When the head-of-household, spouse, or co-head is elderly (62 years of age or older) and/or disabled, the household is eligible for a medical expense allowance. When the household is eligible for the medical expense allowance, the out-of-pocket, unreimbursed expenses of all household members (except live-in aides) are included in the medical expense calculation.

Exhibit 5-3 of HUD Handbook 4350.3 identifies various allowable medical expenses, which include, among other things, transportation costs to and from medical facilities to receive services or treatments.

According to HUD, actual transportation costs by bus, taxi, or ambulance should be included in the medical expense calculation. Such expenses may be verified with receipts or ticket stubs or, if not available, a notarized statement or signed affidavit provided by the household attesting to the out-of-pocket, unreimbursed expenses.

In addition, when driving by car to/from medical appointments, HUD advises owners to apply the IRS mileage rate for medical purposes to the number of miles driven. The IRS medical mileage rate (effective Jan. 1, 2021) is currently $0.16 per medical mile driven and is adjusted annually.

To determine the number of miles driven, you may use an online web mapping service such as MapQuest or Google Maps by entering the tenant’s home address and the address of the medical facility and print the results (ensure that both the date and webpage accessed are displayed on your printout).

Finally, verify the tenant’s number of anticipated medical appointments for the next 12 months.

EXAMPLE

The tenant reports that she drives her car from home to each of her various medical appointments and back again throughout the year to see her general medical practitioner, cardiologist, and psychologist.

Verification revealed the number of anticipated visits to each health care provider for the next 12 months as follows:

General Medical Practitioner: 6
Cardiologist: 2
Psychologist: 8

Now that we know the anticipated number of visits, we need to determine the number of miles between the tenant’s home and the office of each medical provider. To this end, using MapQuest for example, input the tenant’s home address and the address of each medical office to determine the distance between both locations and print the results of each search. For our example, the distances between the tenant’s home address and each medical office are as follows:

General Medical Practitioner: 5.7 miles
Cardiologist: 8.0 miles
Psychologist: 10.2 miles

Therefore, for each health care provider, multiply the number of miles between the tenant’s home and the office of each health care provider by the total number of round-trip visits:

General Medical Practitioner: 5.7 miles/trip x 6 visits x 2 (round trip) = 68.4 miles/year
Cardiologist: 8.0 miles/trip x 2 visits x 2 (round trip) = 32 miles/year
Psychologist: 10.2 miles/trip x 8 visits x 2 (round trip) = 163.2 miles/year

Add up all of the miles: 68.4 miles + 32 miles + 163.2 miles = 263.60 miles driven annually

Multiply the annualized miles driven by the current IRS Standard Mileage Rate of 16 cents per mile driven for medical purposes:

 263.60 miles driven per year x $0.16 = $42.18 (transportation costs)

Therefore, the medical expense calculation will include $42.18 in transportation costs to and from medical facilities for the next 12 months.

You can apply the IRS mileage rate in similar fashion when the tenant drives to receive treatment from other medical facilities such as hospitals and outpatient clinics, as well trips to and from the vet for assistance animals.