Millions of Americans age 60 and older pay for prescriptions, dental work, hearing aids, and other medical needs out of their own pockets each month. When those costs top $35, federal law allows them to be subtracted from countable income on a SNAP application, a step that can directly increase the monthly food benefit a household receives. The rule has existed since the Food and Nutrition Act of 2008, yet many eligible seniors never report these expenses, leaving potential grocery dollars on the table.
How the $35 medical threshold changes a SNAP benefit
SNAP calculates benefits by measuring a household’s net income after subtracting allowable deductions. For households that include someone age 60 or older, or a person receiving certain disability payments, unreimbursed medical costs above $35 per month qualify as one of those deductions. According to the USDA’s guidance on elderly and disabled rules, medical expenses over $35 a month for qualifying household members can be deducted when determining eligibility and benefit amounts. Every dollar above that $35 floor reduces countable income, and lower countable income typically means a higher monthly SNAP allotment.
The deduction is not limited to recurring bills. Georgia’s Department of Human Services spells out in its state SNAP manual that one-time medical expenses can be averaged across a certification period. A $600 dental bill, for example, could be spread over 12 months, adding $50 per month to the deduction calculation. Costs must be out-of-pocket, meaning insurance or another outside party has not already covered them, and households are expected to provide receipts, bills, or similar documentation if the agency requests verification.
Federal statute and state application gaps
The statutory foundation sits in the Food and Nutrition Act of 2008, which established the excess medical expense deduction and set the $35 monthly threshold. The USDA’s detailed medical expense guide translates the law into program rules, clarifying which costs count, from prescription copays and over-the-counter medications to transportation for medical appointments, prescription eyeglasses, and certain medical equipment. The guide also explains how agencies should treat fluctuating expenses and what kinds of documentation are considered acceptable.
State agencies administer SNAP, and how they ask about medical costs during the application process varies widely. Some states include a dedicated section on medical expenses for older adults and people with disabilities; others rely on a single yes-or-no question or leave the topic to caseworker interviews. Massachusetts, for example, directs applicants to report medical costs over $35 per month if anyone in the household is 60 or older or receives a disability-based benefit. Georgia’s policy manual details verification and averaging rules, including how to handle lump-sum bills and changes in ongoing treatment costs.
Yet no publicly available federal data set tracks how many states have built a medical-expense checklist directly into their online SNAP portals, and no official records show the share of eligible households that actually claim the deduction. That information gap matters because a household that never reports a qualifying expense simply never receives the benefit increase, even though the law allows it. Advocates and researchers can infer underuse from anecdotal reports and small studies, but comprehensive, nationwide figures are missing.
The hypothesis that embedding a simple checklist into the application itself would raise deduction claims is logical but unproven. Without baseline data on current claim rates by state, measuring the effect of any interface change is difficult. Neither the USDA nor individual state agencies have published error-rate analyses specific to medical-expense verification, leaving the real scale of missed deductions unclear. It is also unknown how often caseworkers proactively ask follow-up questions about medical costs when older or disabled applicants leave those fields blank.
Unanswered questions and what to do first
Several pieces of the picture are still missing. There is no primary-source data on the average benefit increase tied to specific medical-expense amounts, so it is hard to quantify how much money, on average, seniors lose when they do not report their costs. There is also no national breakdown of which types of expenses-such as prescriptions, dental work, or transportation-most often drive households above the $35 threshold. Without that detail, policymakers cannot easily target outreach toward the costs that matter most.
Still, some immediate steps are clear for both households and agencies. Older adults and people with disabilities who already receive SNAP can start by making a simple list of monthly out-of-pocket medical costs and gathering recent receipts or statements. Submitting that information to a local SNAP office and asking for the medical deduction to be reviewed can, in some cases, raise the benefit for the remainder of the certification period. New applicants can prepare the same documentation before they apply, so they are ready to answer questions about medical spending.
For state agencies, the low-cost options include adding plain-language prompts about medical expenses to online and paper forms, training caseworkers to flag likely eligibility for the deduction, and publishing basic statistics on how many households claim it. Over time, more rigorous data-such as state-level claim rates and error findings specific to medical costs-would allow researchers to test which changes actually help seniors and disabled households capture the food assistance the law already provides.
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