How are medical expense deductions for elderly or disabled household members applied in SNAP 2025?
Executive summary
SNAP allows households with an elderly (60+) or disabled member to deduct unreimbursed medical expenses above $35 per month when calculating net income; states may offer a standard medical deduction instead of itemizing actual costs (FNS handbook and eligibility pages) [1] [2]. Some states set their own standard deduction amounts (examples: Rhode Island $183, Massachusetts $155) and permit averaging large one‑time bills over the certification period; verification is required [3] [4] [5].
1. The basic rule: only unreimbursed expenses over $35 count
Federal SNAP rules let households that include an elderly or disabled person deduct allowable medical costs that exceed $35 per month and are not paid by insurance or another third party; only the excess over $35 is subtracted from gross income to calculate net income for eligibility and benefit levels (USDA FNS handbook; FNS eligibility page) [1] [2].
2. What qualifies as a medical expense — broad list, but proof required
FNS and advocacy guides list a wide range of deductible items — doctor bills, prescriptions, over‑the‑counter meds when doctor‑approved, transportation to medical care, home health aides, service‑animal costs, nursing home care and other out‑of‑pocket charges — but states and caseworkers require documentation and verification before allowing deductions [2] [6] [7].
3. States can use a “standard medical deduction” — why and how
To reduce caseworker burden and simplify enrollment for seniors and people with disabilities, some state agencies use a standard medical deduction for households that demonstrate at least $35 in unreimbursed medical costs. This is a state‑level option the USDA allows; it replaces itemizing every individual expense with a preset deduction amount [8] [9].
4. Standard deduction amounts vary by state — real examples
States that adopt a standard deduction set different flat amounts. Local guides show Rhode Island using $183 per month and Massachusetts using $155 per month as the standard deduction applied when the household reports at least $35 in expenses; these are administrative choices by state agencies and not a single federal dollar value [3] [4].
5. Treatment of one‑time or large bills — averaging is possible
State policy manuals note that one‑time big medical bills (e.g., hospital stay) can be deducted either in the month billed or averaged over the certification period so that a large single bill does not distort eligibility for just one month; caseworkers must apply the state’s procedures and verify non‑reimbursement (Georgia PAMMS example) [5].
6. Impact on eligibility and benefit size — underused but consequential
Research and policy groups document that the excess medical expense deduction can shift households into eligibility or raise benefit amounts because net income is lower after deductions; yet many eligible seniors and disabled people do not claim it — estimates show a minority use the deduction despite potentially meaningful benefit increases (CBPP and FRAC analyses) [10] [9].
7. Administrative limits and required verification
Federal guidance and state practices require proof of expenses and any third‑party payments; expenses counted are the unreimbursed amounts “as billed,” and agencies verify insurance payments or other reimbursements before allowing the deduction. Agencies also follow their own rules for counting credit‑card billed charges, collection agency claims, and prior budget allowances [5] [2].
8. What’s not fully addressed in the sources provided
Available sources do not mention a single nationwide standard dollar amount applied by USDA for the medical deduction in 2025; instead, they show the federal rule ($35 threshold) and that states may set standard deduction amounts (not found in current reporting) [1] [8] [3].
9. Practical advice for applicants and advocates
Document every unreimbursed medical cost, ask your state SNAP office whether it uses a standard medical deduction or requires itemization, and request averaging for a large one‑time bill if that better reflects monthly costs. The USDA handbook, state SNAP pages, and local legal aid or senior services can explain state‑specific amounts and verification forms [1] [2] [7].
Limitations: this summary relies only on the provided FNS materials, state guides and advocacy reports; state practice varies and the cited local examples (Rhode Island, Massachusetts, Georgia) reflect jurisdictional choices rather than a uniform federal dollar amount [3] [4] [5].