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Division/Section Family Support Chapter No./Name 4 – Economic Independence (EI) Part No./Name B – Eligibility Factors Section No./Name B-600-FITAP-SNAP Income Document No./Name B-650-SNAP Deductions Effective Date September 1, 2026

12 of 22 B-653-SNAP - PR MEDICAL DEDUCTION

Budgeting Medical Expenses

Allow a medical deduction for the month the expense is billed or otherwise becomes due, regardless of when the household intends to pay the expense. If a household arranges with the provider to pay medical expenses in installments, the installments would be considered the household’s expenses in the month each payment becomes due. The installment plan must be agreed upon prior to the due date of the original billing. Delinquent amounts carried forward from past billing periods are not deductible even if included with the most recent billing and actually paid by the household, since a particular expense may only be deducted once.

Medical expenses billed through charge accounts such as VISA are considered billed when the charge account statement is received. Charge account expenses such as interest are not allowed as part of the medical expense.

Households are not required to report changes in medical expenses (including new expenses) during the certification period. However, if a household voluntarily reports a change, act on the change only if it results in an increase in benefits or if the reported information is considered verified upon receipt.

If the agency learns about a change in medical expenses from a source other than the household (e.g., Medicaid), the agency will act on the change if it is considered verified upon receipt and if the action can be taken without contacting the household for additional information or verification. If the change would require the agency to contact the household, do not act on the change during the certification period.

If a medical expense is shared with a non-household member or someone who is not eligible for a medical deduction and the expense for the elderly or disabled member cannot be differentiated, the allowable deduction is the elderly or disabled member’s prorated share of the expense. For example, a family of four, that includes a disabled member, has a health insurance policy. The allowable deduction for the insurance would be one-fourth of the insurance premium.

If the client reports caretaker costs that could qualify under both medical and dependent care deductions, the household must be allowed a deduction of either medical or dependent care expense, but not both.

If the client has other medical expenses of at least $35 per month, the caretaker expense may be allowed as a medical or dependent care deduction. If the expense is allowed as a medical deduction, the household will need to provide written documentation of the medical expense.

If the client does not have at least $35 per month in other medical expenses, the caretaker cost should be budgeted as a dependent care expense instead of a medical expense since the medical threshold is not met.