HUD Medical Expense Tracker — Pay Less Rent at Your Next Recertification

Last updated: April 2026

Your medical expenses lower your rent. ExpenseBot finds them in your Gmail, tracks prescriptions, copays, and service animal costs, and generates the worksheet your housing coordinator needs.

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If you live in HUD-assisted housing — Section 8, public housing, Section 202, or Section 811 — and you or someone in your household is age 62 or older, or has a disability, your medical expenses can lower your rent. The HUD medical expense deduction is one of the biggest ways tenants legally reduce their monthly payment, and most people don't know how much they can claim.

The rules come from 24 CFR 5.611, the federal regulation that defines adjusted income for HUD-assisted housing. Under these rules, qualifying medical expenses that exceed a certain percentage of your annual income are deducted from your income before your rent is calculated. Lower adjusted income means lower rent.

The problem: tracking every prescription, copay, doctor visit, and pharmacy receipt across an entire year is hard. By recertification time, half the receipts are missing. ExpenseBot fixes that by scanning your Gmail automatically — every receipt from CVS, Walgreens, your dentist, your doctor, your vet — and turning them into a single worksheet you bring to your housing coordinator.

Free for 60 days. Sign in with your Google account.

ExpenseBot scans your Gmail for medical receipts and generates your HUD recertification worksheet automatically.

No credit card · No app to download · Works with any Gmail account

What Medical Expenses Qualify?

The complete list of qualifying medical expenses comes from 24 CFR 5.611 and HUD Handbook 4350.3, Exhibit 5. HUD generally follows the IRS Publication 502 standard for what counts as a medical expense, with some additions specific to housing. Here's what you can claim:

Health Care Services

  • Doctor and specialist visits (copays, deductibles)
  • Dental care (cleanings, fillings, dentures)
  • Vision care (eye exams, glasses, contacts)
  • Hearing aids and batteries
  • Mental health care (therapy, counseling, psychiatry)
  • Chiropractic and physical therapy
  • Substance abuse treatment

Prescriptions & Medications

  • All prescription medications (every pharmacy receipt)
  • Insulin and diabetic supplies
  • Over-the-counter medications when prescribed by a doctor
  • Vitamins and supplements when prescribed for a specific condition

Insurance Premiums

  • Medicare Part B premiums
  • Medicare Part D (prescription drug plan) premiums
  • Medicare Supplement (Medigap) premiums
  • Long-term care insurance premiums
  • Other private health insurance you pay yourself

Medical Equipment & Supplies

  • Wheelchairs, walkers, canes, crutches
  • Oxygen and oxygen equipment
  • CPAP machines and supplies
  • Diabetic test strips and meters
  • Incontinence supplies
  • Bandages, gauze, first-aid supplies (when medically necessary)

Transportation to Medical Care

  • Bus or taxi fare to and from medical appointments
  • Mileage at the medical rate ($0.21/mile in 2025)
  • Parking and tolls for medical visits
  • Lodging if you have to travel for treatment

Assistance Animals (Most Missed!)

  • Pet food for service or emotional support animals
  • Veterinary care (checkups, shots, treatments)
  • Grooming and supplies
  • Training fees

Attendant Care

  • In-home nursing or personal care
  • Adult day care (medical component)
  • Home health aide services

The HOTMA Threshold (And Why It Matters)

Here's the part that confuses everyone: only the medical expenses that exceed a certain percentage of your annual income count toward your deduction. Under the old rules, that threshold was 3% of income. Under HOTMA (the Housing Opportunity Through Modernization Act), the threshold is increasing to 10% — but it's being phased in gradually for households already receiving the deduction.

HOTMA Phase-In Schedule

  • Year 1: Threshold is 5% of annual income
  • Year 2: Threshold is 7.5% of annual income
  • Year 3: Threshold is 10% of annual income

New households start at 10% immediately. Hardship exemptions are available if the new threshold causes financial hardship — ask your housing coordinator.

Example: Your annual income is $18,000. You have $2,400 in qualifying medical expenses for the year.

  • At the 5% threshold: $18,000 × 5% = $900. Deduction = $2,400 ��� $900 = $1,500
  • At the 7.5% threshold: $18,000 × 7.5% = $1,350. Deduction = $2,400 − $1,350 = $1,050
  • At the 10% threshold: $18,000 × 10% = $1,800. Deduction = $2,400 − $1,800 = $600

That deduction comes off your annual income before rent is calculated. Since most HUD tenants pay 30% of adjusted income in rent, every $1,000 of deduction lowers your rent by about $25/month. A $1,500 deduction = roughly $37/month off your rent, or $450/year.

The bigger your medical expenses, the bigger the savings. And the trick is: you have to track everything or you can't prove it.

How ExpenseBot Tracks It For You

You don't need to keep a folder of paper receipts. You don't need to install an app. You don't need to learn anything new. Here's the entire process:

Step 1: Sign in with your Google account

No new password to create. No app to download. Just click and log in with the Google account you already use for Gmail.

Step 2: ExpenseBot scans your Gmail for medical receipts

The system finds receipts from CVS, Walgreens, your doctor's office, your dentist, your eye doctor, your vet, and any other medical vendor. It tags them as "Health & Medical" automatically. It runs overnight in the background — you don't have to do anything.

