How do medical expense deductions for elderly or disabled SNAP applicants work in 2025?
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Executive summary
The SNAP excess medical expense deduction lets households that include an elderly person (typically age 60+) or a person with a disability subtract out-of-pocket medical costs above $35 per month from their gross income when calculating SNAP eligibility and benefits [1] [2]. States may apply the deduction by verifying expenses, accepting documentation, or—under USDA waivers—applying a standardized monthly deduction for households that demonstrate any expenses over $35, but usage is uneven and the deduction is widely underclaimed [3] [4].
1. Who qualifies and which expenses count
Only households containing an elderly member or a person with a disability can claim the excess medical expense deduction; SNAP rules and the FNS handbook define who is “elderly” or “disabled” for this purpose and list allowable costs like doctor bills, prescription drugs, and many dental or medical supplies when not paid by insurance or another third party [3] [1] [2]. State materials and legal aid guides explain that disability can be proven by receipt of SSI, Social Security disability, or similar benefits in some jurisdictions, and that documentation of expenses is required for verification [5] [2].
2. The $35 threshold and how the math works
The federal baseline is simple: only the portion of allowable medical expenses that exceeds $35 per month may be deducted from gross income when computing net income for SNAP [1] [2]. Practically, if an eligible household has $85 in verified monthly out‑of‑pocket medical costs, $50 would be subtracted from gross income for SNAP calculations—reducing net income and potentially increasing the monthly SNAP allotment [1] [6].
3. Standard deductions, waivers, and state variations
USDA has authorized demonstration projects allowing some states to use a standard medical deduction—effectively a flat amount applied to eligible households that report at least $35 in expenses—so states don’t have to verify every dollar; about fifteen states have used such waivers and some local agencies have raised the practical standard deduction for a period [4] [7]. State implementation varies: some continue to require receipts and itemization, while others apply simplified or fixed deductions; applicants should expect different procedures depending on their state SNAP office [2] [7].
4. Documentation, verification, and common administrative hurdles
Federal guidance instructs eligibility workers to verify both the status of the household (elderly/disabled) and the medical expenses claimed, and agencies commonly ask for bills, receipts, or forms—though some states provide simplified forms or short addenda for elderly/disabled households to report expenses [3] [2]. Advocacy groups and legal services warn that paperwork burdens and inconsistent state outreach contribute to underuse: estimates show a small fraction of eligible seniors actually claim the deduction, even though many have eligible out‑of‑pocket costs [4] [6].
5. How much it can change benefits and why it matters
Lowering countable net income through the medical deduction directly increases SNAP benefits because benefits are calculated as the maximum allotment minus 30 percent of net income; local guides note the rough rule that every $3 lower in net income raises SNAP by about $1, so even modest medical deductions can make a meaningful monthly difference [5] [4]. Research and advocacy reports stress that because there is effectively no upper cap on deductible expenses beyond the $35 threshold at the federal level, households with high unreimbursed costs can see substantial benefit increases, but many do not claim what they qualify for [6] [4].
6. Limits of this reporting and practical takeaways
The federal rule—deduct out‑of‑pocket medical costs above $35 for elderly/disabled members and verify them—frames 2025 practice, but states retain flexibility and some have temporary or permanent variations [1] [2] [7]. Available sources document waivers, standard deductions in some states, and the underuse of the deduction, but specific state amounts, whether a state applies a standardized figure, or how local offices handle verification require contacting state SNAP agencies or local legal‑aid organizations for definitive, up‑to‑date guidance [4] [7].