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ESA SNAP Policy Manual 145  Hospitalization, outpatient treatments or nursing care, including payments made by the household for an individual who was a household member immediately prior to entering a hospital or nursing home; the care must be provided by a District-recognized facility  Prescription drugs or over-the-counter medications, including insulin, prescribed or approved by a licensed practitioner or qualified health professional  Rental or purchase of prescribed medical supplies, sick room equipment or other prescribed equipment  Health and hospitalization insurance policy premiums  Medicare premiums  Co-payments, spend-down or other cost-sharing for Medicaid recipients  Dentures, hearing aids and prostheses  Purchase and maintenance of a specially trained service animal, such as a seeing-eye or hearing dog, including food for the animal and veterinarian expenses  Eyeglasses prescribed by an optometrist or a physician skilled in eye disease  Reasonable transportation and lodging to obtain medical treatment or services  Maintenance of an attendant, such as a homemaker, home health aide, childcare service or housekeeper; this service must be provided by a nonhousehold member and be necessary due to age, infirmity or illness of the elderly or disabled household member − Note: If the household provides the majority of an attendant’s meals, the household is eligible for a deduction equal to the benefit allotment for one person; this deduction must be updated each October when the maximum allotment amount changes to reflect the increased maximum benefit for a one-person household The following expenses are not allowable expenses:  Any portion of an allowable medical expense that is reimbursed  The cost of medical marijuana is never allowed as an expense, even if prescribed by a physician  Life and accident, mortgage or debt insurance policies and disability insurance  Food items purchased for special diets, such as the supplemental drink Ensure If a medical expense could qualify for both the medical deduction and the dependent care deduction, the household can choose to deduct the expense as either medical or dependent care expense but not both. Example Ms. Dodds’ son, James, is 19 years old and has disabilities that require constant care. To enable Ms. Dodds to work, James attends an adult daycare center. Use the cost of the adult daycare as a dependent care expense instead of a medical deduction. This is because the entire amount can be deducted as a dependent care expense but would have to be reduced by $35 if used for the medical deduction.

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