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1086 Chapter 7:Worker guides • Section 2: SNAP worker guides (07/2026) Facts: Harry is eligible for SNAP from January through December. He is 67 and receives $700 per month in Social Security benefits. He also gets Medicare. His Medicare premium payment is $88.50 per month. His monthly Medicare Part D cost is $22.00. Other than his Medicare premium, Harry anticipates no medical expenses for the certification period. He chose not to enroll in QMB. His medical deduction at certification would be $110.50. Situation: Harry is unexpectedly hospitalized in March. The hospital sends him a medical bill of $850 in April, which he sends to his worker that same month. His worker calls him. He states he did not make an arrangement to make payments each month. The worker explains how the bill is averaged over the remaining months of his certification period, beginning in May (the month after the expense was billed). The worker also explains to Harry that anything that Medicare covers cannot be used as a deduction. Harry says that Medicare has already paid their portion. Harry’s gross monthly medical deduction for May through December (eight months) is: ($850 ÷ 8) = $106.25 + $88.50 + 22.00 = $216.75 In July, Harry is billed for two checkups he received in June that were not anticipated. The total amount is $140 after Medicare. His worker receives a copy of the bill on July 6. Harry chooses to have the bill averaged over the remaining months of his certification period, beginning in August. Harry’s gross monthly medical deduction for August through December (five months) is: ($140 ÷ 5) = $28 + $216.75 = $244.75 In September, Harry is billed for a lab test that was not anticipated. The amount due is $35. He has not paid the bill yet. He tells his worker that he would like to have the bill used in full for his October deduction. Gross medical deduction for October only is: $35.00 + $244.75 = $279.75 Gross monthly medical deduction for November and December is $244.75 Medical expenses change, but are not reported Facts: Myrtle gets $900 per month Social Security benefits. Her Medicare premium costs $88.50 but it is covered by Medicaid (SMB). At her initial intake, she was expecting office visits with her doctor twice a month, at the cost of $45 per visit. She also expected her cost at $35 per month in prescription medicines.

The worker calculated 2 x $45 = $90 x 20 percent (Myrtle’s share) = $18 per month for office visits.

$18 office visits + $35 prescriptions = $53.00 medical deduction for the certification period. Situation: At recertification, Myrtle reports that four months ago, she began having doctor’s office visits only once every other month and her prescription costs (GP-A.18) dropped to $12 per month. The charge for the doctor’s office visit continues to be $45 per visit. The worker calculates a new medical deduction for the next certification period as follows: $22.50 ($45 ÷ 2) office visit + $12 prescriptions = $34.50 medical deduction. Although this amount will not affect Myrtle’s SNAP allotment (it is less than $35), it should be coded in ONE.