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Do not count medical expenses incurred by household members who are not aged or disabled toward this deduction.
Do not count medical expenses paid by insurance or another party who is not a household member toward this deduction.
Allowable medical expenses are limited to the following:
Medical and dental care including psychotherapy and rehabilitation services when provided by a State-licensed practitioner;
Hospitalization or outpatient treatment, nursing care, and nursing home care including payments made by the household for an individual who was a household member immediately prior to entering a hospital or nursing home;
Prescription drugs when prescribed by a health professional licensed under State law to prescribe drugs, including the charge for postage and handling of mail-order prescription drugs;
Eyeglasses when prescribed by an ophthalmologist or optometrist;
Over-the-counter medication (including insulin) and other health-related supplies when approved by a licensed health professional;
212.8 Excess Medical Expense Deduction (continued)
Premiums for health and hospitalization insurance policies and long-term care insurance policies (excluding the cost of income maintenance type health policies and accidental policies);
Medicare premiums;
Any cost-sharing or spend down amounts incurred by Medicaid recipients;
Dentures, hearing aids, and prosthetics;
Cost of securing and maintaining a service animal;
This includes Seeing Eye or hearing guide dogs, housekeeper monkeys, and any other animal specially trained to serve persons with disabilities.
Allowable costs include, but are not limited to, the costs of obtaining and training the animal and food and veterinary care.
Actual costs, or when these cannot be determined, the cents per mile figure established by the State, of transportation and lodging necessary to secure medical treatment or services; and
The costs of employing an attendant, homemaker, home health aide, housekeeper, or childcare provider due to age, infirmity, or illness. Include in this cost an amount equal to the SNAP allotment for one person if the household provides most of the attendant’s meals. Treat these costs as a medical expense if the attendant care cost could qualify under both the medical and dependent care deductions.
Verification of Medical Expenses
Verify medical expenses, including the amount of reimbursement, at initial application and at recertification if the source or the amount changes by more than $25. If a household voluntarily reports a change in medical expenses during a certification period, it must be verified if the change would increase the household’s allotment.
Acceptable verification of medical expenses includes, but is not limited to the following:
Current bill or written statement from the provider that shows all amounts paid by insurance, Medicare, or Medicaid;
Insurance, Medicare, or Medicaid statements that show charges incurred and the amount paid by the insurer;
BENDEX for Medicare premium;
Written statement from licensed health care professionals;
Collateral contact with the provider. (Maybe used to determine costs of over-the-counter medication, health-related supplies, and ongoing medical transportation.)
Medical expenses are the exception to the policy that allowable expenses can only be deducted when they are due. The household may report and verify during recertification medical bills incurred in the prior certification period.
REMINDER: Past due bills on which there has been no current payment are not included.
212.9 Excess Shelter Deduction
Allow a deduction, up to the cap noted in Section 600, for monthly billed shelter costs that exceed 50% of the household’s income after the deductions described above have been made.
Note that the excess shelter deduction cap does not apply to households with an aged or disabled member. Those households receive an uncapped shelter deduction.
The expenses do not have to be paid to allow the expense.
Shelter costs are limited to the following:
Rent, mortgage, a second mortgage, or other payments, including interest, leading to ownership of the shelter occupied by the household. The expense must be a continuing one.
Payments that exceed the normal monthly payment are not deductible as a shelter expense.
Note: Meal charges paid by households that reside in a home for the elderly and disabled are not a shelter cost.
Property taxes, State and local assessment, and insurance on the structure itself, but not separate charges on the contents (e.g. furniture, clothing, and personal belongings). If the cost of insurance includes coverage on both the structure and contents, the entire cost is deducted.
Heat and utilities.
This includes the costs of:
Heating and cooking fuel;
Cooling and electricity;
Water and sewerage;
Garbage and trash collection fees;
Well and Septic installation and maintenance; and
Fees charged by the utility provider for utility installation, excluding deposits.
Any household that has an obligation for heating and/or cooling separate from its rent or mortgage payment must use the appropriate utility allowance as its total utility cost.
212.9 Excess Shelter Deduction (continued)
Households not eligible for the utility allowance may claim actual utility expenses for those utilities for which they have an obligation (See Section 214 for further details on the utility allowances).
Households that pay heating or cooling expenses and do not receive Energy Assistance such as: Maryland Energy Assistance Program (MEAP), Electric Universal Service Program (EUSP), Arrearage Retirement Assistance, Utility Service Protection Program (USPP), etc. may be eligible to receive a one time annual payment equal to $21.00 from the H-EAT program. The Heat and Eat (H-EAT) program provides a $21 fuel assistance payment to certain SNAP households.
(i) The $21.00 payment from the H-EAT program makes households not receiving Standard Utility Allowance (SUA) now eligible for the SUA.
(ii) A data sharing process has been established between OHEP and MDTHINK to identify Energy Assistance households that are receiving SNAP benefits and not actively receiving the Standard Utility Allowance (SUA) deduction.
(iii)These households not actively receiving SUA or Energy Assistance will be awarded a $21 payment that will be deposited into their EBT account as cash.
(iv) The $21.00 payment will trigger a SUA allowance in E&E for the household. The SUA allowance will recalculate SNAP benefits to include SUA for 12 consecutive SNAP issuance months.
A household that incurs a separate telephone expense but is not entitled to claim a utility allowance must use the mandatory telephone allowance as listed in Section 600, even if the actual expense is higher.
Condominium and Association Fees. The household is entitled to a shelter deduction for a condominium and association fee. The household is not entitled to a separate deduction for utilities included in the fee.
If the condo fee includes payment for heat, the household is not entitled to the SUA, but is billed separately for electricity, and may receive the LUA. If the condo fee includes electricity , but the household is billed separately for heat, it is entitled to the SUA.
