Empowering seniors against discrimination

A message from Understood Care

If you have ever felt dismissed or talked over because of your age, you are not alone. As Debbie from our team shares in the companion video, we have seen older adults ignored, gaslighted, or judged unfairly. That should never happen. When you tell us about discrimination in a clinic, an agency, a community program, or anywhere else, we reach out to the people involved, advocate for you, and work to stop the behavior. You deserve to be heard, to be safe, and to receive the same respect and services as anyone else.

What age discrimination can look like in everyday life

In healthcare and social services

Age discrimination happens when a provider, health plan, or publicly funded program treats you differently because of your age. Examples include denying services that others receive, dismissing symptoms as “just aging,” setting age cutoffs without a medical reason, or using policies that make it harder for older adults to access care. Federal civil rights law prohibits discrimination on the basis of age in many health programs and activities that receive federal financial assistance.

In employment

If you are 40 or older, federal law forbids employers from discriminating against you because of your age in hiring, firing, pay, promotions, or other terms and conditions of employment. Harassment based on age is also unlawful.

In housing and long term care

The federal Fair Housing Act does not list age as a protected class. However, programs and activities that receive federal financial assistance may not discriminate based on age under the Age Discrimination Act. Residents in Medicare and Medicaid certified nursing homes also have explicit rights to be free from discrimination and reprisal.

Why this matters for health

Research shows that everyday ageism is common and is linked with worse physical and mental health outcomes for older adults. Choosing care that respects your goals and speaking up when something feels off are important steps for your well being.

Your rights under federal law

Age Discrimination Act of 1975
Protects people of all ages from discrimination in programs or activities that receive federal financial assistance, including many health and human services and housing programs supported by federal funds.

Section 1557 of the Affordable Care Act
Prohibits discrimination based on race, color, national origin, sex, age, or disability in certain health programs and activities. HHS issued a final rule in May 2024 that strengthens enforcement and clarifies covered entities and responsibilities.

Age Discrimination in Employment Act
Forbids age discrimination against people age 40 and older in the workplace and provides a process for filing charges with the EEOC.

Resident rights in nursing homes
Residents have the right to exercise their rights without interference, coercion, discrimination, or reprisal. Surveyor guidance and federal regulations reinforce these protections.

If you think you were discriminated against, here is what to do

• Write down what happened
  Record dates, places, names, what was said, and any witnesses. Keep copies of letters, bills, portal messages, and notices.
  How an advocate can help:
  Create a clear timeline, organize your documents, and capture exact wording so your record is complete and easy to use.
• Ask for an explanation, in writing if possible
  Sometimes a misunderstanding can be resolved when a policy or medical reason is explained. If the answer does not make sense or uses age alone as the reason, continue with the steps below.
  How an advocate can help:
  Draft a respectful message or letter, request citations to the specific policy or clinical criteria, join calls to ensure your questions are answered, and document the responses.
• Use any internal grievance process
  Clinics, plans, and facilities often have patient relations or grievance teams. Submit your concern in writing and save a copy.
  How an advocate can help:
  Find the right grievance office, complete forms, submit the complaint, track deadlines, and follow up until you receive a written decision.
• ‍File a civil rights complaint for healthcare or human services
  You can file with the HHS Office for Civil Rights. In most cases you must file within 180 days of when you knew about the discrimination. Assistance is available by phone and TDD. by phone and TDD.
  How an advocate can help
  Confirm which laws apply, prepare your statement, upload evidence, request needed accommodations, and monitor the case for updates and requests for more information.‍
• Report employment discrimination
  Start with the EEOC Public Portal or your local EEOC office. For age cases you generally must file within 180 days, or within 300 days if your state has a qualifying law and agency. You may be able to file a lawsuit 60 days after filing your charge with the EEOC.
  How an advocate can help
  Check deadlines, gather supporting records, draft the intake summary, coordinate with legal aid when appropriate, and set reminders for next steps.‍
• Get help with long term care concerns
  Contact your state Long Term Care Ombudsman Program for free and confidential help with complaints about nursing homes and assisted living.
  How an advocate can help
  Prepare you for the call, share your documentation with the ombudsman at your direction, and escalate urgent safety concerns while protecting your rights.‍
• Bring support and prepare for medical visits
  A trusted family member, friend, or advocate can help take notes and ask questions. Preparation improves communication and follow through.
  How an advocate can help
  Create a visit plan with your top questions, attend by phone or video when allowed, take notes, and summarize next steps so you can follow through with confidence.‍
• If you are worried about retaliation or safety
  How an advocate can help
  Document any new incidents, request accommodations, help you change providers when needed, and alert the appropriate oversight agency if your safety or access to care is at risk.

