SNAP and the Medical Expense Deduction

What is the Medical Expense Deduction?

Older adults (age 60 or over) and individuals with disabilities can claim medical expenses which can increase SNAP benefits. Adults and children qualify as disabled for SNAP if they receive SSI, Social Security as disabled, MassHealth as disabled or another disability-based benefit. 

The household member must have at least $35/month in unreimbursed medical costs to get this income deduction. Once the elder or disabled household member verifies at least $35/month, DTA calculates SNAP with a standard medical expense deduction of $155/month. If the member has over $190/month in expenses ($35 plus $155), the household can claim actual expenses for an even larger income deduction. 

Why is the Medical Expense Deduction important? 

The lower the "countable income" DTA uses to calculate SNAP benefits, the higher the SNAP. As a general rule of thumb, every $3 less in countable net income increases SNAP by $1 - up to the maximum benefit. And because of the way the SNAP math works, claiming the medical expense deduction can also boost the value of the shelter deduction since the shelter deduction looks at shelter costs above 50% preliminary net income. Visit the SNAP Calculation Worksheet page to learn how SNAP benefits are calculated. 

Note: Not every elder/disabled household will benefit from claiming medical costs. This MLRI Benchmarks chart give you a general sense of when medical expenses make a difference for SNAP recipients whose rent is 30% of their unearned income. 

What kind of expenses qualify for the medical deduction?

A wide range of costs that are not reimbursed or covered by health insurance count for the medical deduction. The medical expenses can only be claimed for household members age 60 or older, or who are disabled and receive a disability-based benefit (Medical expenses for non-elder/disabled household members unfortunately do not count). Countable expenses include, but are not limited to:

• The cost of health insurance premiums
• Co-payments for health care visits or prescriptions
• Acupuncture, chiropractic, vitamins, herbal treatments
• Health care supplies and equipment, incontinence supplies
• Home health aides, home maker services, care attendants
• "Medicine chest" items including over-the-counter drugs, ointments, other treatments that are recommended or prescribed by a licensed health care practitioner
• Eyeglasses, contacts, lens solutions; hearing aids, batteries; dental care, dentures and adhesives
• The costs of public or private car transportation to health care appointments and pharmacies - calculated by multiplying the number of round trip miles by the current federal mileage rate. (Use MapQuest or Google Maps to determine mileage between locations.)
• One time medical bills for which there is no 3rd party reimbursement. A one-time bill can be averaged out in different ways to ensure the household's SNAP is maximized. 

When and how can a household verify medical expenses?

Households can claim medical costs with DTA at any point - at SNAP application, recertification, or any time in between. A household can generally self declare frequency of costs incurred. 

EXAMPLES of documents to send DTA: 

• For public/subsidized tenants, a copy of the "rent calculation worksheet" if medical expenses were claimed for rent purposes. For more information, see MLRI's How to Lower Your Rent and Boost Your SNAP Benefits: An Advocacy Tool Kit for Mass Tenants
• A print-out or bill from a health provider showing co-payments and date of service
• Pharmacy printouts of prescription drug costs and purchase dates. 
• Receipts for over-the-counter medications or health supplies (herbal remedies, vitamins, etc) recommended by a health provider (a prescription is not required)
• Transportation receipts from the RIDE, the cost of an MBTA pass, taxi or ride share fees, bus fare. Note, for private vehicle transportation to a doctor, pharmacy or any health care location, a household can verbally self declare transportation costs for medical expenses.
• Bills or statements showing private insurance premiums and deductables (DTA should get information on a Medicare Part B premium paid out of Social Security directly from the Social Security Administration)
• Any other paperwork that shows medical costs incurred by an elder and/or disabled member of the SNAP household.

FAQs, Tool Kits and DTA Guidance on medical expenses:

• MLRI's Know Your Rights FAQ on SNAP medical expenses - in English and Spanish
• MLRI's Advocacy Tool Kit for Mass Tenants: How to Lower Your Rent and Boost Your SNAP Benefits
• MLRI's Medical Expense Benchmarks Chart: Chart highlights when the medical expense deduction makes a difference in the SNAP math for elder/disabled clients with low rent (rent equals 30% of income). 
• MLRI's September 2019 SNAP and Medical Expense Webinar (audio and slide deck) on how to maximize medical expenses. 
• DTA SNAP Medical Expense Brochure and DTA Medical Expense Checklist regarding scope of deductible medical expenses for elder and disabled households. 
• DTA's Online Guide section on SNAP and medical expenses (updated August 2019)
• Medical Release of Information -- If a household needs help getting proofs of medical costs, they can sign a release form giving medical providers permission to share records with DTA or a helping organization or advocate. Here is an example of a health care release form.