Not every American 65 and older is worrying about Medicare's open enrollment period, now underway. Some who are eligible for the government insurance plan are staying on the job, and gaining access to employer-based plans they say are a better option.
People like Largo resident Ken Milanese. who is up by 5 a.m. and out the door by 5:30. It's a familiar scene to anyone who works. But Milanese is 71.
“Being my wife is 62, she wouldn't have any insurance, unless I continue working, at least good insurance,” he said.
He was automatically eligible in Medicare Part A when he turned 65. He signed up for the plan that helps cover emergency care, such as hospital visits.
But Medicare has no family plan and would have left his wife uninsured. So, Milanese is working as a hospital security guard, so she has coverage.
His wife, Anne, said they researched plans on HealthCare.gov. She said they couldn't afford it.
"That's out of the price range right now because of the outrageous premiums and we wouldn't get a subsidy,” Anne Milanese said. “Also, the extremely high deductible we would have, so it would be financially disastrous not try to keep the employer insurance at this point."
Ken Milanese doesn't pay for the Medicare he qualifies for. He doesn't use it. He's also opted out of Medicare Part B, which covers doctor visits and other medical expenses.
Jim Mulcahy, a Medicare insurance counselor at the Senior Connection Center in Tampa, volunteers to help seniors enroll in Medicare through the “Serving Elder Serving Health Insurance Needs of Elders,” or “SHINE program.
He said a lot of seniors keep working so they can get health benefits.
"In most cases when you're on employers insurance, it’s covered,” Mulcahy said. “You get very good coverage. In all my working career, I never had a problem because my whole family was covered."
Nationwider, seniors accounted for about 16 percent of the national labor force in 2011, according to U.S. Census estimates. Of those seniors, 44 percent were working fulltime.
But Mulcahy warned that some employers don't want to cover workers eligible for Medicare. They may boot their employee from company coverage. He said that’s why it's important for everyone to enroll in Medicaid within three months of their 65th birthday.
"Once you reach 65, your employer wants you on Medicare because they don't want the expenses of carrying you for five extra years,” Mulcahy said. “A lot of people that come in here, they continue working because you almost have to in today's society when you're paying $2,000 to $3,000 a year for car insurance and the same for homeowners insurance."
Over in Orlando, 66-year-old Jim Sawyer produces the "Freaky Florida" TV show for Brighthouse Networks. He enrolled in Medicare Part A at 65, but went back to work a few months after retiring to get better coverage.
"I pretty much stuck the (Medicare) card in my wallet and forgot about it,” Sawyer said.
Like Ken Milanese, Sawyer chose his company plan over Medicare Part A. He said the employer insurance covers hospital trips, doctor's visits and prescriptions.
He and his wife also tried looking on HealthCare.gov before he decided to go back to work to get insurance.
"We looked on the Internet, through the website and looked at co-pays and all that, especially when it comes to prescriptions, and the insurance I get through my employer is exceptional,” Sawyer said. “I've had some major surgeries done over the past 15 years. I've worked for the company and they pretty much covered all of it."
When Sawyer does retire - he says that will be four years from now -- he will likely sign up for Medicare Advantage or an insurance plan through AARP.
And Ken Milanese, the 71-year-old hospital security guard, said he will work until he can't anymore. His wife, Anne, said it could be devastating to go without the plan they have now.
"We'd have to drain the bank account, lose our house....it just goes with that domino effect,” Anne Milanese said.
“He's got to keep working. We just wind him up every day and send him out the door because we have no choice. The alternatives and the options are not good for people in our situation.”