SNAP's Medical Expense Deduction for Older and Disabled Households

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SNAP counts most of your income, but for people 60 and older and people with disabilities, it also subtracts most of what they pay out of pocket for medical care. Few households claim this deduction in full, and the receipts can be worth real money each month. Here's what counts, how the math works, and how to get the expenses into your case file.

AT A GLANCE

Who gets it: household members who are 60 or older or who meet SNAP's definition of disabled.
How much: out-of-pocket medical costs above $35 a month, with no upper cap in the federal rule.
What counts: doctor and dental bills, prescriptions, insurance and Medicare premiums, medical travel, dentures, glasses, hearing aids and more.
Proof: the amount must be verified before you're first certified, so bring receipts, statements or pharmacy printouts.
Shortcut in some states: 25 state agencies used a Standard Medical Deduction as of October 2024.

Who can claim the deduction

The deduction applies only to costs for a household member who is "elderly or disabled" under federal SNAP rules (7 CFR 271.2). Elderly simply means age 60 or older. You count as disabled if, for example, you:

receive SSI, or Social Security disability or blindness benefits
receive state disability or blindness payments based on SSI rules
get a government disability retirement benefit for a disability considered permanent
are a veteran the VA rates or pays as totally disabled, or who needs regular aid and attendance or is permanently housebound
are a surviving spouse or child of a veteran in certain VA benefit categories, as the rule spells out
get a Railroad Retirement annuity and are eligible for Medicare, or are disabled under SSI criteria
get Medicaid based on disability, or interim assistance while an SSI claim is pending, when the state uses standards at least as strict as SSI's

One group is shut out. Under 7 CFR 273.9(d)(3), spouses or others who receive benefits only as a dependent of an SSI or disability recipient can't claim it for their own costs. People getting emergency SSI based on presumptive eligibility can.

Other members' costs don't count. If a 35-year-old parent with no disability has a large dental bill, it isn't deductible, even if the household includes a grandparent who qualifies. Only the qualifying person's expenses go in.

What you can deduct

The federal rule lists the allowable costs. If an insurance company or someone outside the household pays for something, that part doesn't count. FNS says only costs you actually pay are deductible.

Category	Examples from 7 CFR 273.9(d)(3)
Care from professionals	Medical and dental care, psychotherapy and rehabilitation from a licensed practitioner or other qualified health professional
Hospital and nursing	Hospital stays, outpatient treatment, nursing care, nursing home care
Medicine	Prescription drugs, plus over-the-counter medication (including insulin) when a practitioner approves it
Supplies and equipment	Medical supplies, sick-room equipment (including rentals) and other prescribed equipment
Insurance	Health and hospitalization premiums, Medicare premiums, Medicaid cost-sharing or spend-down
Devices	Dentures, hearing aids, prosthetics, prescribed eyeglasses
Service animals	Getting and keeping a seeing-eye or hearing dog, including food and vet bills
Travel	Reasonable transportation and lodging to get medical treatment
Help at home	An attendant, homemaker, home health aide, housekeeper or child care needed because of age, infirmity or illness

A few things are excluded. Special diets don't count. Neither do policies that pay lump sums for death or dismemberment, or income-protection policies that cover a mortgage while you're disabled. Schedule I controlled substances are excluded, and so are any expenses tied to their use.

There's one bonus in the attendant rule. If your household provides most of an attendant's meals, the state adds an amount equal to the one-person SNAP allotment to the deduction. For fiscal year 2027 the one-person maximum is $306 in the 48 states and D.C. An attendant cost that could also count as dependent care can be claimed one way or the other, but not both.

For elderly members and disabled members, allowable medical costs that are more than $35 a month may be deducted unless an insurance company or someone who is not a household member pays for them. (USDA Food and Nutrition Service)

How the deduction changes your benefit

A SNAP allotment is the maximum benefit for your household size minus 30% of your net income. Every dollar the medical deduction removes from net income adds about 30 cents a month to your benefit. It can do more than that, because a lower adjusted income also makes the shelter deduction bigger.

