What Healthcare Providers Need to Know about SNAP Medical Exemptions:
In July, the federal government signed devastating cuts to Medicaid and SNAP (food stamps) into law. Starting September 1, 2025, many adults will need to prove they work 20 hours a week to keep their SNAP.
If your patient has a physical or mental health condition that limits their ability to work, signing the SNAP Medical Exemption Form (Form PA 1921) will help them keep their SNAP.
Download the Medical Exemption Form and Instructions
Why has my patient asked me to complete this form?
Your patient gave you this form because new work requirements are making it harder for many adults to keep SNAP. As of September 1, 2025, adults who don’t work at least 20 hours per week can only get 3 months of SNAP every 3 years unless they meet an exemption to these rules.
If your patient has a physical or mental health condition that limits their ability to work, signing this form will help them keep their SNAP.
What type of providers can complete this form?
Any medical personnel whose services can be reimbursed by Medicaid can complete this form. This includes a wide range of providers, ranging from physicians and osteopaths to social workers and counselors. Question 3 of this form can also be completed by school officials aware of the patient’s reasonable accommodations or services.
How do I complete this form?
You must mark YES for Question 1 of this form for your patient to qualify for a medical exemption for SNAP. Complete Questions 2 and 3 if relevant. Sign and give to your patient as soon as possible so that they can return it to their County Assistance Office.
How will this medical exemption help my patient?
Even if your patient currently works, this exemption will protect them from losing SNAP if their health declines and they can no longer work, they lose their job, or their work hours decrease. Your patient can also avoid extra paperwork and red tape at the County Assistance Office.
Where can I find more information about this form or SNAP for my patients?
To learn more, go to clsphila.org/SNAPchanges or the PA Department of Human Services website: pa.gov/agencies/dhs/resources/snap/snap-work-requirements-abawds
