3SquaresVT Medical Expense Deduction for Elderly Kinship Caregivers

If you are 60 or older and raising a grandchild in Vermont, you may be leaving money on the table every month. The 3SquaresVT medical expense deduction is one of the most underused provisions in Vermont's SNAP program, and it can increase your monthly food benefits when your allotment is below the maximum.

How the Deduction Works

Standard 3SquaresVT households have a cap on the excess shelter deduction. Households with a member who is age 60 or older or has a qualifying disability have no cap on that deduction, but it only covers shelter costs above 50% of monthly income after other applicable deductions. They also get an out-of-pocket medical expense deduction:

• Out-of-pocket medical expense deduction — allowable, verified medical costs above $35 per month are subtracted from your countable income

Lower countable income means higher 3SquaresVT benefits. For a grandparent with regular prescriptions, doctor visit copays, and transportation costs to medical appointments, this deduction can add meaningful dollars to the monthly EBT deposit.

What Counts as a Medical Expense

ESD accepts a wide range of out-of-pocket medical costs for the deduction. Qualifying expenses include:

• Prescription drug copays and over-the-counter medications approved by a licensed practitioner or other qualified health professional
• Doctor, specialist, and dentist visit copays
• Medicare premiums (Parts B, C, and D)
• Medigap or supplemental insurance premiums
• Medical transportation costs (mileage to appointments, bus fare, parking)
• Hearing aids, prescribed eyeglasses, dentures, and prosthetic devices
• Home health aide costs not covered by insurance when an aide is needed because of age, infirmity, or illness
• Physical therapy, mental health counseling, or substance use treatment copays

The deduction covers expenses for any household member who is 60+ or has a disability — so if both you and a spouse are in the household, both sets of medical costs count.

How to Document and Report

The key to claiming this deduction is documentation. ESD needs verification of each recurring expense, which means:

• Save pharmacy receipts or print prescription histories
• Keep copay receipts from every medical visit
• Track mileage to medical appointments (a simple notebook log with date, destination, and round-trip miles works)
• Retain premium statements for Medicare or supplemental insurance
• Keep documentation showing that any over-the-counter medication was approved by a licensed practitioner or other qualified health professional

At your initial 3SquaresVT application and each recertification (every 12 or 24 months, depending on the household), report your total monthly medical expenses to your ESD worker. Bring the documentation to your interview or upload it through the DCF Document Uploader.

If your medical expenses change significantly mid-year — a new prescription, a surgery, ongoing physical therapy — report the change to ESD. Your benefit amount can be adjusted between recertifications.

Running the Numbers

Consider a 67-year-old grandmother raising her grandchild in a combined 3SquaresVT household. She has $120 in monthly prescription copays, $175 in Medicare Part B and Part D premiums, and $40 in monthly medical transportation. Her total medical expenses are $335 per month. After subtracting the $35 threshold, the deductible medical expense is $300.

That $300 reduces her countable income dollar-for-dollar, which can increase the household's monthly 3SquaresVT allotment by roughly $90 if the allotment is not already at its maximum (SNAP benefits generally decrease by about 30 cents for each dollar of net income). Over a year, that is an additional $1,080 in food benefits from documentation she already has.

Applying the Deductions to Your SNAP Household

Under federal SNAP rules, a non-foster child under 18 who lives with and is under the parental control of a household member other than a parent must be included in that adult's household, even if food is bought and prepared separately. For SNAP, parental control includes financial or other dependence, unless State law defines the child as an adult. Apply the medical expense and excess shelter deductions using the required household composition.

Our Vermont Kinship Financial Help Guide includes a 3SquaresVT medical expense tracking worksheet and explains how to apply SNAP household rules to a kinship family.

See more Vermont guides →