Quick answer: the SNAP medical deduction most seniors miss
If anyone in your SNAP household is 60 or older (or disabled), you can deduct medical costs above $35/month from your income. That lower income can raise your SNAP benefit—often by more than seniors expect. Many common costs count (e.g., Medicare Part B/D premiums, prescriptions, eyeglasses, hearing aids, medical transportation). Some states also offer a Standard Medical Deduction (SMD) so you don’t have to itemize every month. Legal Information Institute+2fns.usda.gov+2
Bottom line: If you’re 60+, list your medical costs over $35—it can immediately boost your benefit.
Who qualifies? The 60+ and disability rules (plain English)
You can claim the medical deduction if your household has an elderly member (60+) or a member who is disabled as SNAP defines it. Only that person’s medical costs count, and only the unreimbursed portion (i.e., not covered by insurance or anyone else). fns-prod.azureedge.us
The $35/month threshold
SNAP lets you deduct the portion above $35/month, per household, for combined eligible seniors/disabled members. Example: if your total eligible medical costs are $120/month, your deduction is $85. Legal Information Institute+1
Bottom line: Add up all eligible medical costs for the elderly/disabled member(s); subtract $35—that remainder is deductible.
Actual expenses vs Standard Medical Deduction (SMD)
- Actuals: You list and verify real monthly costs (after reimbursements). There is no federal cap on actuals. Legal Information Institute
- SMD (state option): In some states, once you show you have > $35/month in allowable costs, you can take a fixed deduction amount (set by the state) instead of tracking every penny—this simplifies paperwork. Which states and the dollar amount vary over time; check your state SNAP or the latest USDA State Options Report. fns-prod.azureedge.us+1
Bottom line: If your state has SMD and your costs are steady or modest, SMD may be faster; if your actual costs are higher than the SMD, itemizing may increase benefits.
What counts as “medical expenses” for SNAP (and what doesn’t)
Allowed (examples from federal regulation):
- Medicare premiums (Part B, Part D), other health insurance premiums, Medicaid spend-down and cost-sharing. Legal Information Institute
- Prescription drugs and OTC meds when approved/prescribed by a licensed/qualified practitioner; medical supplies, sick-room equipment, prescribed devices. (Schedule I substances are excluded.) Legal Information Institute
- Medical/dental care, psychotherapy/rehab by licensed providers; hospital/outpatient/nursing home care (including for a former household member if you’re still legally responsible). Legal Information Institute+1
- Dentures, hearing aids, prosthetics; eyeglasses/contacts when prescribed. Legal Information Institute
- Service animals (acquisition/maintenance including food and vet bills) for seeing/hearing/other trained service needs. Legal Information Institute
- Transportation and lodging to obtain medical treatment or services (e.g., mileage to doctor/pharmacy) within state-set “reasonable” rules. Legal Information Institute+1
- Home health aide/attendant care; if you provide the attendant’s meals, an extra SNAP-specified allowance applies. Legal Information Institute
Not allowed (key examples):
- Special diets/supplements (even if prescribed) and any item that can be purchased with SNAP (e.g., general groceries). fns-prod.azureedge.us
- Schedule I controlled substances (e.g., marijuana under federal law) and related costs. fns-prod.azureedge.us
Bottom line: If it’s prescribed/approved by a licensed professional and not reimbursed, it likely counts—except special diets and Schedule I substances.
Proof you’ll need (verification that won’t slow you down)
USDA instructs eligibility workers to verify deductible medical expenses but not to judge whether a prescribed treatment is “necessary.” Bring (or upload):
- Bills/receipts/statements for premiums, prescriptions, medical/dental visits, devices.
- Provider letters/prescriptions for OTC items, devices, therapy, or services.
- Mileage log or transport receipts for trips to doctors/pharmacies; states set reasonable mileage rates and lodging caps.
- Insurance policy pages showing premium amounts and who’s covered; prorate if the policy covers multiple people.
- Service animal training and cost records (food/vet).
Workers do not verify expenses ≤ $35 because they won’t change benefits. fns-prod.azureedge.us
Bottom line: Keep it simple—show who, what, when, amount, and proof of payment (or billing).
How to report and keep it active (initial app vs recertification)
- At application or recertification: List your medical expenses and submit proof. If you’re in an SMD state, ask if you qualify for the standard amount after you show >$35 monthly. fns-prod.azureedge.us
- During your certification period: If a new medical expense starts (e.g., new premium, new prescription), report it; you can get the deduction the month it begins (or per your state’s rules). fns-prod.azureedge.us
- Annual updates: Re-verify continuing expenses at recertification; many states accept current bills/letters or benefit statements (e.g., Medicare). fns-prod.azureedge.us
Bottom line: Don’t wait until renewal—report increases when they happen.
Example: how $150/month in medical costs can increase SNAP
Scenario (48 states + DC rules): Single senior, fixed income, consistent medical costs:
- Monthly eligible medical costs: $150
- Deductible amount: $150 − $35 = $115
- That $115 reduces net income used in SNAP math, often translating to a higher monthly benefit (impact varies by income, shelter costs, and the year’s COLA). See USDA COLA pages for current deductions/allowances. fns.usda.gov
If your state offers an SMD of, say, $160 and your actuals are $150, claiming SMD could be better (and simpler). If your actuals run $300, itemizing likely yields a larger deduction than SMD. fns-prod.azureedge.us
Bottom line: Compare your actual monthly average to your state’s SMD—pick the bigger (or the simpler) path.
