made an arrangement with the provider to make payments within 30 days after the initial billing date or within 30 days after third party payment.

Medicals expense that have been turned over to collection are not allowable medical expenses.

Any medical expense that will be covered by a third-party payment or an excluded vendor payment A full or partial money payment made by an individual who is not a household member or by a public or private organization directly to a third party for a household expense. is not allowed as a deduction. No deduction can be allowed until:

• The third party has made a determination regarding payment.

• The medical vendor The person or business who provides goods or services. has billed the household for the remaining balance.

• The household must report and verify within 30 days of the billing.

A household’s statement that no third- party payment will be received must be accepted unless it is questionable.

A medical expense can only be allowed once as a medical deduction.

Intent to pay is not considered when allowing a medical expense. Even if a household states it will not be paying a medical expense, it is used as a medical deduction. If the household states an intention for someone else to pay the medical expense, the expense is being reimbursed and is not allowed as a deduction.

Table of Allowable Medical Expenses

Medical Bill	Allowable for SNAP Expense
Medical Marijuana	No.
CBD Oils and CBD products	Possibly. The following criteria must be met: The cannabis product is an FDA-approved drug prescribed by a licensed healthcare provider. As of 03/01/2022, the only FDA approved cannabis-derived drug is Epidiolex (Cannabidiol), which is a treatment for two rare types of Epilepsy.
Past due obligations	No.
Special diets	No. Items that can be purchased with SNAP benefits cannot be allowed as a medical expense. There is no exception for tube feeding
Dental and medical care including psychotherapy and rehabilitation services.	Yes, if provided by a licensed practitioner authorized by State law or other qualified health professional.
Costs reimbursable or paid by a third party.	No.
Prescriptions, over-the-counter drugs, medical supplies, sick room equipment (including rental) or other equipment.	Yes. Each must be prescribed OR approved by a State-licensed healthcare practitioner or professional. Prescription or any approval document is acceptable verification.
Postage for mail-prescription drugs.	Yes
Medicare premiums	Yes, unless paid by a third party. QMB, SLMB, QI-1 approved month of SNAP application expense is allowed month of application and not allowed following Month. If approved in second month of SNAP application expense is allowed application and second month and not allowed following month. Ongoing SNAP, applying for Medicare Savings Program (QMB, SLMB, QI-1) the Medicare expense is allowed until system generated validation message is received indicating the participant is no longer paying the premium.
Health, hospitalization, and ambulance insurance policy premiums.	Yes, only the portion of the premium assigned to the elderly or disabled household member. If the policy does not state the amount of the premium for each insured individual, the premium is prorated among the insured household members. Only the prorated amount for the eligible member is allowed as a deduction.
Dentures, hearing aids and prosthetics.	Yes
Costs of attendant, homemaker, home health aide, childcare or housekeeper services necessary because of age, infirmity or illness.	Yes, if the service is provided by someone outside the SNAP household. If the household provides the majority of the attendant’s meals, also deduct an amount equal to the one-person thrifty food plan Diet required to feed a family in accordance with guidelines established by the U.S. Department of Agriculture. The cost of that diet is the basis for uniform allotments for all households. The thrifty food plan is based on 100% of the federal poverty level.: amount paid to individual PLUS an amount equal to the one-person thrifty food plan = the total allowable deduction. The attendant care cost must be deducted as a medical expense not dependent care expense.
Medicaid co-payments	Yes, generally the best estimate for co-payments is to anticipate for initial months and average for ongoing eligibility.
Cancer or other specialized insurance policy costs.	Yes, if the policy itself states the monies are intended to be used to cover medical expenses. If the policy pays personal debt (car loan, mortgage etc.), the premium is not an allowable expense.
Prescription for home meal delivery service.	No, generally payable with SNAP benefits.
Loan payments for medical debt.	Yes, including medical expenses charged to a credit card. The interest or late fees are not allowed as part of the deduction.
Prescription to buy exercise equipment or get exercise at a health club.	No, club membership or purchase of equipment is not allowed. The services of a medical provider such as a physical therapist would be allowed.
Acupuncture	Yes
Chiropractor	Yes
Reasonable costs of transportation and lodging to obtain medical treatment or services; including, the cost of a trip to a pharmacy or other location to fill a prescription for medicine, dentures, a hearing aid, eyeglasses, etc.	Yes, all costs must be verified and not exceed current lodging reimbursement rates for state employees and Medicaid travel costs for transportation. Meals are not an allowable expense. Reminder: expenses being reimbursed are not allowed as a deduction. If Medicaid travel will reimburse the expense, it cannot be allowed for SNAP.
Prescription eyeglasses or contacts	Yes, if prescribed by an ophthalmologist or by an optometrist.
Securing and maintaining 'service animals' such as seeing eye dogs, hearing guide dogs and monkeys specially trained to provide a service to the disabled.	Yes, in addition to the initial purchase of the animal, animal food and veterinary bills are also allowed as a deduction.
Hospitalization or outpatient treatment, nursing care, and nursing home care.	Yes, including payments by the household for an individual who was a household member immediately prior to entering a hospital or nursing home. Only medical costs are allowed. The cost of room and board is not allowed.
Current cash option payments made to meet a spend-down obligation of Medicaid recipients	Yes, if the household anticipates paying the cash option.
Medic Alert System, Life Line or other home monitoring system.	Yes, as follows: The basic fee for the telephone is a utility expense; and the additional expense for the medic alert system is an allowable medical expense.
Medical Bill	Allowable for SNAP Expense
Fee for membership in a mail- order prescription drug company.	No. The fee is not insurance, and the fee does not actually pay for the drugs, treatment, or other specified medical expenses.