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Overview of Medical Expense Deduction

This is an optional verification.

Overview

Claiming medical expenses can substantially boost SNAP benefits for certain households not already receiving the maximum SNAP benefit for their household size. Individuals aged 60+ (i.e., elderly) and/or individuals with a verified disability are eligible for a medical deduction if their average out-of-pocket medical costs exceed $35. per month.

Individuals aged 60+ will automatically be credited with a medical deduction if verified medical expenses exceed this threshold.
Individuals with a verified disability will be credited as long as they meet the disability criteria outlined in SNAP Disability Requirements and Verifications. You may need to confirm that the appropriate disability verification is indicated in BEACON for the medical expense deduction to be applied.
For clients under 60 years of age who receive EAEDC cash assistance, check the Disability page in BEACON. For a non-elderly client, they must be coded as Federal Certify Disabled Yes on the Disability page for the medical expense to be applicable to them.

Note: EDSAP households are subject to the same rules for medical expenses as non-EDSAP households. Medical expenses are applied based on individuals qualifying for the expense; the medical expense is then applied to the singular SNAP calculation for the household.

You must always explore the possibility of out-of-pocket medical expenses when interviewing a household with an elderly member and/or individual with a verified disability. Do not assume that clients with state paid Medicare Part B or MassHealth do not have countable medical costs (see How to Discuss Medical Expenses with Clients).

Medical Deduction Amounts

Medical expenses are calculated by adding each individual medical expense including both dollars and cents. After the medical expenses are totaled, standard rounding logic is applied based on SNAP regulations. This means if the total medical expense ends in .49 or less, the total will round down to the nearest dollar amount; and if the total medical expense ends in .50 or more, the total will round up to the nearest dollar amount.

Example: Elena (she/her) has monthly medical expenses of $12.50 for prescriptions and $22.89 for copays. Because Elena’s total monthly medical expenses are $35.39, BEACON will round down to $35. Elena will not be credited with a medical expense deduction. However, if Elena was to call back and report her copay cost increased to $30, her total medical expenses would be $12.50 + $30 = $42.50. BEACON would then round her total monthly medical expense cost to $43 and she would be credited with the SMD of $155.

It is important to remember that if a client contacts DTA regarding their medical expenses because they are not receiving a deduction, you must explain how medical expenses are calculated and review the allowable medical expenses to see if they have any additional medical expenses that were not previously considered.

Below is a chart to represent how totaled medical expenses are credited to a household’s SNAP calculation based on rounding rules and the application of the SMD or Actual medical expenses:

Total Medical Expense Amount after Rounding Rules are Applied	Amount of Medical Expense Deduction
$35 a month or under	$0
$36 to $190 per month	$155 (SMD)
$191 a month or more	Excess over $35 (Actual)

Countable Expenses

A broad range of unreimbursed medical costs can be claimed by a person aged 60+ and/or with a verified disability. This cost can still be claimed even if the client is not able to make payments or a bill is outstanding.

A medical expense is not countable if the:

expense was or will be paid by someone else (e.g., a third-party reimbursement);
cost is claimed for a household member who is not aged 60+ or does not meet the SNAP disability criteria; or
expense is non-recurring and already fully credited to the client for the allowable number of proration months.

Verifying Medical Expenses

Documentary evidence is preferred for medical expenses. A collateral contact must be explored if the client cannot obtain documentary evidence. Self-declaration of medical expenses may only be accepted as a last resort if the client has provided a reasonable explanation as to why they cannot obtain documentary verification or a collateral contact. If an elderly and/or disabled client indicates that they incur medical expenses, they must submit verification, at minimum, showing over $35 per month of medical expenses to be credited with the standard medical deduction (SMD).

Example: Cory (they/them) has a monthly medical expense of $40 for prescriptions and submits pharmacy receipts proving the prescription cost when he applies for SNAP. Cory receives the SMD in their household's SNAP calculation. Cory later reports having to now pay a health insurance premium of $200 per month during his case maintenance period. To receive an Actual medical expense deduction of $205 ($40 + $200 - $35 = $205) they must provide verification of the health insurance premium. If Cory does not provide verification of the health insurance premium, they will continue to receive the SMD as his prescriptions were already verified.

