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A household member who is not elderly or disabled but who is receiving disability benefits as the dependent of a disabled or elderly person is not entitled to this deduction. In addition, only the medical expenses of the individual who qualifies as elderly or disabled are used as a deduction for excess medical expense. The following are allowable medical expenses when incurred for the care of an elderly or disabled member: • medical and dental care, including psychotherapy and rehabilitation services. These services must be provided by a licensed practitioner authorized by District law or by another qualified health professional. • hospitalization, outpatient treatments, or nursing care. The deduction will include 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, when prescribed or approved by a licensed practitioner or another qualified health professional. • rental or purchase of prescribed medical supplies, sick room equipment, or other prescribed equipment. • health and hospitalization insurance policy premiums. The costs of health and accident policies such as those payable in a lump sum upon death or dismemberment of the policy holder or income maintenance policies such as those that continue mortgage or loan payments while the beneficiary is disabled are not deductible. • Medicare premiums. • co-payments for MA recipients. • dentures, hearing aids, and prostheses. • purchase and maintenance of a seeing eye or hearing dog, including dog food 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, child care service, or housekeeper. This service must be provided by a non-household member and be necessary due to age, infirmity, or illness of the elderly or disabled household member. In addition, if the household provides the majority of an attendant's meals, the household is eligible for a deduction equal to the coupon allotment for one person. This deduction must be updated when the standard allotment amount changes to reflect the increased maximum benefit for a one-person group. If an elderly or disabled person has an expense that could be used for either a dependent care deduction or a medical deduction, it will be used as a medical deduction.

Ms. Dodds has a 19-year-old mentally retarded son, James, who requires constant care. In order for Ms. Dodds to work, James attends an adult day care center. The cost of the adult day care services in excess of $35 per month qualifies as a medical expense since James is disabled. A disabled mother who works and has an expense for babysitting for her child so she can work is not entitled to a medical deduction, but she may be eligible for a dependent care deduction which is discussed below. A fluctuating expense may be averaged to arrive at a monthly figure. An expense which is billed less often than monthly, such as every three months, may be averaged over the period of time it is expected to cover. A one-time only medical expense may be averaged over the remaining months of the certification period in which it is billed.