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Standard Medical Deduction Waiver

Overview

The Standard Medical Deduction (SMD) is a $155 deduction that is credited to elderly and/or disabled SNAP clients who incur medical expenses greater than $35 and less than (or equal to) $190 per month. Elderly and/or disabled SNAP clients who incur medical expenses above $190 are credited with the actual cost of the medical expenses minus $35. These deductions usually result in a higher SNAP benefit level.

Acceptable Verification of Medical Expenses

Verifying Medical Expenses Less Than or Equal to $190 per Month

If an elderly and/or disabled client declares that they incur combined medical expenses less than or equal to $190 per month, they must submit documentary evidence for at least $35.50 of medical expenses to receive the SMD. They may submit documentary evidence for all medical expenses they incur up to $190 per month; however, they will only receive credit for the SMD.

Verifying Medical Expenses Above $190 per Month

If an elderly and/or disabled client indicates that they incur medical expenses above $190 per month, they must submit documentary evidence of all medical expenses to receive a deduction above $190 for all the medical expenses that they are reporting.

Examples of acceptable verifications include receipts, bills, invoices, etc.

If the client was already credited with the SMD because they submitted documentary evidence for medical expenses in the SMD range, you must continue to credit the client with the SMD while pending the return of verifications for the additional medical expenses bringing the client above $190. The additional medical expenses may be processed once documentary evidence for those items is received. For more information, see the procedures detailed in the Procedures for Taking Medical Information section of this page.

Example

Alfred (he/his) is currently receiving credit for the SMD because he provided documentary evidence of his monthly medical expenses totaling $180. During case maintenance, Alfred reports that he now must pay an additional $20 per month for health insurance.  To receive credit for the $20 insurance premium and get into the Actuals range with $200 per month, Alfred only must submit verification of the new $20 expense. He does not need to reverify the $180 per month medical expenses for which he has already submitted documentary evidence. If Alfred does not submit verification of the new $20 expense, DTA cannot give him any additional credit and must continue crediting the SMD of $155 per month.

Example

April (she/her) is currently receiving credit for Actuals because her monthly medical expenses total $215. During case maintenance, April reports that she must pay an additional $30 per month for a new prescription. To receive credit for the prescription and bring her total medical expenses to $245 per month (for which DTA would credit $210), April must submit verification of the prescription. Otherwise, DTA must continue crediting April with the monthly medical deduction of $180 (i.e., $215 – $35) that she previously verified. April does not have to reverify all the medical expenses that she previously verified to first get credit for Actuals.

If the client is already credited with medical expenses above $190 per month and they report an additional medical expense during Interim Report or recertification, you must follow the procedures outlined in Medical Expense Deduction During Review Periods.

Procedures for Taking Medical Information

A client may report medical expenses at application, recertification/IR, or case maintenance. Clients may report these expenses verbally, in writing, or just by submitting the verification. Regardless of where they are in their certification period and how they choose to report the expenses, you must do the following:

  1. Determine whether the client has any medical expenses that they pay on a regular (recurring) basis.
  2. If yes, determine the type, amount, and frequency of the recurring medical costs. Enter the recurring medical expense information into the Medical Expense and/or Health Insurance pages in BEACON.
  3. Determine whether the client has any one-time (non-recurring) medical expenses from the last 36 months that they paid off or have yet to pay off.
  4. If yes, determine the type and amount of the non-recurring medical expense. Enter the non-recurring medical expense information into the Medical Expense and/or Health Insurance pages in BEACON.
  5. Send an optional VC-1 for any unverified medical expenses.
  6. If there is another elderly/disabled member in the household, follow the previous steps to record their medical information.
  7. Once verification is received, determine the number of months by which to divide the one-time medical expenses following the procedures in Non-recurring Medical Expenses. Enter the appropriate number of months in the “Number of months” field available to input for non-recurring medical expenses. (Note that the Start and End Dates for the non-recurring medical expenses will be automatically determined upon the number of months entered.)

    1. Remember: The Optimal Proration Tool is not mandatory for recurring medical expenses; however, it is helpful in determining if the expenses are in the SMD or Actual range. The tool, however, is mandatory when calculating nonrecurring medical expenses.

Reminder: If a client whose SNAP benefits are already at max reports that they have new medical expenses, they will continue to receive the maximum SNAP allotment even if the expenses are not verified. Therefore, if you happen to be speaking with the client, you must explain that they must submit medical expenses to be fully credited but will not benefit from verifying the expenses at this time. Also tell them that they can still submit verification if they want the information on record to potentially offset future changes that would otherwise decrease their benefit amount.

Best Practices

Screen, Explain, and Advise

If you are processing a case with an elderly and/or disabled client, it is important to screen for medical expenses. You must explain to the client that reporting and verifying medical expenses may result in more SNAP benefits. During this conversation, you must determine what medical expenses the client has (if any), and whether they are eligible for the SMD or an actual medical expense deduction. You must also explain how the medical deduction works and advise the client to retain hard copies of their medical documentation (e.g., receipts, invoices) in the event their case is selected for review by DTA’s Quality Control division.

How to Discuss Medical Expenses with Clients

When asking clients about medical expenses, you must ask questions in general terms. For example, instead of asking “What prescription medications do you pay for?”, ask “Do you pay for any prescription medications?” Similarly, instead of asking “What did you go to the hospital for?”, ask “Do you have any hospital bills?” For more information, refer to the How to Discuss Medical Expenses with Clients page.

Duplicates

When a client reports a new medical expenses, you must always make sure that the reported medical expense is not a duplicate of an item that is already on record. If it is, then you must disregard it and document it in the narrative. You must also cold call the client to remind them that we already know about the item they are reporting.

Using External Data Sources

When possible, you must use SVES and BENDEX to verify medical expenses if the information is available through these data sources. For example, if the client newly reports that they pay for Medicare Part B, use SVES to validate the Part B information (in accordance with the guidance in SSA Data).

Retention of Prior Medical Expense Records at Case Maintenance

If a client is adding new medical expenses at case maintenance, you must not remove any existing recurring medical expenses on record unless the client tells you that they no longer have to pay for those items.

Last Update: July 22, 2026

 

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