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Which specific prescription drugs and OTC items count as SNAP medical deductions in 2025?
Executive summary
SNAP allows elderly or disabled household members to deduct unreimbursed medical expenses over $35 per month — including many prescription drugs, over‑the‑counter (OTC) medicines, medical supplies, transportation to care, and home health services — but exact eligible items and how states apply the deduction vary and often require verification [1] [2]. Federal guidance and state fact sheets list broad categories (prescription meds, OTC drugs, supplies, attendant care, etc.), but available sources do not provide a single exhaustive 2025 list of "every specific prescription drug or OTC item" that counts [3] [2] [4].
1. Rules that determine what counts: the $35 threshold and “unreimbursed” test
SNAP’s federal rule is categorical: households with an elderly (60+) or disabled member may deduct unreimbursed medical expenses that exceed $35 per month; those expenses must not be paid by insurance or another third party [1] [5]. Centers that explain the deduction emphasize that only the out‑of‑pocket portion above $35 is deductible and that verification (receipts, bills, proof of payment) is required [1] [4].
2. Typical categories states and advocates list as deductible
While no single source lists every product by brand, multiple official and advocacy sources describe recurring categories that count: prescription drugs covered and not covered by insurance; over‑the‑counter drugs (when they're a medical necessity); transportation to medical appointments and pharmacies; medical supplies and equipment; home health or personal care attendants; and costs of hospitalization, outpatient or nursing‑home care [2] [3] [4]. The Center on Budget and Policy Priorities and AARP both enumerate OTC drugs and medical supplies among deductible items [2] [3].
3. Prescription drugs: generally deductible if unreimbursed — but watch Part D and caps
Unreimbursed prescription drug costs are routinely deductible for eligible SNAP households, but many people’s out‑of‑pocket prescription spending changed in 2025 because Medicare Part D introduced a $2,000 annual out‑of‑pocket cap for covered Part D drugs; once Part D enrollees hit that cap, further covered Part D costs would not be unreimbursed and therefore wouldn’t increase the SNAP medical deduction [6] [7] [8] [9]. Available reporting notes that the Part D cap applies to covered Part D drugs but not to drugs outside Part D or to Part B drugs like certain infused or injected therapies — those unreimbursed costs can still be deductible for SNAP [9] [10]. Sources do not provide a state‑by‑state list tying specific drug names to SNAP deductions (not found in current reporting).
4. Over‑the‑counter items: permitted but often require justification
Advocacy groups and state guides say many OTC drugs and medical supplies are deductible when they are out‑of‑pocket and medically necessary (for example, OTC pain relievers, diabetic test strips, bandages), but beneficiaries should be prepared to verify purchases and medical necessity [2] [3] [4]. State SNAP offices and legal aid materials advise documenting receipts and, when needed, asking a health care provider to confirm why an OTC product is required [11] [4].
5. State variation and the “standard medical deduction” complication
About half the states operate a Standard Medical Deduction (SMD) demonstration that lets eligible households claim a fixed monthly amount (which ranges by state from roughly $115–$200 in recent demonstrations) instead of itemizing every expense; other states require itemization/verification of actual expenses [12]. Massachusetts and some local guides describe state‑specific standard amounts and processes — check your state SNAP manual because the dollar figure and whether SMD is available differ [13] [12].
6. Practical steps for claimants and common pitfalls
Households should: 1) gather receipts, pharmacy printouts and insurance Explanation of Benefits showing what was paid by the household; 2) track OTC purchases and transportation costs tied to medical care; 3) ask their SNAP worker whether their state allows a standard deduction or requires itemization; and 4) consider averaging large one‑time bills over the certification period if that yields a larger deduction — this averaging option is described in state handouts [14] [11] [4].
7. What the current sources do not provide (limitations)
Available sources do not publish a single definitive 2025 roster naming “these specific prescription drugs and these OTC brand‑name items” that count for SNAP medical deductions; guidance is categorical and principle‑based rather than brand‑by‑brand, and states differ in administration (not found in current reporting) [1] [2] [12].
Conclusion — how to get a definitive answer for your situation
For a precise, itemized determination, consult your state SNAP office or caseworker and bring documentation (receipts, EOBs, physician notes). Federal guidance and state materials list categories and give examples, but they stop short of enumerating every covered brand or formulation; state practice (itemize vs. SMD) and Medicare/insurance reimbursements materially affect what counts [1] [12] [9].