Does the Affordable Care Act (ObamaCare) really help LGBT seniors? Secretary of Health and Human Services Kathleen Sebelius spoke recently in Philadelphia. She stated: “All Americans, regardless of where they live, what their age, sex, race, sexual orientation or gender identity, have a basic right to get the health care they need here in the United States, and that’s a principle we are committed to fighting for here in this administration. Now, that is one of the key reasons that we fought for the Affordable Care Act.”
There are some key parts of the law that benefit LGBT communities and older adults in particular. You should know that under the Affordable Care Act:
— Your coverage cannot be dropped by your insurer if you become ill or if you made an error on your application form;
— There is no longer a lifetime limit on key benefits of your insurance coverage. All restrictions on annual limits will be removed in 2014;
— If you are HIV positive, there is health insurance coverage available now (it may be very expensive); and
— You can include your children on your health insurance policy until they reach age 26.
Additional changes go into effect in 2014:
— You will be able to get health insurance coverage if you have a pre-existing condition;
— Millions of Americans will be able to purchase affordable coverage and have the same choices of insurance that members of Congress have;
— The Medicaid program will be expanded to include millions of low-income adults; and
— Tax credits will help middle-class families afford health insurance.
According to Sebelius, “The law is helping millions of LGBT Americans gain access to the care they need and stay healthy in the first place.” If you are covered under Medicare, or have an insurance policy that began before March 23, 2010, you can get preventative screenings at no charge. These screenings include the following:
— mammograms, colonoscopies, prostate and other cancer screenings
— blood pressure, diabetes, cholesterol and HIV tests
— some vaccinations
— smoking-cessation programs
— nutrition and weight-loss counseling
You can get complete details on what Medicare covers by calling 800-MEDICARE or by visiting www.medicare.gov.
In addition to the benefits listed above, the ACA is designed to reduce the cost of prescription drugs for seniors and people with disabilities who are on Medicare. Co-pays for prescription drugs under Medicare Part D have been reduced. By 2020, the “doughnut hole” will close, meaning that people on Medicare Part D who have high prescription drug costs will only pay the co-pay on their medications. For some, this will be a savings of over $1,500 a year.
Harvey Hurdle, chief operating officer of Sellers Dorsey, a national health-care consulting firm, said, “The act helps address the so-called doughnut hole in Medicare for prescription drugs — important for all seniors. More importantly, however, may be the steps the administration has taken to address the unique needs of aging LGBT individuals through bold administrative action. Among many other meaningful policies and actions, they have funded an initiative to provide information, assistance and resources for aging services and, through the leadership of the president, have ensured we have hospital visitation rights to see our partners in the hospital. They have also clarified that states can protect the assets of LGBT couples when one individual needs to receive long-term-care services.”
The ACA is also designed to make the health-care workforce more diverse and sensitive to the unique needs and cultural issues of LGBT people through additional training. This won’t change our world overnight, but it is a good start.
More dollars will be going to community health centers, such as Mazzoni Center, that will serve up to 20-million more patients. There will be increased research and data collection on the specific health needs of LGBT Americans.
Finally, for LGBT people who do not currently have health insurance, there is a website to help you find the health insurance best suited to your needs, www.healthcare.gov. The site even allows same-sex couples to eliminate plans that would not cover both people.
Ed Bomba is communications chair of the LGBT Elder Initiative. The LGBTEI is dedicated to supporting and sustaining the lives of LGBT older adults in the Delaware Valley. To comment on this column, suggest topics for future columns or for more information, visit www.lgbtei.org.com and watch for “Gettin’ On” each month in PGN.