Troubleshooting: common denials & easy fixes
- “We can’t count this—no prescription/approval.” → Ask your provider to document the OTC/drug/device/service and upload the note. fns-prod.azureedge.us
- “We need proof of mileage.” → Keep a simple trip log (date, from/to, purpose, miles) plus appointment cards or pharmacy receipts. States set the mileage rate; bring that state’s guidance if needed. fns-prod.azureedge.us
- “Special diet disallowed.” → Correct: food/supplements are not deductible even if prescribed. Focus on eligible costs (premiums, meds, equipment, transport). fns-prod.azureedge.us
- “SMD not available here.” → True in non-SMD states. Use actuals; there’s no cap on allowable actual medical deductions. Legal Information Institute
Bottom line: Most issues are verification problems—match your proof to the rules.
Checklist: Documents & expenses to bring (print-friendly)
- Identity of the 60+ or disabled member (to establish eligibility for the deduction). fns-prod.azureedge.us
- Insurance premium statements (Medicare Part B, Part D, Medigap, other health insurance). Legal Information Institute
- Prescription/OTC (when approved/prescribed) receipts or pharmacy printouts. Legal Information Institute
- Bills/receipts for medical/dental visits, therapy, rehab. Legal Information Institute
- Eyeglasses/contacts, hearing aids, prosthetics invoices. Legal Information Institute
- Service animal costs (training, food, vet). Legal Information Institute
- Transportation/lodging proof for medical trips (mileage log, tickets, hotel receipts). fns-prod.azureedge.us
- Attendant/home health aide invoices; note if you provide the attendant’s meals. Legal Information Institute
- If your state has SMD, ask the worker to screen you for the SMD after you show >$35. fns-prod.azureedge.us
Bottom line: Bring proof for each line item—the clearer your packet, the smoother your increase.
Comparison table: Actual vs SMD vs No claim
| Option | What it is | When it shines | Pros | Cons |
|---|---|---|---|---|
| Actual medical deduction | Deduct real eligible costs above $35; no federal cap. | Your monthly medical costs exceed your state’s SMD. | Maximizes deduction when costs are high or variable. | Requires itemizing & ongoing proof. Legal Information Institute |
| Standard Medical Deduction (SMD) | Fixed amount (state-set) after showing >$35 costs. | You’re in an SMD state and prefer simple paperwork. | Easy to administer; predictable; boosts participation. | Amount may be lower than your actuals; not in all states. fns-prod.azureedge.us+2Food Research & Action Center+2 |
| No medical claim | You skip it or report < $35. | You truly have no eligible, unreimbursed costs. | None (fastest). | You likely leave money on the table. fns.usda.gov |
Disclaimer
This article is general information, not legal advice. SNAP rules can change and states differ, especially with Standard Medical Deduction amounts. Always check your state SNAP agency or call your local office.
Sources (high-authority)
- 7 CFR §273.9(d)(3) — the federal rule for SNAP medical deductions; includes full list of allowable expenses and exclusions; excess over $35 per month for elderly/disabled members. Source: Legal Information Institute (Cornell), last checked: November 1, 2025. Legal Information Institute
- USDA FNS — Elderly/Disabled SNAP page — confirms the medical deduction over $35/month and other special rules. Source: FNS, last checked: November 1, 2025. fns.usda.gov
- USDA FNS (April 2025) Medical Expenses Handbook — official guidance on what counts, verification, mileage/lodging, service animals, and prohibited items like Schedule I substances. Source: FNS, last checked: November 1, 2025. fns-prod.azureedge.us
- USDA FNS State Options Report (17th ed., Oct. 1, 2024 status) — documents which states use Standard Medical Deduction (SMD) and other options; amounts vary by state. Source: FNS, last checked: November 1, 2025. fns-prod.azureedge.us+1
- FRAC report & peer-reviewed analysis — describe SMD adoption (~21 states) and participation effects (background; always verify current state policy). Sources: FRAC; Health Affairs/PMC, last checked: November 1, 2025. Food Research & Action Center+1
- USDA SNAP COLA (FY 2026) — current standard deduction amounts and key parameters that interact with net income calculations. Source: FNS, last checked: November 1, 2025. fns.usda.gov
FAQ
1) What medical expenses can seniors deduct for SNAP?
Medicare premiums, other health insurance premiums, prescriptions and approved OTCs, eyeglasses, hearing aids, medical/dental visits, service animal costs, medical transportation/lodging, and home health aide/attendant care—above $35/month. Legal Information Institute
2) Do I have to be disabled to claim the deduction if I’m 60+?
No. Age 60+ alone qualifies your household for the medical deduction; only your unreimbursed costs count. fns-prod.azureedge.us
3) Are special diets or supplements deductible?
No. Special diets/supplements aren’t deductible even if prescribed; focus on eligible expenses like premiums, meds, devices, and transportation. fns-prod.azureedge.us
4) What proof do I need?
Bills/receipts, insurance statements, provider letters/prescriptions for OTC items/devices, mileage logs, transport/lodging receipts, and service animal documentation. fns-prod.azureedge.us
5) What is the Standard Medical Deduction (SMD)?
In some states, once you show >$35 in monthly costs, you can claim a fixed deduction instead of itemizing. Amounts and availability vary by state. fns-prod.azureedge.us
6) Can I switch between SMD and actuals?
Usually yes at recertification (and sometimes mid-period if costs change); ask your state SNAP office which path yields the higher deduction. fns-prod.azureedge.us
7) Do transportation costs to the doctor count?
Yes—reasonable transportation and lodging for medical care are deductible; states set mileage/lodging guidance and verify costs. fns-prod.azureedge.us
8) Do I get the deduction for both me and my spouse if we’re 60+?
Yes, combine eligible costs for all elderly/disabled members; the $35 threshold is per household, not per person. fns-prod.azureedge.us