Step 3: Generate your recertification worksheet

When it's time for your annual recertification, click one button. ExpenseBot creates a single worksheet with every medical expense listed by date, vendor, and category. Grand total at the top. Receipts attached. You print it and bring it to your housing coordinator.

The Service Animal Deduction Most People Miss

This is the deduction nobody tells you about. The HUD Occupancy Handbook explicitly lists "assistance animal and its upkeep" as a qualifying medical expense. This applies to both service animals and emotional support animals (ESAs) when you have one as a reasonable accommodation.

What counts:

  • Pet food (every Chewy, Petco, or Walmart purchase)
  • Vet bills (annual checkups, shots, treatments, medications)
  • Grooming (especially for service dogs that need to be clean)
  • Training (especially for service animals in training)
  • Supplies (leashes, harnesses, vests, beds)

For someone with a service dog, this can easily add $1,500 to $3,000in qualifying expenses per year. ExpenseBot automatically creates a "Pet Supplies" tag and includes those expenses in your medical worksheet — so you don't have to remember which Chewy order was for the dog versus the cat.

Don't lose deductions to lost receipts.

ExpenseBot automatically tracks every medical receipt in your Gmail and creates your HUD recertification worksheet in one click.

60 days free · Works with any Gmail · CASA Tier 2 certified

The Walgreens Problem (And How to Fix It)

Here's a real problem with mixed-use stores: you go to Walgreens for your prescription, but you also pick up snacks, soap, and a greeting card. The receipt has medical and non-medical items mixed together. AI can't always tell which line items are medical and which are personal.

ExpenseBot handles this two ways:

  1. Itemized parsing. When the receipt is detailed enough, ExpenseBot splits the medical line items from the non-medical ones automatically.
  2. Force-tagging. If a receipt is ambiguous, you can add TAG:Health & Medical in the email subject line or anywhere in the email body. ExpenseBot will classify the entire receipt as medical, no matter what AI thinks.

This same trick works in reverse — if a receipt is incorrectly tagged as medical, you can change the tag and it will be recategorized.

What Your Recertification Worksheet Looks Like

When you click "Generate Worksheet," ExpenseBot creates a single document with:

  • Grand total at the top (the number your housing coordinator wants to see first)
  • Every line item sorted by date — vendor, amount, category
  • Subtotals by category (prescriptions, doctor visits, dental, vision, transportation, assistance animal, etc.)
  • Original receipts attached for backup if your PHA asks for proof
  • Date range covering the past 12 months (the standard HUD lookback period)

The format follows HUD Handbook 4350.3 guidance, so any Public Housing Agency (PHA) will accept it. Print it, bring it to your appointment, hand it to your housing coordinator. Done.

Frequently Asked Questions

What medical expenses qualify for the HUD deduction?

Doctor visits, prescriptions, dental, vision, hearing aids and batteries, mental health care, medical equipment (wheelchairs, walkers, oxygen), transportation to medical appointments, health insurance premiums (including Medicare Part B and D), Medicare supplement insurance, attendant care, and assistance animal upkeep (food, vet, grooming) all qualify under 24 CFR 5.611. Over-the-counter medications qualify if prescribed by a doctor.

Do service animal expenses count for the HUD deduction?

Yes. The HUD Occupancy Handbook specifically lists 'assistance animal and its upkeep' as a qualifying medical expense. This includes pet food, vet bills, grooming, training, and supplies for service animals and emotional support animals (ESAs) when documented as a reasonable accommodation. Most tenants don't know this — and it can add hundreds of dollars to your annual deduction.

What is the HOTMA medical expense threshold?

Under HOTMA, the threshold is increasing from 3% to 10% of annual income, phased in over 3 years for households already receiving the deduction. Year 1: 5%. Year 2: 7.5%. Year 3: 10%. New households start at the 10% threshold immediately. Only medical expenses that exceed the threshold count toward your rent reduction. Hardship exemptions are available.

How do I track medical expenses for Section 8?

Save every receipt — pharmacy, doctor copays, dental, vision, transportation. ExpenseBot scans your Gmail automatically for medical receipts (CVS, Walgreens, dentist offices, eye doctors), tags them as medical expenses, and generates a single recertification worksheet showing every line item with the grand total. You bring the worksheet to your annual recertification appointment with your housing coordinator.

What do I bring to my HUD recertification?

Most PHAs require: a list of medical expenses for the past 12 months with receipts, doctor's letter estimating expected medical costs for the coming year, proof of insurance premiums (Medicare statements, supplement bills), pharmacy printouts showing prescription costs, and documentation for assistance animals if applicable. ExpenseBot generates this worksheet automatically with the receipts attached.

Does ExpenseBot work with all PHAs?

Yes. ExpenseBot generates a standard medical expense worksheet that any Public Housing Agency (PHA) will accept — the format follows HUD Handbook 4350.3 guidance. It works for Housing Choice Voucher (Section 8), Public Housing, Section 202 (elderly), Section 811 (disabled), and Project-Based Section 8 programs. The worksheet shows every receipt with date, vendor, amount, and category, with the grand total at the top.

Start Tracking Your Medical Expenses Today

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This page is informational and not legal or financial advice. Always confirm deduction eligibility with your Public Housing Agency. ExpenseBot is not affiliated with HUD or any government agency.