This study compares the cost of implementing a Medical Food Pantry (MFP) serving food insecure (FIS) patients to the predicted hospital utilization costs incurred in the absence of an MFP by FIS patients. This case-control study utilized propensity score matching to match patients identified as FIS who received a voucher to an MFP between June 2018 and July 2019 to individuals in the Medical Expenditure Panel Survey to estimate health care utilization and costs. FIS patients who did not redeem a voucher had a higher average cost per inpatient visit compared to those who redeemed their voucher (redeemed a voucher: $13 464.87 vs never redeemed the voucher: $15 238.63). They also had higher aggregate annual expenditures (redeemed a voucher: $46 112.52 vs never redeemed the voucher: $50 071.59). This research suggests that the cost of addressing nutritional risks through a hospital-based MFP is feasible and cost-effective.