How do medical expense deductions affect SNAP benefit amounts and recertification reviews?
Executive summary
SNAP lets households with an elderly or disabled member deduct unreimbursed medical expenses that exceed $35 per month when calculating net income; this can both make a household eligible and increase monthly benefits (federal rule: expenses over $35) [1] [2]. Some states use a standard medical deduction (amounts cited include $155, $183, $209 or state-specific figures) to simplify processing, and take-up of the deduction appears low even though it can materially raise benefits [3] [4] [5] [2].
1. How the deduction works and who qualifies — the plain rule
SNAP’s core rule: only unreimbursed medical expenses for household members who meet SNAP’s “elderly or disabled” definition count, and only the portion over $35 per month is deductible from income; that reduced net income is used to determine both eligibility and the benefit amount [1] [2]. The Food and Nutrition Service manual and CBPP analysis state clearly that the deduction is specifically for unreimbursed costs over $35 and requires verification [1] [2].
2. What can be deducted — a broad list
Federal guidance and advocacy groups list many allowable items beyond doctor bills and prescriptions: transportation to appointments, over‑the‑counter meds when approved, medical supplies, attendant care, service‑animal costs, insurance premiums when paid out‑of‑pocket, and some housing‑related items tied to disability [5] [2] [6]. State manuals and nonprofit guides echo this breadth and note specific inclusions such as attendant meal calculations and Ticket to Work premiums in some jurisdictions [7] [6].
3. How deductions change your benefit amount and eligibility
Deductions lower a household’s SNAP net income, which can both move a household below income thresholds for eligibility and increase the allotment under federal benefit calculations; CBPP gives examples where modest monthly medical expenses ($50–$200) can add $7–$69 per month to a typical senior’s SNAP benefit [2]. Nonprofits emphasize that because net income determines benefit size, the excess medical deduction is one of the most powerful tools for seniors and disabled adults to “maximize” SNAP [8] [2].
4. Standard deductions and state flexibility — administrative shortcuts
States may request waivers to use a standard medical deduction to reduce paperwork; examples in guidance and state materials show standard amounts vary by state and over time (e.g., references to $155, $183, and the federal standard deduction context like $209 in other SNAP rules), and some states allow recipients to choose actual expenses instead if they exceed the standard [4] [3] [5] [6]. California guidance notes a statewide waiver through Sept. 30, 2025, highlighting that administrative policy, not just federal statute, shapes how deductions are applied in practice [6].
5. Recertification reviews — verification and averaging
SNAP rules require verification of medical expenses at certification and recertification; agencies may ask for bills, insurance documents, and statements, and they can average one‑time large bills over the certification period to better reflect ongoing costs [1] [4] [7]. State manuals point to explicit verification steps and adjustments at recertification [7] and the FNS handbook explains how workers should “determine allowable medical expenses, calculate the actual deduction, and act on reported changes” [1].
6. Take‑up, underuse, and practical barriers
Research and advocacy reports say the deduction is underutilized: only a small share of eligible households claim it despite many having qualifying expenses (CBPP estimates low take‑up and potential for meaningful benefit increases) [2]. Advocates cite administrative burden, verification demands, and lack of client awareness as barriers; toolkits and legal services guidance urge applicants to report all unreimbursed costs and submit forms to maximize allotments [9] [8] [3].
7. Competing viewpoints and policy tradeoffs
Advocates frame the deduction as a necessary correction that aligns benefits with real household resources and can materially increase food security [2] [8]. Administrators and some states favor standard deductions to simplify processing and reduce caseworker workload, but that standardization can leave some households with actual higher expenses under‑counted unless they opt to report and document actual costs [4] [3] [6]. Available sources do not mention how different states’ choices affect national aggregate SNAP spending; they do, however, document the tension between simplification and precision [4] [3] [6].
8. Practical next steps for applicants and recertifying households
Report all out‑of‑pocket medical expenses for elderly/disabled members, keep bills/insurance statements, ask whether your state uses a standard medical deduction or requires CF‑31/other forms, and request averaging of large one‑time bills across the certification period if appropriate [4] [6] [7]. If you suspect agency error or undercounting, legal aid and advocacy groups publish guides and calculators to demonstrate potential increases and support appeals [3] [8].
Limitations: this summary relies on federal guidance, state examples, and advocacy reports in the provided sources; it does not include every state’s current standard deduction amount or post‑2025 policy changes beyond the cited materials (available sources do not mention more recent state‑by‑state figures) [4] [3] [6].