Using ExpenseBot for HUD Medical Expense Tracking
What is the HUD medical expense deduction?
If you live in Section 8, public housing, Section 202, or Section 811 housing and the head of household, spouse, or co-head is 62 or older or has a disability, federal law (24 CFR 5.611) lets you deduct unreimbursed medical expenses from the income your rent is based on.
Since HUD tenants pay roughly 30% of adjusted income in rent, every $1,000 you document in qualifying expenses reduces your rent by about $25/month — $300/year. Most tenants leave this money on the table because they can't pull the paperwork together in time for recertification.
What expenses qualify?
Any out-of-pocket medical cost not covered by insurance:
- Doctor, dentist, hospital, and therapy visits
- All prescription medications
- Over-the-counter medications and vitamins prescribed by a doctor
- Medical equipment (wheelchairs, oxygen, CPAP, hearing aids, glasses)
- Medicare Part B, Part D, and Medigap supplement premiums
- Transportation to medical appointments
- Attendant care and in-home nursing
- Service animal and ESA expenses — vet bills, food, grooming, and supplies for a service animal or emotional-support animal count as medical expenses under 24 CFR 5.611(c)(3). Most tenants don't know this. If you have a service dog or ESA, this category alone can add $1,500–$3,000 to your deduction.
How does ExpenseBot find my medical receipts?
ExpenseBot scans your Gmail daily and automatically recognizes receipts from pharmacies (CVS, Walgreens, Rite Aid, GoodRx, Amazon Pharmacy), doctors, dentists, hospitals, vision centers, and pet supply stores (Chewy, PetSmart) if you have a service animal. Each receipt is pulled into your expense sheet with the date, vendor, and amount — no typing required.
How to set it up (five-minute setup, then automatic)
- Choose HUD Medical during setup. ExpenseBot automatically creates the Health & Medical tag for pharmacies, copays, therapy, dental, vision, hearing, and assistive devices. It also creates a Pet Supplies tag for service and ESA expenses. You do not need to create either tag yourself, and selecting HUD again will not create duplicates.
- Catch up on past receipts. Run a historical Gmail scan for your recertification date range. ExpenseBot scans as far back as your Gmail goes — receipts from several years ago are still found and tagged automatically.
- New receipts tag themselves. From this point on, every new medical receipt in Gmail is tagged automatically. You don't touch anything.
- Generate the report. Go to My Reports → HUD Medical Recertification (under Tax Reports), pick your date range, and click Generate. You get a clean itemized worksheet — grand total at the top, then every qualifying expense listed by date, vendor, and amount, with links to the original receipt in your Google Drive. The format is designed to hand directly to your housing coordinator.
The simplified home screen
HUD residents get a simplified view by default: instead of the full dashboard, your home screen shows four large capture buttons — Take a Receipt Photo, Choose a Receipt Photo, I Paid Cash, and Trip to the Doctor — followed by clear steps to Review my expenses and Create my HUD report. Cash entries and doctor trips launched here are saved as Health & Medical; doctor trips use the IRS medical mileage rate for the trip date, not the business rate. You can also open guided Gmail setup so new medical receipts are found automatically.
Saving a coordinator stores their contact details with your HUD setup. It does not email them or expose your master expense sheet. You review and generate a medical-only report before sharing it. Prefer the full dashboard? Tap Full view at the top; the full dashboard always offers a visible way back to the simple view.
What about Medicare premiums? There's no receipt.
The HUD report wizard has a field where you enter your monthly Medicare Part B, Part D, or Medigap premium. It multiplies by 12 and adds it to your total automatically. This is the most commonly missed deduction — Social Security deducts these premiums silently from your check so there's no bill or receipt. Your Social Security award letter shows the monthly amount.
My recertification isn't based on a calendar year
The wizard asks for your recertification appointment date and automatically computes the 12-month lookback window your PHA uses. You can also override the start and end dates manually if your PHA uses a different window. The report only includes expenses from that exact period.
Can I preview my rent savings before submitting?
Yes. Enter your annual household income and select the threshold your PHA applies to you — ask your housing coordinator, because the lower thresholds are granted by the PHA and are not automatic:
- 10% — the HOTMA threshold. This is the baseline, and where new households start immediately.
- 7.5% — year 2 of the phased-in relief for households that already had the deduction under the old 3% rule.
- 5% — year 1 of that same phase-in, and also the figure that applies if the PHA grants a general financial hardship exemption (which runs until the hardship ends or 90 days, whichever comes first, with possible 90-day extensions).
- 3% — the pre-HOTMA legacy rule, kept in the wizard for reconstructing an earlier period. It is not a current threshold.
The wizard shows your projected monthly and annual rent reduction before you generate the report.
If your qualifying expenses are above 5% of annual income but below 10%, ask your housing coordinator about a hardship exemption rather than assuming you get nothing. Source: HUD Exchange, HOTMA Resident Fact Sheet on health, medical and childcare deductions; see also HUD Handbook 4350.3 and 24 CFR 5.611. Estimates — confirm with your housing authority or a qualified professional.
HOTMA threshold example
$18,000 income, $2,400 in qualifying medical expenses, 5% threshold = $900 net deduction = ~$22/month rent reduction.
Is the report destructive? Can I run it multiple times?
Completely non-destructive. Generating the HUD report never changes your expense data or marks anything as submitted. You can regenerate for any date range, including prior years, as many times as you want without affecting your current data.
Is this the same thing as deducting medical expenses on my taxes?
No — and this is the most common confusion in this area, so it is worth stating plainly. There are three genuinely different mechanisms hiding behind the phrase "medical expense deduction", and only one of them is the HUD one described above:
- HUD / Section 8 (this entry): qualifying medical expenses reduce the income figure used to calculate your rent. It is not a tax deduction, and it can help even in a year when you owe no tax at all.
- A US personal tax return: an itemised deduction, where only the portion of costs above a percentage-of-income floor counts, and only if you itemise instead of taking the standard deduction. For many filers that combination means the answer is no.
- A Canadian tax return: a non-refundable tax credit, not a deduction. A credit reduces the tax itself; a deduction reduces the income you are taxed on. See the CRA medical expense tax credit entry.
More than one can apply to the same person in the same year — someone in subsidised housing still files a tax return. They are separate calculations drawing on the same pile of receipts, which is the practical reason to capture medical spending once, properly, and use it for whichever mechanisms apply.
Which rule applies to you: https://www.expensebot.ai/medical-expense-tax-deduction-hub Full guide: https://www.expensebot.ai/blog/hud-medical-expense-deduction-guide Tracker: https://www.expensebot.ai/hud-medical-expense-tracker