From the DTA Mailbox August 2015: SNAP Medical Expense Deductions


The questions below pertain to SNAP medical expense deductions and the verification of these deductions for elderly or disabled clients. For additional policy information on this topic, refer to 106 CMR 364.400(C).

Q. 1. Do I need approval from a doctor before deducting over-the-counter medications from the income of an elderly or disabled client, as defined in 106 CMR 361.210?

A. 1. No. For verification of out-of-pocket costs associated with over-the-counter medications or medical supplies and equipment, use the client’s proof of incurred expenses such as copies of receipts, bills or medical supply rental agreements. These expenses do not require a letter or documentation from a licensed practitioner, unless the information provided is inconsistent. See Operations Bulletin 2015-2 for more details.

Q. 2. At application, all medical expenses must be verified for an applicant to receive a medical deduction. Is the same true at recertification?

A. 2. No. The following situations do not require verification at recertification:

  • The client reports no change in medical expenses,
  • The client with the Standard Medical Deduction reports a change in medical expenses but based on the amount (i.e. medical expenses are greater than $35 but no more than $190), the client would remain at the Standard Medical Deduction,
  • The client reports a medical expense decrease to less than $35 per month or reports zero medical expenses, or
  • The client who is being credited with an actual medical deduction reports that his or her medical expenses have decreased to $190.

For more information, refer to the SNAP Medical Deductions Job Aid.

Q. 3. My SNAP client is behind in his rent. He initially reported zero medical expenses, but when I gave him examples of allowable medical expense deductions, he explained that he has very high monthly bills from a dentist that he’s been unable to pay. Without paying on these dental bills, is this client still eligible for the medical expense deduction?

A. 3. Yes. Remember that an elderly or disabled client who is behind in paying any of his other financial obligations may also be struggling to pay medical bills. Also, a client need not be making payments on his medical bills to be eligible for the deduction. If asking applicants and clients about their medical expenses, remember to also include examples of the types of expenses that qualify. Allowable SNAP medical deductions include items that clients may not at first consider such as vitamins, foot and dental care products, batteries for hearing aids, mileage for private car, taxi, bus or subway when necessary to obtain treatment or care, securing and maintaining service animals and attendant services. For a complete list of allowable expenses in SNAP, refer to the SNAP Medical Deductions Job Aid.

Q. 4. Are there certain medical expense activities I should keep in mind helping elderly and disabled clients maximize?

A. 4. While the medical expense regulations at 106 CMR 364.400(C) have not changed, accurate and consistent medical expense deduction procedures are important. Clients may not realize certain items that can be counted towards the medical deduction such as adult diapers, over the counter medications or transportation. It is important to thoroughly review all eligible deductions as they may make a substantial difference in the SNAP benefit amount.


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