PM 13-01-05-a: Allowable Medical Expenses

WAG 13-01-05-a

Medical expenses are not allowed if:

  • reimbursable by insurance or a third party, or
  • paid by a vendor payment, or
  • paid by a non SNAP unit member, unless the amount paid is counted as income.

Allowable Medical Expenses

Regardless of intent to pay, allowable medical expenses include, but are not limited to, bills received or expected to be received for the following services:

  • Medical and dental care.
  • Psychotherapy and rehabilitation services provided by a state licensed practitioner or other qualified health professional.
  • new manual textThe cost for acupuncture, massage therapy, or herbs prescribed for therapeutic purposes, if a state licensed practitioner or other qualified health professional prescribes or approves as an alternative therapy or medicine. The cost for the practitioner and the therapy or medicine may be allowed as a medical expense, if it cannot be otherwise purchased with SNAP benefits and is not prescribed as a part of a special diet.
  • Hospitalization or outpatient treatment.
  • Nursing care or nursing home care including bills received by the unit for a person who was a unit member immediately before entering the hospital or nursing home.
  • Prescribed drugs, including insulin and other over the counter medications when approved by a physician or other qualified health professional.
  • new manual textPostage for mail order prescription drugs is an allowable medical expense.
  • Cost of medical supplies, sickroom equipment, including rental, or other prescribed equipment.
  • new manual textAdaptive equipment in vehicles and homes as well as monthly telephone fees for amplifiers and warning signals for elderly or disabled individuals (PM 05-06-01) and the costs of telecommunications devices for the elderly or disabled.
  • Health and hospitalization insurance policy premiums.

    NOTE: Do not allow for the costs of:

    • health and accident policies such as those payable in a lump sum for death or dismemberment, or
    • income maintenance policies such as those that make mortgage or loan payments while the beneficiary is disabled, or
    • health insurance premiums paid by the Health Insurance Premium Payment (HIPP) Program.
  • new manual textInsurance premiums for policies intended to cover cancer treatments.
  • revised manual textInsurance premiums for ambulance insurance policies.
  • new manual textPayments made on a conventional loan when the loan is used to pay a one time only medical expense, but loan expenses such as interest are not allowed as part of the deduction. If a mortgage is obtained for the purpose of financing a large medical expense, the mortgage payment should be allowed as a shelter cost and is NOT allowed as a medical expense.
  • Medicare premiums, Supplementary Medical Insurance Benefits (SMIB), and/or the Hospital Insurance Benefits (HIB), regardless of whether the qualifying member pays the premium directly or has it deducted from their Social Security check. Do not allow costs for Medicare SMIB and/or HIB premiums, if the person is enrolled in the Department of Healthcare and Family Service (HFS) SMIB/HIB buy-in agreement, or in the QMB or SLIB program. 
  • Pay-in Spenddown payments. Pay-in Spenddown payments are centrally entered by the system see (PM 13-01-05-f and WAG 13-01-05-f).
  • Dentures, hearing aids, and prosthetics.
  • Cost of securing and maintaining an animal specially trained to serve the needs of a disabled person. When determining the cost, include the cost of food, veterinary bills, and other maintenance costs.
  • revised manual textContact lens or eyeglasses prescribed by an optometrist or a physician trained in eye disease.
  • Physician's charges to complete medical or insurance reports.
  • Reasonable cost of transportation and/or lodging to obtain needed medical treatment or services. If the unit's automobile is used for medical transportation, the allowable rate is 24¢ per mile. new manual textTransportation and lodging costs must be verified.
  • Costs of maintaining an attendant, homemaker, home health aide, housekeeper, or child care provider, when needed due to age, infirmity, or illness of a unit member. In order to allow the costs, the provider cannot be a SNAP unit member.

    If a SNAP unit incurs attendant care costs for an incapacitated person of any age that could qualify as either a medical care deduction or as a dependent care deduction, allow the unit the option to choose how the costs will be deducted. The unit may choose to deduct the entire attendant care cost as a dependent care deduction or as a medical expense deduction but not both. Discuss with the customer and determine the option that would be most beneficial for them. Incapacitation is:

  • any permanent or temporary condition that prevents an individual from participating fully in normal activities without supervision (including, but not limited to, work or school); and
  • that requires the care of another person to ensure the health and safety of the individual, or condition or situation that makes a lack of supervision risky to the health and safety of that individual. Do not refer to the Client Assessment Unit (CAU).
  • In addition to other costs, if the unit provides the attendant with a majority of their meals, allow an amount equal to the maximum benefit amount for a one person SNAP unit as a medical expense.
  • Group home services, such as CILA services, for persons living in group homes. See PM 06-11-02-b for an explanation of CILAs. Accept the group home's statement of the amount of the client's income the group home keeps and what portion of the amount is for shelter expenses. Count the rest of the amount the group home keeps as a medical expense. See WAG 13-01-05. NOTE: CILA services are allowable medical expenses, even when the client resides in their own home. 
  • Supportive Living Facility (SLF) services. If the resident receives medical assistance, the amount of the medical expense is the SLF credit amount. See WAG 05-11-05.
  • new manual textHemp derived CBD (cannabidiol) Oil may be allowed as a medical deduction ONLY if verification is provided that specifically indicates:
    1. a State licensed practitioner or qualifying health professional has approved or prescribed the product; AND
    2. certifies that the product contains a delta-9 tetrahydrocannabinol (THC) concentration in an amount that does not exceed 0.3 percent on a dry weight basis.
      • When requesting verification from a customer claiming CBD oil as a medical expense, make sure the customer understands what needs to be provided as proof of their usage. Specifically state what is needed on the 267 VCL. If the customer's verification does not specifically include #1 and #2 above, do not allow a medical deduction. There is no exception to this requirement.

Note: See PM 13-01-05-e for Medical Expenses not allowed.