Department of Human Services
Food Stamp Online Policy Manual
I. What Is a Medical Deduction?
Medical Deductions Supplement
(1) Medical Expense
A medical expense is an identifiable medical cost incurred by a household member who meets one of the criteria given in Section B.
Allowable medical costs are:
1. medical and dental care, including psychotherapy and rehabilitation services, provided by a licensed practitioner authorized by state law, of other qualified health professional;
2. hospitalization or outpatient treatment, nursing care, and nursing home care, including payments by the household for an individual who was a household member immediately prior to entering a hospital or nursing home licensed (or recognized) by the state;
3. prescription drugs when prescribed by a licensed practitioner authorized under state law, and over the counter medication (including insulin) when approved by a licensed practitioner or other qualified health professional; in addition, costs of medical supplies, sickroom equipment (including rental) or other prescribed equipment are deductible;
4. health and hospitalization insurance policy premiums (Refer to definition);
5. Medicare premiums related to coverage under Title XVIII of the Social Security Act; and cost-sharing or spend-down expenses incurred by Medicaid recipients;
6. dentures, hearing aids and prosthetics;
7. costs of securing and maintaining an animal specially trained to provide service to the disabled including the cost of food and veterinarian bills. Costs over and above that covered by a reimbursement constitute an allowable deduction;
8. eyeglasses or contact lenses, prescribed by a physician skilled in eye disease or by an optometrist;
9. reasonable cost of transportation and lodging to obtain medical treatment/services;
10. monthly telephone fees for amplifiers and warning signals for handicapped persons;
11. costs of typewriter equipment for the deaf;
12. special diets that require a prescription and must be obtained from a pharmacist (do not count other special diets); and
13. costs of maintaining an attendant, homemaker, home health aid, child care services, or housekeeper that are necessary due to age, infirmity, or illness. In addition, deduct an amount equal to the one-person coupon allotment if the household furnishes the majority of the attendant’s meals. The allotment for this meal-related deduction will be that in effect at the time of initial certification. Update the allotment amount at the next scheduled recertification.
(2) Medical Deduction
A medical deduction is the non-reimbursable portion of an allowable medical cost that exceeds $35 per month.
An individual is considered disabled if he/she meets any of the following criteria (also see Definition Section for Disability):
(a) receives payments for disability or blindness under Titles I, II, X, XIV or XVI of the Social Security Act;
(b) receives federally or state administered supplemental benefits under section 212 (a) of Public Law 93-66;
(c) receives disability retirement benefits from a governmental agency because of a disability considered permanent under Section 221 (i) of the Social Security Act;
(d) receives an annuity payment under Section 2 (a)(l)(iv) of Railroad Retirement Act of 1984 and is determined to be eligible to receive Medicare by the Railroad Retirement Board;
(e) receives an annuity payment under Section 2 (a)(i)(v) of the Railroad Retirement Act of 1984 and is determined to be disabled based on the criteria used under Title XVI of the Social Security Act (SSI);
(f) receives interim or presumptive assistance payments pending receipt of SSI;
(g) receives medical assistance based on disability under Title XIX (Medicaid);
(h) is a veteran receiving VA benefits for a service or non-service connected disability rated or paid as total or is considered by VA standards to be in need of regular aid and attendance or considered permanently housebound;
(i) is a disabled surviving spouse of a veteran and is considered by VA standards to be in need of regular aid and attendance or is permanently housebound;
(j) is a disabled surviving child of a veteran and is considered by VA standards to be permanently incapable of self-support;
(k) is a surviving spouse or child of a veteran and entitled to VA compensation for a service-connected death or VA pension benefit for a non-service-connected death and has a disability considered permanent under the Social Security Act.
(4) Entitled (in relation to disability)
“Entitled” refers to a surviving spouse and children of veterans who are receiving the compensation or benefits stated in the Disability definition, or have been approved for such payments but are not yet receiving them.
(5) Health & Hospitalization Insurance Policies
A health and hospitalization insurance policy pays for medical services, either on an out-patient basis (major medical), or due to hospitalization. The payment is normally made directly to the medical service provider or as a reimbursement to the insured.
Do not consider the following:
a. the cost of “health and accident” policies that are payable in a lump sum settlement for death or dismemberment;
b. the cost of income maintenance policies that continue mortgage or loan payments while the beneficiary is disabled; or
c. the entire amount of a health or insurance premium if it includes coverage for household members not entitled to a medical deduction.
Allow only that portion of a health or hospitalization insurance premium assigned to a HH member eligible for a medical deduction. If specific information is not available on what portion of the premium is for the eligible member, pro rate the premium to determine the allowable amount for the eligible HH member.
(6) One Time Medical Expenses
One time medical expenses are medical expenses that are not recurring, either on a stable or fluctuating basis.
· a hospital bill;
· a doctor bill for a temporary illness or a minor surgical procedure done in the doctor’s office;
· bills for the purchase of prescription eye glasses or contact lens; or
· bills for the purchase of hearing aids.
Recurring medical expenses are those expenses that occur again and again over a period of time. They may be stable or fluctuating.
Generally, insurance premiums and attendant care costs are stable, while prescriptions, doctor bills, and transportation costs are fluctuating.
As a rule, a medical expense recurring at regular intervals, and with a constant cost per occurrence, would be considered stable. An expense which recurs at irregular intervals, or with a changing cost, would be considered fluctuating.