Simplifying Your Medicare Journey, One Step at a Time
Navigate Medicare Advantage, Supplements, and Part D with expert support and personal care
Simplify
How We Simplify Your Medicare Journey
From the first consultation to annual reviews, we simplify Medicare. Whether you’re evaluating Advantage, Medigap, or Part D, McKinley Romero provides unbiased, no-cost advice tailored to your unique health, lifestyle, and budget needs.
Compare options: Advantage, Medigap, and Part D plans
Timely advice tailored to your health & financial priorities
No-cost, one-on-one plan recommendations
Annual plan reviews and enrollment support
Clear, jargon-free guidance throughout the process
How
How It Works
Navigating Medicare doesn’t have to be confusing—or overwhelming. At Northwest Insurance Professionals, we break down the process into clear, manageable steps. With expert guidance from McKinley Romero, you can move from uncertainty to coverage with confidence, ensuring you choose the best Medicare Advantage, Medigap, or Part D plan for your unique needs.
Schedule Your Free Consultation
Let’s discuss your healthcare needs and goals.
Enroll with Confidence
Personalized assistance with paperwork and plan selection.
Compare Your Plan Options
We’ll help you evaluate Advantage, Medigap, and Part D benefits.
Ongoing Support & Annual Check-ins
Your plan evolves with life—stay protected through every change.
Medicare Advantage (Part C)
Medicare Advantage plans—also known as Part C—are offered by private insurers and bundle your Original Medicare coverage (Parts A and B), often alongside prescription drug coverage (Part D) and extra benefits like dental, vision, or fitness programs. These plans may come with low or even $0 premiums, but typically limit you to in-network providers. Notably, they include an annual out-of-pocket cap—unlike Original Medicare, which lacks this feature.
What is a Medicare Advantage plan?
A Medicare Advantage plan (Part C) is a private insurer alternative to Original Medicare (Parts A & B). Most include prescription drug coverage (Part D) and often offer extras like dental, vision, or fitness benefits.
Do I still pay my Medicare Part B premium?
Yes. You must continue paying your Part B premium even if you’re enrolled in a Medicare Advantage plan. Some plans may also include their own premium, though many offer $0 premium options.
Is there an annual out-of-pocket limit?
Yes. In 2025, the standard limits are $9,350 in-network and $14,000 combined in- and out-of-network—though many plans offer lower caps.
Medigap (Medicare Supplement Insurance)
Medigap plans work differently. Instead of replacing your existing Medicare, they supplement it—helping cover costs that Original Medicare doesn’t, like copays, coinsurance, and deductibles. These policies are standardized by letter (e.g., Plan G or Plan N), meaning benefits remain the same regardless of provider, though premiums may vary. Importantly, Medigap cannot be paired with a Medicare Advantage plan.
What does Medigap cover?
Medigap fills coverage gaps in Original Medicare (Parts A & B), helping pay deductibles, copays, and coinsurance. Plans are standardized (e.g., G, N), but costs vary by provider.
Can it be used with Medicare Advantage?
No. Medigap supplements Original Medicare and cannot be paired with Medicare Advantage plans.
Is there a guaranteed enrollment period?
Yes. You get a six-month open enrollment window starting at age 65 when your application cannot be denied for health reasons. Beyond that, insurers may underwrite based on your health.
Prescription Drug Plans (Part D)
Part D plans help cover the cost of prescription medications. You can enroll in a standalone plan if you’re on Original Medicare, or select a Medicare Advantage plan that already includes drug coverage. Premiums and drug formularies (which medications are covered and at what cost) vary by plan; the federal government caps total out-of-pocket spending for Part D.
What is Medicare Part D?
Part D is prescription drug coverage offered via private insurers. You can enroll in a standalone plan—or get it through a Medicare Advantage plan that offers drug coverage.
What are the coverage phases and cost-impacting factors?
You typically move through:
- Deductible phase – pay full cost of drugs until deductible (up to ~$590 in 2025).
- Initial coverage – you pay copays/coinsurance until reaching $2,000 out-of-pocket limit.
- Catastrophic coverage – after reaching $2,000, you pay very minimal costs for covered drugs.
What happens if I delay enrolling?
If you go 63+ days without creditable drug coverage after eligibility, you face a lifelong penalty: 1% of the national base premium per month delayed, added to your monthly premium.
Compare Medicare Options
| Plan Type | What It Covers | Pros | Things to Consider |
|---|---|---|---|
| Medicare Advantage (Part C) | Combines Parts A & B, often Part D; may include dental, vision, hearing, fitness extras. | Usually lower premiums; one card; annual out-of-pocket max; extra benefits. | Provider networks (HMO/PPO) may limit choice; benefits vary by county and plan. |
| Medigap (Supplement) | Helps pay Original Medicare cost-shares (copays, coinsurance, deductibles); standardized plan letters. | Broad provider access (anyone who accepts Medicare); predictable costs. | Separate premium; drug coverage not included (add standalone Part D); can’t pair with Advantage. |
| Part D (Rx) | Prescription medications via standalone plan or bundled in some Advantage plans. | Helps lower drug costs; nationwide plans with formularies and pharmacy networks. | Formularies, tiers, and premiums vary; check your meds and pharmacies each year. |
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Office
421 W Francis Ave.
Spokane, WA 99205
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M-F: 9am - 5pm
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(509) 868-0364