Households with an elderly or disabled member also get two other breaks. They only have to pass the net income test, not the gross test. And their excess shelter deduction has no cap. Other households in the 48 states and D.C. are capped at $769 for fiscal year 2027.

A worked example

Here's our own illustration using FNS's fiscal year 2027 figures for the 48 states and D.C. A 68-year-old lives alone on $1,151 a month in Social Security. She pays $550 a month in rent and utilities and $185 a month out of pocket for her Medicare premium and prescriptions. States round slightly differently, so treat the results as approximate.

Step	Without the medical deduction	With it
Gross income	$1,151	$1,151
Standard deduction (1 person)	−$217	−$217
Medical costs over $35 ($185 − $35)	$0	−$150
Adjusted income	$934	$784
Excess shelter (costs above half of adjusted income)	−$83	−$158
Net income	$851	$626
30% of net income, rounded up	$256	$188
Monthly SNAP ($306 maximum minus 30%)	$50	$118

In this example, $150 of medical costs raises her benefit by $68 a month. That's more than $800 over a year.

States with a standard medical deduction

Some states let qualifying households skip itemizing. Under the Standard Medical Deduction demonstration, a household that shows more than $35 a month in medical costs gets a set deduction amount. The household can still claim its actual costs if they're higher. FNS's State Options Report (17th edition, data as of October 2024) lists 25 state agencies using it:

Alabama, Arizona, Arkansas, California, Colorado, Georgia, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Missouri, New Hampshire, North Dakota, Oregon, Rhode Island, South Carolina, South Dakota, Texas, Vermont, Virginia and Wyoming.

The report doesn't list each state's dollar amount, and states can change their options. Ask your SNAP office what the standard amount is. If your real costs are well above it, ask the office to use your actual expenses instead.

Getting your expenses counted

CLAIM THE MEDICAL DEDUCTION

On your application or recertification form, list every medical cost for each member who is 60+ or disabled. Don't leave the section blank because the amounts seem small.
Gather proof: pharmacy printouts, premium notices, Medicare or insurance statements showing what you owe, bills, receipts, and mileage or bus fares for medical trips.
Mention costs you expect in the months ahead, such as an ongoing prescription or a scheduled procedure. The state must factor in changes it can reasonably anticipate.
Bring or upload the proof before your interview, or as soon as you can after it.
Check your approval notice to see whether a medical deduction was used. If it's missing or too low, ask why, and request a fair hearing if needed.

Proof and timing rules worth knowing

Verify first. The amount of medical expenses, including what insurance reimburses, must be verified before initial certification (7 CFR 273.2(f)(1)(iv)).
Missing proof doesn't sink your case. If verifying would delay things, the state can approve you without the deduction. If you can't verify the expense within 30 days of applying, the state decides your benefits without it.
Late proof still counts. If you report a cost at certification but can't prove it yet, the state adds it once you report and verify it.
One-time bills can be spread out. A one-time medical expense during your certification period can be deducted in a single month or averaged over the remaining months. Households certified for 24 months get extra averaging choices for bills in the first 12 months.
You don't have to report changes, but you can. Under 7 CFR 273.10(d)(4), you aren't required to report medical expense changes during your certification period. If you report an increase, the state must verify it, either before acting or before the second normal monthly allotment after your report.
At recertification, new expenses, and recurring totals that changed by more than $25, must be verified.

Related guides

Official sources

Last checked: October 30, 2026. Federal rules come from eCFR (7 CFR 271.2, 273.2, 273.9, 273.10 and 273.12). Dollar figures are from FNS's fiscal year 2027 tables (effective Oct. 1, 2026, through Sept. 30, 2027). The state list is from FNS's 17th State Options Report (data as of October 2024). The worked example is our own math.

This is general information, not legal advice. Your state SNAP agency decides your benefits, and FNS says its elderly and disabled page is being updated for the One Big Beautiful Bill Act of 2025. Confirm current rules with your local office.