Sat, Jun 14, 2025, 6:00 AM8 min read

My recent columns drew thousands of questions and comments, largely centered on rising medical debt and Medicare as well as retirement confusion on Social Security and health savings accounts, known as HSAs. The following is an edited sample of those 6,000-plus comments—good and bad!—and my take on them.

As always, if you have a personal finance question, you click here to drop me a note. I’ll try and answer in a future column.

Here we go. Let’s start with someone who wasn’t too happy with me:

While well intentioned, I was disappointed in your article. You neglected to mention that Medigap policies will cover all or most of what Medicare does not. Also: people you mention could likely be eligible for Medicare Savings Plans that will lower beneficiary costs. A Qualified Medicare Beneficiary or QMB is the most generous plan and covers all copayments and deductibles, the Part B premium, and also provides the extra help you noted.

Kerry: Guilty. Regular Medicare does not come with built-in caps on a variety of out-of-pocket costs, so you don't want to be enrolled in it if you don’t also have supplemental protection. The bills that lead to medical debt typically include routine healthcare services such as lab fees and diagnostic tests, dental care, and visits to the doctor, and long-term care services not covered by Medicare, according to KFF. And Medicare typically requires patients to pay out of pocket around 20% of their doctor bills. Many retirees can’t.

Now let’s talk about Medigap health insurance. Not everyone has this coverage. These policies are sold by private insurance companies and, as you noted, pay part or all of some leftover costs, such as outstanding deductibles, coinsurance, and co-payments, and may also cover healthcare costs that Medicare does not cover at all like most medical care received when traveling out of the US.

In most states, however, the guaranteed right to buy a Medigap is limited to the time when you first sign up for Medicare Part B. That’s because Medicare does not permit Medigap plans from rejecting you or charging a higher premium because of a preexisting condition during that period. In most states, your premium, however, will vary depending on factors such as your age, gender, and where you live.

The Medigap guarantee policy is also good if you joined an Advantage plan during your first year of Medicare but disenrolled within a year and switched to traditional Medicare. After that, though, Medigap plans in most states can flat-out reject you if you have a preexisting condition, such as diabetes. The exceptions are New York, Connecticut, Maine, and Massachusetts.