The federal government's recognition of same-sex marriages regarding Medicare, Medicaid and Social Security benefits has done little to alleviate the confusion many Americans have about those benefits, according to experts who spoke, on March 24, at the 2015 American Society on Aging's Conference at the Hyatt Regency.
The programs have many "different parts, and different parts use different rules," said Karen Loewy, who heads up Lambda Legal's work for older LGBT adults and older adults with HIV/AIDS. She emphasized that the programs' administrators were striving to be culturally competent, but were dealing with complex regulations that were conceived decades before same-sex marriage was an issue.
At the core of many problems were the programs' eligibility requirements based either on laws of a "place of celebration"—where a couple is married—or their "place of domicile," where they reside. Medicare Part A, for example, relies on the place of domicile, while Medicare Part B relies on place of celebration.
As such, many older LGBT Americans leave a lot of money on the table, said Ellen Morgenstern, director of the National Committee to Preserve Social Security and Medicare Foundation. Her organization, in 2014, launched the "Know Your Rights Initiative," which holds town hall meetings so that older LGBT adults can be apprised of their rights and benefits under government benefit programs. The program is in the pilot stages in California right now, but will be expanded to other states.
"Social Security is the most byzantine program in terms of benefits, but is the most wonderful program in terms of keeping people out of poverty," she said, adding that anyone thinking they may be eligible to collect benefits should apply, even if they think their chances are slim. Should they be ruled ineligible, and that ruling is successfully appealed, payments will be backdated.
Casey Schwartz of the Medicare Rights Center emphasized that comprehensive financial planning is necessary for LGBT persons at all income levels. In fact, she said that most of the retirement-planning mistakes she has seen were made by well-off, financially savvy individuals.
"It's not people of limited means who make most of the mistakes," she said. "It's people who assume that, because they've figured out lots of complicated things in their lives, they'll be able to easily figure out [retirement planning]."
Another session at the conference addressed the needs of older LGBT adults for a gathering place, especially in communities without a sizeable LGBT population. Community senior centers fit the bill, but getting LGBT residents there can be a challenge, said presenters Robert Linscott, assistant director of the LGBT Aging Project at the Boston-based Fenway Institute, and Maryanne Ryan, outreach coordinator for the Orleans ( Massachusetts ) Council on Aging.
LGBTs often experience the same hardships when aging that their straight counterparts do, Linscott said, but often to a higher extent. Those include loneliness and social isolation, lack of caregiving resources, disconnection from elder services and family estrangement. Community engagement can turn many of those problems around, but it takes a significant commitment from a community center, requiring buy-in from all levels of its organization.
"All it takes is one negative comment or one bad look" for someone not to come back, Linscott said.
Community centers also need to seek out significant engagement with straight clients from the center, and plan sessions that balance education and social activities, he added. Ryan described how she organized such a group in Orleans, which is located on Cape Cod.
"Even if [your town] is more rural, there is a need out there," Ryan noted.
