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Title 7: SNAP Page 44 Iowa Department of Health and Human Services Employees’ Manual Chapter E: Income Deductions Revised September 27, 2024 Medical Expenses of Elderly or Disabled…  Reasonable cost of transportation and lodging to get to and from medical treatment or services. This includes transportation to the dentist and to fill prescriptions, including eyeglass prescriptions. If the person uses a car owned by a household member or a relative, allow the state employee reimbursement rate. Use the rate per mile that is in effect at the time of certification. If the amount changes during the certification period, change it at the next certification.  Securing and maintaining service animals like a seeing-eye or hearing dog, including the cost of dog food and veterinarian bills.  The cost of a medic alert or lifeline system.  The cost of an attendant, homemaker, home health aide, or housekeeper, or of child care services that are necessary due to age, infirmity, or illness. If the household furnishes the majority of the attendant’s meals, also deduct an amount equal to the maximum SNAP allotment for one person. Allow the allotment that is in effect at the time of certification. If the maximum allotment changes during the certification period, do not update the deduction until the next certification. Allow the client participation cost when a household has in-home health-care expenses. When a household has dependent care costs that could be either a medical deduction or a dependent care deduction, use it as a medical deduction.  The cost of amplifiers and warning signals for handicapped people. Cost of typewriter equipment connected to the telephone for deaf people (like TDD). The cost of building a ramp for a wheelchair is also an allowable expense.  Health and hospitalization insurance policy premiums. Do not deduct costs of: • Health and accident policies, such as those that pay lump-sum settlements for death or dismemberment; or • Income maintenance policies, like those that continue mortgage or loan payments while the beneficiary is disabled. Some insurance policies pay a specific amount for each day in the hospital or make cash payments for each day that nursing home care or cancer treatment is needed. Allow premiums only if the insurance policy itself says that the policy’s benefits are intended to cover medical expenses rather than normal living expenses. Medical expenses may include: • Ambulance service, • Medically necessary nursing home care, or • Treatments for cancer or other illnesses.