1115.035.15.05 Amount of Medical Deduction – DSS Manuals

IM-10 January 26, 2023 ; IM-117 August 7, 2019 ; IM-55 September 13, 2011 ; IM-90 August 24, 2005

For elderly or disabled household members, a medical expense standard (MES) of $170.00 has been established. To qualify for the medical expense standard, the household must incur a total of allowable verified medical expenses that exceed $35.00 up to $170.00. All allowable, verified medical expenses are subject to a $35.00 excess medical deduction (EMD), which is taken off of the household’s total medical expenses prior to the calculation of the medical deduction in the eligibility system.

The eligibility system will grant the Standard Medical Deduction (SMD) of $135.00 ($170.00 medical expense standard less $35.00 EMD) for any household with allowable, verified medical expenses that exceed $35.00 but are less than $170.00 in total. If allowable verified medical expenses are more than $170.00, the eligibility system will not use the SMD but the actual verified medical expenses less the $35.00 EMD for the medical expense deduction.

The eligibility system determines the medical expense deduction as follows:

Verified Household Medical Expenses (Range) EMD Medical Expense Deduction used in Eligibility System $0.00 – $35.00 $35.00 $0.00 = ($35.00 – $35.00) $35.01 – $170.00 $35.00 $135.00 = ($170.00 – $35.00) $170.00 < Verified Expense $35.00 Deduction = (Verified Expense – $35.00)

If the total medical expense is $35 or less, no medical expense deduction will apply. Example: Mr. L reports medical expenses of 25.00 per month. The eligibility system will not count any medical expenses.

If the total medical expense is greater than $35 and less than or equal to $170, the eligibility system deducts the $35 Excess Medical Deduction from the $170 standard, ($170 – $35 = $135). The Standard Medical Deduction (SMD) is $135. Example: Mr. S is disabled and claims medical expense on his SNAP case. He provides verification he pays $75 per month for transportation to his chemo treatments. Since his verified expense is over $35 and under $170, Mr. S will receive the $135 SMD.

If the total medical expense is greater than $170, deduct the $35 excess medical deduction and allow the remainder as an expense. Example: Mr. T verifies he pays prescription expenses and approved over-the-counter medicines totaling $190 per month. The verified expenses exceed $170 therefore the entire amount, minus $35, is allowed. Mr. T’s medical deduction is $155.

The medical expense deduction is calculated using the verified medical expenses for all household members entitled to medical deductions as a whole, not just the medical expenses from individual persons. Example: Mr. and Mrs. A are both entitled to medical deductions. Mr. A has $18 in verified expenses and Mrs. A has $18 in verified expenses. Since both Mr. and Mrs. A are disabled, the eligibility system adds their individual expenses together for a total of $36 in medical expenses for the household. The total amount is over the $35 excess medical deduction; therefore the household is eligible for the $135 medical expense deduction.

When medical expenses are averaged over the certification period, the $35 is deducted monthly from the averaged amount to arrive at the allowable medical deduction.

Example: Mr. O has a prescription which he fills quarterly at a total cost of $75.00. When entered into the eligibility system with the correct frequency code, the system will convert the $75.00 into a monthly total and calculate the medical deduction. No excess medical deduction is allowed for Mr. O as his verified medical expenses total $25 per month.