Shelter costs for a temporarily unoccupied home due to employment or training away from home, illness, or abandonment caused by a natural disaster or casualty loss. The shelter costs for a temporarily unoccupied home can be included provided:
the household intends to return to the home;
the current occupants of the home, if any, are not claiming shelter costs on that home for SNAP purposes; and
the home is not being leased or rented to others during the household’s absence;
NOTE: Do not use the utility allowance for unoccupied homes. Use only the actual utility costs.
G. Verification of Shelter Expenses
1. Shelter and dependent care verification is mandatory for the customer to receive the deduction, however, it is not mandatory to receive SNAP benefits.
NOTE: Note: A case manager will still be required to send a Request for Information, ie.1052 when a customer indicates they pay shelter expenses to include a utility expense at application, redetermination, benefit review, and interim change.
A. If a customer provides the requested verification, the case must be updated and the SUA deduction applied to the case in the application and or new redetermination month.
B. If the customer fails to submit the requested verification, the data match process previously stated will be performed.
C. If the customer is not currently an energy assistance program recipient then they will become eligible for Heat and Eat.
2. Verify utility expenses if the household is entitled to only actual expenses instead of the utility standard.
3. Verify utility expenses for an unoccupied home. Do not use the utility standard.
H. REQUIRED ACTION:
A case manager must:
A. Send a Request for Information (ie.1052) when a customer indicates they pay shelter expenses to include a utility expense at application, redetermination, benefit review, and interim change.
B. When a customer provides the requested verification, the case manager must update the case appropriately.
NOTE: The appropriate shelter deduction LUA or SUA will be applied by E&E in the month of application and or new redetermination month.
○ The SUA deduction will be added to the case in the month following the completion of the data sharing process.
○ Heat and Eat is an approval process that does not apply to any retroactive periods.
○ SNAP benefit calculation includes the SUA.
NOTE: As a result, some households may receive an initial SNAP benefit amount that is different from their ongoing benefit amount. This is based on several factors: the client’s application date; the date the case is approved for SNAP benefits; and the household’s monthly issuance date.
212.9 Excess Shelter Deduction (continued)
Acceptable shelter expense verification includes, but is not limited to the following:
Mortgage or rental contracts, or a statement from the mortgage company, bank, or landlord;
Copy of tax, insurance, assessment bills, or a collateral contact with the appropriate government or insurance agency;
Current bills or a written statement from the provider for heat/utility expenses;
Collateral contact with the heat/utility provider;
(e) H-EAT E&E System generated narration from the Office of Home Energy Program regarding the approval of the one time annual $21 fuel assistance payment.
(f) Verification is not required for the Maryland Senior Nutrition Assistance
Program (MSNAP) or Elderly Simplified Application Project (ESAP).
NOTE: H-EAT does not affect the way Maryland Senior Nutrition Assistance Program (MSNAP) or Elderly Simplified Application Project (ESAP) cases are processed. The policy for MSNAP and ESAP customers has not changed, verification is not required for MSNAP and ESAP. Please refer to Knowledge Base: Section 107-ESAP and MSNAP in the SNAP Manual.
212.10 Homeless Shelter Allowance
Households in which all members are homeless but are not receiving free shelter are entitled to the standard homeless shelter allowance of $148. Allow actual shelter expenses, instead of the homeless shelter allowance, if the actual shelter costs would result in a higher deduction under the excess shelter calculation.
The determination that a household is homeless is important when deciding if a household is eligible for the homeless shelter allowance. The $148 allowance cannot be claimed unless the household meets the definition of homeless.
A homeless individual is one who:
Lacks a fixed and regular nighttime address; or
Has a primary nighttime address that is:
a supervised publicly or privately operated shelter designed to provide temporary living accommodations; or
an institution that provides a temporary residence for individuals intended to be institutionalized; or
a temporary accommodation in the residence of another individual for no longer than 90 days; or
a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation.
NOTE: Homeless households are not entitled to the one time $21 fuel assistance payment as they are entitled to the standard homeless shelter allowance of $148. For additional information, please refer to 20-02 AT Homeless Shelter Deduction Increase.
○ Households who are identified as homeless are distinguished on the E&E Contact Information Page.
212.11 Child Support Deduction
Allow a deduction for legally obligated child support payments paid by a household member to or for a non-household member.
To be entitled to the deduction the household member must:
Have a legal obligation to pay; and
Make payments.
The child support deduction includes the following:
The anticipated payments that the household member will pay over the certification period.
Payments to a third party on behalf of the non-household member in accordance with a support order.
Payments to obtain health insurance, if legally obligated.
Arrearages if the payments are anticipated to continue during the certification period. Do not include arrearages during the certification period if there is no basis for expecting future payments.
Do not include the following in the child support deduction:
Alimony payments;
Amounts paid over the obligated amount, except for allowable arrearages.
Verification
Verification of child support payments must be requested from households that claim this deduction.
Acceptable forms of verification include the following:
Court Order
Separation Agreement
Divorce Decree
Information from Child Support Enforcement (IV-D)
212.12 Action While Awaiting Verification
Do not allow any questionable expense as a deduction until verification is provided.
Determine eligibility and SNAP benefit level without providing a deduction for the unverified expense if the expense cannot be verified within 30 days of the date of application. This includes medical expenses that may be covered by a reimbursement if the amount of the reimbursement cannot be verified.
When a household fails or refuses to provide verification of the legal obligation or of the actual child support payments, calculate eligibility and benefit level without the deduction.
D. Treat as a reported change any verification an eligible household provides after the 30th day.
E. Do not restore lost SNAP benefits to the household if verification is provided after
the 30th day.