How Understood Care advocates stand with you

When you share a concern, your advocate can:

• Listen to your story, review documents, and clarify your goals
• Reach out to the provider office, plan, or agency contact to address the issue directly
• Join calls or visits with you and help make sure your questions are answered
• Draft letters, gather records, and help you submit complaints to the right office
• Connect you with the Long Term Care Ombudsman when facility issues arise
• Coordinate next steps so you can keep your care on track

Helpful Understood Care resources include care coordination, clear communication, appointment support, transportation help, medical bill review, and medication cost assistance.

Sample words you can use

On the phone or in person
I want to understand this decision. Can you please explain the specific policy or medical reason. I am concerned that age is being used as the reason. Federal civil rights laws prohibit discrimination based on age in many health programs that receive federal funds. I would like my request reconsidered and documented in my chart.

In a short letter or portal message
I am writing to request reconsideration of the decision described on date. The explanation I received suggests the decision was based on my age. I am asking for a written explanation that cites the specific policy or clinical criteria. If the decision relied on my age alone, please correct it and let me know the next available option for my care.

Where to go from here

You deserve care, services, work, and housing decisions that are based on your needs and abilities, not your age. If something does not feel right, say so. Bring a support person, write down what happened, and use the steps above. Understood Care is here to stand with you, reach out to the people involved, and help you move forward with confidence.

