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Title 7: SNAP Page 41 Iowa Department of Health and Human Services Employees’ Manual Chapter E: Income Deductions Revised September 27, 2024 Earned Income Earned Income Legal reference: 7 CFR 273.9(d)(2) Deduct 20 percent of all gross earned income. Apply this deduction as directed in 7-F, Net Income Limit. Medical Expenses of Elderly or Disabled Household Members Legal reference: 7 CFR 273.9(d)(3) Deduct medical expenses in excess of $35 a month. Allow the expenses of a household member who is elderly or disabled, as defined in 7-A, Definitions. Allow a deduction for the medical expenses of:  Elderly or disabled household members.  People who get emergency SSI benefits based on presumptive SSI eligibility.  An elderly or disabled person who was a household member immediately before death or before entering a hospital or nursing home. The expense must: • Be the responsibility of the remaining household, and • Meet the criteria under Allowable Medical Expenses. Start deducting the medical expenses in the month when a person:  Turns 60, or  Starts getting SSI or social security disability benefits. Do not allow the medical expenses of a household member who gets benefits only because the member is a dependent of the person who receives the SSI or disability payment. Households eligible for medical expenses as a deduction have the option of using actual medical expenses or choosing the standard medical deduction. Do not allow expenses that will be reimbursed. Allow only the part of the expense that the household owes after reimbursement. (The ABC system subtracts the $35 from the medical expenses you enter.) The following sections explain:  Standard medical deduction  What are allowable medical expenses  When to allow medical expenses of a person in a residential care facility  How to determine medical expenses  The effect of changes in medical expenses  Spenddown as a medical deduction