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How are medical expenses counted for elderly/disabled SNAP applicants in 2025 and what threshold applies?
Executive summary
SNAP allows elderly (generally 60+) and disabled households to deduct unreimbursed medical expenses that exceed $35 per month when computing net income for benefits; only out‑of‑pocket costs not paid by insurance or another third party count [1] [2] [3]. Advocates say the deduction is underused and can substantially raise benefits because there is no federal cap on the excess‑over‑$35 deduction for the calculation [4] [3].
1. How the basic rule works: “Subtract $35, then deduct the rest”
Federal SNAP rules let a household with an elderly or disabled member subtract unreimbursed medical expenses above $35/month from countable income; you total eligible out‑of‑pocket costs, subtract $35, and the remainder reduces net income for benefit calculation [1] [3] [5].
2. Who qualifies as “elderly or disabled” for this deduction
The deduction applies only when an elderly or disabled household member is present; SNAP guidance treats “elderly” as older adults (commonly 60+) and people with severe disabilities under program definitions — states administer verification but the national rule is focused on households that include qualifying elderly/disabled members [1] [6] [7].
3. What counts as an allowable medical expense
Allowable items typically include premiums (Medicare, private), prescriptions, over‑the‑counter medicines when allowed, medical supplies, equipment, home modifications for accessibility, transportation to medical care, and unreimbursed hospital bills — but only the portion actually paid by the household and not covered by insurance or another party [1] [3] [5].
4. Verification and documentation practicalities
States require verification of recurring or incurred costs; some agencies ask for recent bills/receipts (for example, proof for the prior 60 days in some state materials) and procedural guides from FNS outline how eligibility workers should verify and calculate deductions [1] [6] [8].
5. Alternatives states sometimes use: “standard” vs. actual expense
Some jurisdictions offer or apply a standard medical deduction or waiver options in lieu of itemizing actual expenses; for example, California guidance mentions a standard medical deduction waiver through Sept. 30, 2025, and some local agencies may use a preset figure in calculations if households don’t itemize [8] [9]. Available sources do not fully describe every state’s use of a standard versus actual calculation for 2025–2026, so practices can vary (not found in current reporting).
6. Size of the benefit effect and underuse
Policy groups note the deduction can markedly increase SNAP benefits because every dollar deducted from net income increases allotments; national analyses estimate relatively few eligible older adults claim it (around the low‑teens percentage) so the deduction is underutilized and could materially raise benefits for those with high medical costs [4] [3].
7. Edge cases and caps — what the federal sources say and don’t say
Federal FNS guidance emphasizes the $35 threshold and that only unreimbursed costs count; advocacy reporting stresses there’s effectively no federal cap on the deduction beyond the program’s normal maximum allotment mechanics. State materials mention procedural adjustments (for example, dividing lump sums across certification months) but available federal sources do not present a separate numerical cap on the deduction beyond the threshold [1] [4] [10]. If you need whether a given state caps or applies a standard amount differently, state guidance should be consulted because practices vary (not found in current reporting).
8. Recent rule context and timing (2025 updates)
USDA/FNS pages updated for the Oct. 1, 2025 – Sept. 30, 2026 guidance period still restate the $35 threshold and the unreimbursed requirement; some pages also note broader SNAP rule changes in 2025 (e.g., work requirement or benefit updates) but they do not change the $35 excess medical expense rule itself in the cited materials [2] [7].
9. Practical advice for applicants and advocates
Collect itemized receipts, bills, and insurance denials for unreimbursed costs; report monthlyized amounts (divide lump sums across certification months) and ask caseworkers to apply the excess‑over‑$35 deduction — advocacy orgs and legal aid groups emphasize helping seniors claim this deduction because it is historically underclaimed and can increase eligibility/benefit size [10] [4] [9].
Sources referenced: USDA Food and Nutrition Service medical expenses and eligibility pages [1] [2] [7], advocacy and explainer pieces from NCOA and CBPP [4] [3], state and legal aid guides and reports [9] [8] [6] [10] [5].