Households with total medical expenses above $35 per month can verify the costs through a variety of sources, including but not limited to invoices, receipts, cancelled checks, pharmacy print outs, documentation from Housing Authorities (when all household members are elderly and/or have a disability), or insurance printouts indicating patient responsibility. The verification does not need to specify the medical procedure, names of medications, or other private information regarding the nature of the health care treatment received.

Remember: You must attempt a cold call in all instances where a verification is received, but the document is unclear or unusable, so the client is informed of what is happening with their case.

If the household is already receiving credit for medical expenses from the Housing Authority, the only additional expenses that may be considered are over the counter medications or healthcare products. For more information, see Medical Expenses Claimed by Subsidized Housing Tenants.

Medical Expenses: Frequency of Verification Needed

When it comes to medical expenses, we cannot restrict the type of verification provided by the client, e.g., a receipt versus a printout from the pharmacy. The frequency of medical expenses may be difficult to verify as all verifications do not include standardized information. While we cannot limit the type of verification, we can determine the frequency of the medical expense from what the client tells us on the Application, Interim Report, or Recertification. If the information is not clear from the documentation provided, you must cold call the client to get verbal confirmation of the frequency.

If a client states in writing or verbally confirms that they purchase specific over-the-counter medications at a specific frequency (e.g., monthly, quarterly, etc.), you may use this as verification of frequency if the information is not questionable. If a client states that they are purchasing certain medical items every month such as a hearing aid you must require actual verification since the frequency of this information is questionable.

Example: Jane (she/her) submits a statement of her prescription co-payments for the month of July and a receipt for allergy medicine. She does not indicate if this is one-time or ongoing. You must contact Jane to find out if these are recurring amounts. If Jane submits two months of documentation of her pharmacy bills, you do not need to call her and may presume these are recurring monthly expenses.

This self-declaration of frequency of medical expense is acceptable when provided verbally, telephonically, on DTA Connect, in a written/typed statement from the client, or on any DTA form. You must use discretion when allowing the self-declaration of frequency and must narrate the reasons why the self-declaration of frequency was or was not acceptable.

If an expense covers a period exceeding one month, be sure to designate the correct frequency on the Medical Expenses page. For example, if a client purchases a three-month supply of medicine in one month, the total amount of the purchase must be entered, and the frequency coded as quarterly. This will ensure that the correct monthly amount is used in the SNAP calculation.

If you have questions about the frequency of a medical expense, but you are unable to reach the client for clarification, you must send an optional VC-1 for the frequency. To ensure that the client knows specifically what you are requesting on the VC-1, select Additional Verification for Element and type the following for Document(s) of evidence:

“You reported that you have medical expenses, but we need more information about how often you pay for these costs. Please call us or send us a signed letter to tell us how often you pay for the medical expenses that you have just reported.”

If the client does not follow up, you cannot credit the medical expense.

Assisting Clients with Obtaining Medical Expense Verification

Getting proof of medical expenses can be a challenge for clients. When a client indicates that they need assistance obtaining verifications, you are required to assist the client.

Assistance can include (but is not limited to):

Re-explaining different types of acceptable verifications;
discussing disability accommodations;
conducting a collateral contact to seek verification directly from the source, if the client is in the office with you or you have a properly signed release of information; or
explaining transportation related costs (if they drive to medical appointments or the pharmacy, mileage costs can be self-declared)

Households at Maximum SNAP Benefits

Sometimes, it will be clear that the household will receive the maximum SNAP allotment for their household size even if they are not credited with medical expenses. For example, a household with no income will receive the maximum benefit allotment, regardless of expenses on record.

In this situation, you do not have to delay processing of the case and/or request verification of medical expenses. Advise the household that they will not benefit from verifying medical expenses at this time, but they can submit the verification if they want the information on record to potentially offset future changes that will otherwise decrease their benefit level.

For more information, see Standard Medical Deduction Waiver and Medical Deduction During Review Periods.

Last Update: July 22, 2026

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