How do VA means tests treat health insurance premiums and Medicare Part B/D premiums in 2025?
Executive summary
VA means testing looks at a veteran’s family income and net worth to determine enrollment group and copay liability; VA guidance and the VA “cost of care” pages state income and assets are central to means testing [1] [2]. Medicare premiums for 2025 include a standard Part B monthly premium of $185 and Part D rules changed in 2025 (MOOP $2,000) — CMS and VA materials note that Medicare premiums are separate from VA means tests and that Medicare Part B premiums are not paid or offset by VA [3] [4] [5].
1. How the VA “means test” works in practice: income and net worth drive eligibility and copays
The VA’s means test for non–service‑connected care is explicitly based on your family’s income and net worth; the outcome places you in a priority group and determines whether you must pay copays or face enrollment changes [2] [1]. VA public pages and the VA Health Care Benefits Overview emphasize the annual income review and verification process to decide eligibility and whether fixed copays apply for non‑service‑connected conditions [6] [7] [1]. Available sources do not mention any 2025 change that makes Medicare premiums automatically reduce VA means‑test income.
2. Treatment of health insurance premiums (private or employer) in the means test
VA guidance asks veterans to provide insurance information and indicates VA will bill private carriers for non‑service‑connected care, but the provided material focuses on insurance coordination and reimbursement rather than a clear formula for excluding premiums from countable income [2] [8]. Military.com and other explainers note that the means test looks at income and net worth and that veterans are asked for insurance information, but they do not set out a definitive rule saying general health insurance premiums are deductible from countable income for the VA means test in 2025 [2] [9]. Therefore: available sources do not mention a clear VA rule that treats private health insurance premiums as an automatic deduction when calculating countable income for VA means testing [2] [8].
3. Treatment of Medicare Part B and Part D premiums in VA income calculations
Several sources state Medicare premiums remain the responsibility of the enrollee and that VA programs (including CHAMPVA guidance) do not pay beneficiaries’ Medicare Part B premiums; VA encourages enrollment in Medicare when eligible but warns that unpaid premiums and late enrollment penalties are a separate Medicare matter [10] [5]. CMS sets the Part B standard premium at $185 for 2025 and documents Part D premium adjustments and IRMAA rules; these are Medicare obligations and, according to the VA materials cited, are not handled as VA premiums or covered by VA means testing [3] [5] [4]. Harbor Life and other explainer sources note that some medical expenses — including Medicare premiums — may be deductible in other benefit programs’ means calculations, but the explicit VA public pages provided do not state that the VA will deduct Medicare Part B or D premiums from countable income in its means test [11] [2]. Thus: available sources do not confirm that Medicare Part B or Part D premiums are automatically excluded from VA means‑test income calculations in 2025 [3] [2].
4. Creditable coverage and Part D interactions with VA drug benefits
VA prescription drug coverage is treated as creditable for Medicare Part D purposes: VA drug coverage typically has no premiums and can satisfy the “creditable coverage” requirement so veterans avoid Part D late‑enrollment penalties if they keep VA drug coverage [7] [12] [13]. The VA encourages veterans to enroll in Medicare benefits they qualify for but makes clear that enrolling or not enrolling in Medicare carries separate Medicare rules and penalties — the creditable status of VA drug coverage matters for Part D penalties, not for VA means‑test income math [7] [12] [13].
5. Practical implications and divergent perspectives
If you’re a veteran deciding whether to keep Medicare Part B or Part D, VA guidance stresses preserving your options (enroll if eligible) because delayed enrollment can trigger Medicare penalties and because VA does not cover Part B premiums [5] [10]. Consumer and third‑party explainers (Medical News Today, Medicare Interactive) draw a different practical balance: some veterans skip Part B to avoid the premium and rely on VA care; others enroll in Part B for access to non‑VA providers — both paths have tradeoffs and Medicare premium schedules set by CMS [14] [15]. The sources differ on how much net financial relief veterans get from deducting medical premiums in means tests; while Harbor Life and similar explainers discuss using medical expense deductions (including Medicare premiums) in some VA or benefit calculations, the VA’s official pages provided here do not state that Medicare premiums are an automatic means‑test deduction [11] [1].
6. Bottom line and recommended next steps
VA means tests hinge on income and net worth (VA pages and the 2025 Health Care Benefits Overview) and the VA does not pay Part B premiums nor say Medicare premiums are automatically excluded from VA income calculations in the cited documents [1] [7] [3]. If you need a definitive, personal answer, get your local VA benefits office to confirm whether a specific premium or expense will be deducted from your countable income; the VA site directs veterans to update insurance information and to use forms like 10‑10EZR for income verification [7] [8].