A Supplemental Nutrition Assistance Program household with a member who is 60 or older, or who has a disability, can deduct out-of-pocket medical costs above a set monthly threshold from the income used to calculate its benefit, a deduction that can raise a monthly SNAP allotment without any change in the household’s actual earnings. The rule has existed for years, yet federal data shows only a small share of eligible households ever claim it, often because the paperwork of tracking and reporting medical bills discourages people from bothering. For an older adult on a fixed income covering copays, premiums or prescriptions out of pocket, the deduction can turn medical spending that already strains a budget into a larger food benefit.
How the Medical Deduction Lowers Countable Income
SNAP benefits are calculated from a household’s net income, and medical expenses for a member who is elderly or disabled count toward a deduction once they exceed $35 in a given month, as long as insurance or another person is not already covering the cost. Because SNAP benefits fall as net income rises, subtracting qualifying medical costs from that income calculation can push a household’s benefit higher, and in some cases can be the difference between qualifying for SNAP at all and falling just above the eligibility line.
The deduction also changes which income test a household has to meet in the first place. A household with a member who is 60 or older, or who receives certain disability payments, only has to satisfy the net income limit rather than the stricter gross income limit that applies to most other households, giving older applicants more room to qualify even before the medical deduction is factored in. That combination, a looser income test plus an added deduction, is built specifically around the reality that medical costs tend to rise later in life while income from work typically falls.
The same households also get more room on the asset side of the eligibility test. Most SNAP households can hold up to $3,000 in countable resources such as bank accounts and still qualify, but a household with a member who is 60 or older or has a disability can hold up to $4,500, an allowance meant to keep modest savings, often set aside for exactly the kind of medical expense the deduction later accounts for, from disqualifying an otherwise eligible household.
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Why So Few Eligible Households Claim It
Despite the potential benefit, the medical expense deduction is one of the least-used pieces of the SNAP formula. The Center on Budget and Policy Priorities found that only about 5 percent of SNAP households claim the medical deduction, compared with 68 percent that claim the shelter deduction, a gap the organization attributes in part to how the deduction is underutilized relative to how many households likely qualify for it. Documenting and reporting recurring medical costs each certification period asks more of an applicant than simply listing rent or a mortgage payment, and that extra step appears to keep otherwise-eligible households from ever claiming the money.
To close some of that gap, roughly half of all states have adopted a standardized medical expense deduction, letting a household with medical costs above the $35 threshold claim a set deduction amount without submitting itemized receipts each time benefits are recalculated. The standardized approach trades precision for simplicity: a household with modest medical costs may claim slightly more or less than its actual expenses would justify, but it avoids the recurring burden of documentation that discourages many people from claiming the deduction at all.
What Counts as a Deductible Expense and How to Report a Change
Qualifying costs include the kinds of routine medical spending an older adult is likely to already be paying, and documentation can include medical bills for household members age 60 or older or for those receiving disability benefits such as Social Security disability or Supplemental Security Income. A state SNAP office typically accepts proof such as billing statements, pharmacy receipts or an insurer’s explanation of benefits showing the portion a household paid itself, since only the unreimbursed amount above the threshold counts toward the deduction.
A household does not have to wait for its next scheduled recertification to report a change in medical costs. Because a rise in monthly medical expenses can increase a household’s benefit, a household experiencing that change can contact its state SNAP agency directly to update its case file, rather than continuing to receive a lower monthly allotment simply because the original application predated the new expense.
The deduction’s low uptake illustrates a broader pattern in how safety-net benefits reach the people entitled to them: eligibility on paper does not automatically translate into money in an account, and the households most likely to benefit from a provision built around medical costs are often the same households least equipped to navigate the reporting requirements attached to it. A program design intended to account for the extra burden of medical spending in later life instead ends up under-delivering precisely because of the administrative burden layered on top of it.
For a household weighing whether the paperwork is worth the effort, the calculation is straightforward even if the reporting is not: every dollar of qualifying medical expense above the $35 floor lowers countable income, and in a program where the benefit shrinks as income rises, that reduction can turn into real, recurring grocery money rather than a one-time adjustment.
This article was drafted with AI assistance and edited for accuracy.
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