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MS 5420

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Volume 2 - Supplemental Nutrition Assistance Program (SNAP) MS 5420 - R. 8/01/25 – OMTL - 677 Medical Deductions – General

Handle allowable medical deductions as follows: If paid, the expense and, if applicable, the reimbursement must have been reported timely:

A. Determine if the reported medical expense is currently being billed and the reimbursement status of the expense.

Consider only the existing balance of a currently billed expense. If the expense is no longer being billed, do not allow the expense.

1. If verified medical expenses are less than or equal to $35, then no medical deduction is allowed. 2. If verified medical expenses are more than $35 but less than or equal to $172, the Standard Medical Deduction (SMD) of $137(the current average medical expense for the state) is applied ($172-$35=$137). 3. If verified medical expenses are greater than $172, the actual medical expense, minus $35, is applied.

If multiple individuals have verified medical expenses more than $35, the system shall apply the SMD to the household. Do not consider any medical expense reported timely, which will be reimbursed or reimbursement is undetermined, until the reimbursement is verified or denied and the non-reimbursable amount is determined. If the reimbursement status cannot be determined, document the case record accordingly.

Refer to Items G. and H. when medical expenses are reported during the certification period.

B. Determine if the member eligible for a medical deduction has medical insurance or is included in a Medicaid case.

Medical insurance or a Medicaid case indicates the possibility of reimbursement, which must be resolved prior to consideration of the expense.

If an SSI individual has prescription medicine expenses not covered by Medicaid, advise the individual to contact the prescribing physician and ask about preauthorization by the Medicaid program.

C. Determine if any currently reported one-time only medical expenses were considered during any previous certification period. Examples of one-time expenses are hospital bills, ambulance bills, laboratory fees, non-continuing doctor visits and/or prescription costs such as treatment for flu, etc.

Once a one-time only expense has been considered during a certification period, do not consider the same expense in succeeding periods. However, if