This is an optional verification.
Elderly and/or disabled SNAP clients are eligible for a medical deduction if their average out-of-pocket medical expenses exceed $35 per month. Elderly clients will automatically be credited with a medical deduction if it exceeds this threshold and all entries are verified. Disabled clients must meet the criteria outlined in 106 CMR 361.210 and have the appropriate disability verification indicated in BEACON for the medical expense deduction to be applied.
You must always explore the possibility of out-of-pocket medical expenses when interviewing a household that includes an elderly or disabled person.
BEACON will automatically credit the appropriate medical expense based on the entered and verified expenses, i.e. no medical deduction, standard medical deduction, or actual deduction.
Verification of Medical Expenses
Medical expenses must be verified before they are applied to the SNAP calculation. You must enter verified expenses in BEACON even if the benefit does not change to ensure an accurate Electronic Case Folder. Annotate the Narrative tab explaining the action taken.
A list on subsequent pages provides examples of countable medical expenses for SNAP. These expenses can be verified through a variety of sources, including invoices, receipts, documentation from Housing Authorities (when all household members are elderly and/or have a disability), and insurance printouts indicating patient responsibility.
You must enter the line item from housing authority documentation as Medical/ Dental Care and use “documents from housing authority" as the document of evidence on the Verification tab details. The language and line item differs by housing authority.
You must review the documentation carefully and enter the amount that reflects the total expense verified and not the value that the housing authority used in their calculation.
If this verification type is used, the only additional expenses that may be considered are over the counter expenses.
You must not subtract self-paid Medicare premiums unless the housing authority documentation specifically itemizes that expense
The same procedures apply for private health insurance premiums. The health insurance value must be left in the Health Insurance page.
Hospital or outpatient care
Nursing care or nursing home care
Prescribed alternative therapy such as acupuncture
Postal and handling costs for mailed medicines
Medicinal marijuana is not an allowable medical expense for SNAP purposes.
Special diets, including Boost and Ensure, are not countable as a medical expense for SNAP purposes.
Over-the-counter medication does not require a letter of authorization unless it is questionable that a qualified health professional would advise his/her patient to use the medication being claimed.
Batteries for hearing aids/other medically related devices
Contact lenses and related supplies
Sickroom equipment (including rental)
Purchase/repair of wheelchair or mobility aid
Personal emergency response system
Communication equipment for the hearing or visually impaired
Health insurance and hospitalization policy premiums
Medicare premiums or monthly subsidy
Medicaid spend-down or cost-sharing
Transportation/Lodging to Obtain Medical Treatment or Services
Mileage for use of private car using the Federal Mileage Rates
Parking costs to attend appointments (may be self-declared)
Actual cost of bus, subway, shuttle or taxi (a receipt is required, but frequency may be self-declared.
If a client purchases a monthly pass, the percentage used for medical transportation may be part of the medical expense.)
Clients may verbally declare the address and frequency of eligible transportation costs. You must enter the home address of the client and the destination of the trip into a map service such as Google Maps or MapQuest. These sites will provide mileage based on a default route. The default route should be used to calculate the allowable expense unless the client indicates that s/he takes a different route.
You must print the route results, write the calculation on the printout, and scan it into the Electronic Case Folder (ECF). Clients must not be asked to provide these printouts. You must include a clear explanation of the expense in the case narrative.
Since we cannot restrict the type of verification provided by the client, i.e. a receipt versus a print out from the pharmacy, the frequency of medical expenses will be difficult to verify as all verifications are not equal. However, we cannot limit the type of verification, but we can determine if the frequency the client tells us or records on the IR, recertification or application form makes sense relative to the item that was verified. If a client states that s/he purchases specific over-the-counter medications every month, we may use this as verification of frequency if it is not determined to be questionable. If, however, a client states that s/he is purchasing a medical expense item every month such as a hearing aid or a ninety-day supply of medication, you must assume that it is questionable and require actual verification of the frequency as this is unlikely.
All taxes, postage, and/or shipping fees incurred with medical expenses are considered an allowable medical deduction.
EDSAP Reporting households are required to verify medical expenses according to the procedures detailed above.
Other Medical Expenses
Securing and maintaining service animals (including Therapy and Emotional Support Animals), including food and veterinarian bills
All animals recommended by a medical provider are eligible to claim medical expenses but only service animals recognized by the Americans with Disabilities Act are allowed in TAOs.
Attendant services (See 106 CMR 364.400)
Home health aide
client may choose to average non-recurring medical expenses (such as a
bill for a one-time dental procedure) over the certification period or
s/he may have non-recurring medical expenses applied as a deduction for
a single month. You must write a clear narrative explaining which expense
was averaged and indicate when credit for the specific medical expense
will end. Remember to remove nonrecurring medical expenses, when appropriate.
Clients who elect to use housing authority documentation as verification of medical expenses must have that expense treated as a non-recurring expense.
You must determine the appropriate way to average the expense over the certification period.
Entering Medical Expenses Data
Changing Medical Expense Data
Medical Expenses Policy and Procedures