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ESA SNAP Policy Manual 146 Medical expense deductions would be based on current verified medical expenses and any anticipated changes that can reasonably be expected to occur during the certification period. If the household reports a medical expense at certification but cannot verify the expense, ESA must not give the deduction until the expense and reimbursement are verified. See Section 5.3.1, Verification of Medical Expenses, for additional information about verification and treatment of medical expenses. 12.6.1 Nonrecurring Medical Expenses Nonrecurring medical expenses occur on a one-time basis (e.g. expenses related to surgery).  For households assigned a certification period of 12 months or less, allowable nonrecurring medical expenses may be given, at the individual’s option, as a one-time deduction in the month the change would become effective, or the expense can be averaged over the certification period.  For households in which all adult members are elderly or disabled with no earned income, allowable nonrecurring medical expenses may be given, at the individual’s option, as a one-time deduction in the month the change would become effective, averaged over a 12-month period or averaged over the entire certification period. Households reporting allowable nonrecurring medical expenses during the certification period have the same options as above to have a one-time deduction or averaged over the certification period. Averaging would begin the month the change becomes effective. Example Zelda is 66, lives alone and is receiving a $90 medical deduction. On March 2 (the seventh month of her 36-month certification period), Zelda reports paying $1,680 for a hip replacement. Zelda can choose to treat this expense in one of the following ways beginning in the month of April (when the change becomes effective):  One-time deduction: In April, the medical deduction would be $1,770 ($90 + $1,680). For May through the end of the certification period, the deduction would go back to $90.  Average deduction: Average the expense over the remaining 28 months in the certification period to get $60 ($1,680 ÷ 28). Add this amount to Zelda’s existing deduction to get a total of $150 ($90 + $60). Zelda’s medical deduction will now be $150 for the remainder of the certification period.  Note: The $35 excess is already factored in Zelda’s existing $90 deduction.

12.6.2 Recurring Medical Expenses Recurring medical expenses continue to occur over a specific period. The expense can be allowed in the month the expense is billed or otherwise becomes due. Past due medical expenses may be considered if reported at the appropriate certification/recertification as required. ESA must average fluctuating recurring expenses to calculate an average monthly expense. Return