How to SNAP: Health & Medical Expenses Rules

These rules apply to anyone who is

🍎  A senior (60+) or

🍎  Disabled (any age) and getting one of these forms of disability benefits

If this is you, then your medical or health expenses can cause your food stamps to go up.

What Counts As a Medical Expense?

According to the USDA website, these things count:

• most medical and dental expenses, such as doctor bills
• prescription drugs
• over-the-counter medication when approved by a doctor
• dentures
• inpatient and outpatient hospital expenses;
• nursing care.
• certain transportation costs (medical transport)
• attendant care
• health insurance premiums.
• Co-pays and deductibles on doctor’s visits

But wait! There’s more!

Allowable medical expenses will vary by state, and sometimes things not clearly state on the list may still count. For most items and services, you may need to show proof that these were recommended by a doctor or healthcare provider. Examples from our readers of deductions that were allowed:

• Vitamins, herbs or supplements when recommended by a doctor
• Driving or taking transportation to the doctor or pharmacy (see below)
• Dental care, dentures, dental adhesives
• Prescription drugs, including postage costs
• Eyeglasses, contact lenses, hearing aids, batteries, communication equipment for the hearing or visually impaired;
• Medicare premiums
• Health treatments (chiropractic, acupuncture, physical, therapy, etc)
• Attendant care services you need (even if the caregiver is a relative)
• Housekeeping services you pay for
• Costs for child care if you need to pay for child care due to your age or illness
• Health-related supplies recommended by a health provider including incontinent supplies, creams and ointments, commodes and walkers
• Any other un-reimbursed medical expenses prescribed or recommended by your health care providers.

The Mass Legal Help website has a helpful page on medical deductions. They include suggestions for several things you might not have thought about.

Unreimbursed

You can only declare medical expenses that are not being reimbursed or paid for by anyone else.

Notes on Medical Transportation

Medical transportation includes any of your trips to the pharmacy or doctor. This can be calculated at the IRS mileage. Keep a list of each appointment along with the mileage. It does not matter if you drive yourself or someone else drives you and you reimburse that person’s mileage. If you take a taxi or other transportation, then you can use the actual cost instead. Also, you can count parking and tolls.

The Magic $35 Rule

In order to get this deduction, you must spend at least $35 on medical expenses.

Here’s the magic part: In some states, there is a standard medical deduction. If you spend $35.01, you get a standard medical deduction. The standard deduction may wind up being different than your actual medical expenses. For example, in some states the standard deduction is $155. See how this works:

🍎 John has $34 in medical expenses. He gets $0 in deductions. His food stamps are $50.

🍎 John has $36 in medical expenses. He gets $155 in deductions. His food stamps are $100.

Crazy! But true! Once again, we don’t make the rules. This is how the government decided to do it.

Please double check: $35 is the federal number at this time (2019). Please check your state policies as this number may increase or vary in different states. Also: If your actual medical expenses exceed the standard deduction, you may be able to request that they calculate based on actual expenses instead.

Does My State Have the Magic $35 rule?

Not all states have the standard medical deduction rule. Some states will base the deduction on the amount you actually spend (or project to spend) on medical and health needs.

If your state does not have the standard rule, then medical expense deductions will only be significant if you have more than $35 in expenses. For example, if your expenses are $38, that is $3 worth of countable expenses, so your SNAP may go up $1. You might not find it worth it to do all the paperwork for $1.

Which states have standard deduction amounts? We can’t tell you that because rules constantly change. This guide to Medical Deduction Rules for SNAP lists the following states in 2014: Arkansas, Idaho, Illinois, Iowa, Kansas, Massachusetts, Missouri, New Hampshire, North Dakota, Rhode Island, South Dakota, Texas, Vermont, Virginia, and Wyoming. Please check your state guidelines for updated info.

Documenting Medical Expenses

There seems to be conflicted information about how much proof you need to show for your medical expenses. It is probably easier if you can get the documentation, if possible, but if you don’t have documentation, you can still write down your expenses on the Food Stamps application form and see if they ask you for more documentation.

The guidelines say “physician or licensed health care provider”, so you do not need to see an MD. You can get this documentation from another licensed health care provider you are seeing.

If your items are already listed in your medical records, you may be able to use this. Otherwise you can ask your doctor to write down and sign a list of recommended items: Sample Doctor’s Form for Medical Expenses

It may go smoother if you write and enclose a budget of medical expenses. Here’s a sample of Rosemary’s Medical Expenses Budget.

More info on How to Work With Your Provider To Get Documentation of Medical Expenses.

For California – Here is a form you can use for CalFresh – CalFresh Medical Expense Deduction Form

For Florida: See good info in reader’s comments below.

What Can a Doctor Recommend?

Depending on your state and what type of documentation you submit, there are many other types of items and services that may be considered disability expenses if recommended by a doctor or medical practitioner:

🍎  Neroli’s Magic List: “I am going to address this to everyone who is disabled and is not getting enough food stamps to feed the themselves or their family: Please make sure you are writing off every single medical expense. Stuff you don’t even think relates to your disability counts.” Neroli’s Amazing Guide to Deducting Medical Expenses for SNAP

🍎 Ideas suggested by readers: Waterless shampoo, adaptive clothing, bed pans, shower chairs, bed trays, weighted blankets, pressure vests, waterproof mattresses, therapeutic classes, walker accessories, noise canceling headphones, assistive technology (many different types of electronics are considered assistive technology with appropriate medical assessment), home modifications, Air purifiers, Water purification systems, Air Conditioning Units, etc.

🍎 The items above are only medical expenses if they are needed for disability-related reasons, and recommended in writing by your doctor.

🍎 There is no guarantee your caseworker will approve all your expenses, however it won’t hurt to submit the request. Some items may get approved and some may not.

🍎 If you are not sure if something will count as a medical expense, you can ask your caseworker or you can submit it and see if it is approved. Sometimes caseworkers will say “no” when asked something, but if submitted in writing along with a doctor’s note that it is medically necessary, the “no” will magically turn into a “yes”!

Next Steps

If you have a change in your income, savings, rent, utilities, medical expenses, or household, notify your food stamps caseworker.

If you would like to request that your food stamps be reassessed based on changes, you can request this at any time.

Some of our readers report that they found it easier to report changes and communicate with their caseworker by email. This has the added advantage of creating a written record of changes you report. You can ask your caseworker if she has an email where you can reach her.

If you are asked to go to an in-person meeting and you cannot attend due to your disability, you can request an accommodation to do the meeting by phone or mail.

If you think your food stamps were not processed correctly, here’s some ideas for next steps.

There are a bunch more food stamps rules and regs it may really help you to know: How to Get Enough Food Stamps to Actually Eat

Excellent detailed guide to Medical Deduction Rules for SNAP

Complete policy manual with lots more nitty gritty details: USDA Guide to Medical Expense Deductions

Bonus, if you are in HUD housing, the same materials you submit to SNAP can also be used for housing:

Updated March 2019. Please comment below with stories, ideas, questions or suggestions. Please let us know if any links on this page stop working.