FAQ: Standing Up To Age Discrimination In Care, Services, And Daily Life

• What is age discrimination and where does it show up?
  Age discrimination happens when you are treated differently or unfairly because of your age. In healthcare and social services, it can look like your symptoms being dismissed as “just aging,” services being denied that others receive, or rules that make it harder for older adults to get care without a clear medical reason. In employment, if you are 40 or older, it can involve unfair hiring, firing, pay, or promotion decisions because of your age. In housing and long term care, programs that receive federal funds may not discriminate based on age, and residents in Medicare and Medicaid certified nursing homes have explicit rights to be free from discrimination and reprisal.
• Why does age discrimination matter for my health?
  Everyday ageism is common and research links it with worse physical and mental health for older adults. When your concerns are brushed aside, you may delay care, accept unsafe decisions, or feel less comfortable speaking up. Choosing care that respects your goals and naming age discrimination when you see it are important for both your health and your sense of dignity.
• What rights do I have under federal law?
  Several federal laws protect you. The Age Discrimination Act of 1975 prohibits discrimination based on age in many programs and activities that receive federal financial assistance, including many health, human services, and housing programs. Section 1557 of the Affordable Care Act forbids discrimination based on race, color, national origin, sex, age, or disability in certain health programs and activities. The Age Discrimination in Employment Act protects people age 40 and older from age discrimination at work and provides a structured process for filing charges with the Equal Employment Opportunity Commission. Residents in Medicare and Medicaid certified nursing homes have rights to be free from discrimination, coercion, and reprisal and to be treated with dignity and respect.
• Can a program or clinic ever consider age at all?
  In limited situations, age can be considered when it is necessary for the program to operate or to meet a specific legal objective and when strict conditions are met. For example, some programs are designed for older adults only. However, using age alone to deny medically appropriate care, ignore your symptoms, or exclude you from services without a valid program rule or clinical reason may violate your rights. If you are told a decision is based on age, ask for the policy or clinical rule in writing and seek help.
• What should I do first if I think I was discriminated against because of my age?
  Start by writing down what happened. Include dates, locations, names, what was said, what you requested, and any witnesses. Save letters, bills, portal messages, and notices. A clear timeline will help you, your advocate, and any agency that reviews your complaint understand exactly what occurred.
• Should I ask the provider or agency for an explanation?
  Yes. Ask for a clear explanation and request it in writing when possible. Sometimes there is a misunderstanding or a medical reason that can be clarified. If the explanation does not make sense or points to your age alone as the reason, that is a signal to move forward with a grievance or civil rights complaint.
• How can I use an internal grievance process?
  Most clinics, health plans, and facilities have patient relations, member services, or grievance departments. You can submit your concern in writing, describe what happened, and explain why you believe age was a factor. Keep a copy of everything you send and note the date. Ask for a written response and how long the review will take.
• How do I file a civil rights complaint about healthcare or human services?
  If the issue involves discrimination in a health program or human services program that receives federal funds, you can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. In most cases you need to file within 180 days of when you learned about the discrimination, although this deadline can sometimes be extended for good cause. Complaints can usually be submitted online, by mail, or by email and you can request accommodations if you need help completing the process.
• What if the discrimination involves my job or my employer?
  For age discrimination at work, the main agency is the Equal Employment Opportunity Commission. You can start through the EEOC Public Portal or by contacting your local EEOC office. For age cases, you generally must file a charge within 180 days, or within 300 days if your state has a qualifying law and agency. In many situations you may have the option to file a lawsuit after you have filed a charge and a certain amount of time has passed. The EEOC can explain the exact steps and timelines for your case.
• What can I do if I have concerns about a nursing home or assisted living facility?
  If you live in a nursing home or assisted living and feel your rights are being limited because of your age or you are treated disrespectfully, your state Long Term Care Ombudsman Program can help. Ombudsmen provide free and confidential assistance with complaints, help residents understand their rights, and work with facilities to resolve issues. You can contact them directly or ask an advocate to help you reach out.
• What if I am afraid of retaliation or losing care if I speak up?
  Worry about retaliation is very common. It is important to know that residents in nursing homes and many program participants have a right to exercise their rights without discrimination, interference, or reprisal. If you see new negative behavior after speaking up, write it down with dates and details. An advocate can help you document these events, request accommodations, change providers when needed, and alert the appropriate oversight agency if your safety or access to care is at risk.
• How can an Understood Care advocate support me with age discrimination concerns?
  Your advocate listens to your story, reviews your documents, and clarifies what you want to see happen. They can reach out to provider offices, health plans, or agencies to address the issue directly and ask for corrections. With your permission, they can join calls or visits to help make sure your questions are answered and your concerns are taken seriously. Advocates can draft letters, gather records, and help you submit complaints to the right civil rights office, the EEOC, or the Long Term Care Ombudsman. They also help you coordinate follow up so you can keep your care on track while the complaint is reviewed.
• What are some phrases I can use if I want to speak up in the moment?
  On the phone or in person, you might say: “I want to understand this decision. Can you please explain the specific policy or medical reason. I am concerned that my age is being used as the reason. Federal civil rights laws prohibit discrimination based on age in many health programs that receive federal funds. I would like this decision reconsidered and documented in my chart.”
  In a letter or portal message, you might write: “I am writing to request reconsideration of the decision described on [date]. The explanation I received suggests the decision was based on my age. I am requesting a written explanation that cites the specific policy or clinical criteria. If the decision relied on my age alone, please correct it and let me know the next available option for my care.”
• Are there strict deadlines I should keep in mind?
  Yes. For most healthcare and human services complaints to the HHS Office for Civil Rights, the standard deadline is 180 days from when you knew about the discrimination, although OCR may extend this for good cause. For employment cases with the EEOC, the usual deadline is 180 days, or up to 300 days in some states that have their own laws and enforcement agencies. Because deadlines can be complex, it is wise to contact the appropriate agency or an advocate as soon as you can.
• What if I am not sure whether what happened really counts as discrimination?
  It is normal to feel uncertain. If something felt disrespectful, dismissive, or unfair and you suspect age played a role, it is worth writing it down and talking it through with someone you trust or with an advocate. Together you can review what happened, compare it to policies and laws, and decide whether to ask for clarification, file an internal grievance, or take a formal step with a civil rights or employment agency.
• How can I get help from Understood Care right now?
  If you feel you were treated unfairly because of your age, you do not have to handle it alone. Understood Care advocates can help you prepare for visits, document what happened, reach out to clinics and agencies, and support you through grievance or complaint processes. You can also get help with related needs such as appointments, transportation, medical bill review, and medication costs so that discrimination does not derail your care. To get started, you can contact Understood Care by phone or through the online portal and ask to speak with an advocate about age discrimination concerns.

References

• https://www.hhs.gov/civil-rights/for-individuals/age-discrimination/index.html
• https://www.hhs.gov/civil-rights/for-individuals/section-1557/fs-sex-discrimination/index.html
• https://www.federalregister.gov/documents/2024/05/06/2024-08711/nondiscrimination-in-health-programs-and-activities
• https://www.eeoc.gov/age-discrimination
• https://www.eeoc.gov/time-limits-filing-charge
• https://www.eeoc.gov/what-you-can-expect-after-you-file-charge
• https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-B/section-483.10
• https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf
• https://acl.gov/programs/Protecting-Rights-and-Preventing-Abuse/Long-term-Care-Ombudsman-Program
• https://ltcombudsman.org/about/about-ombudsman
• https://www.hhs.gov/civil-rights/filing-a-complaint/index.html
• ‍https://ocrportal.hhs.gov‍
• https://www.hhs.gov/civil-rights/filing-a-complaint/complaint-process/index.html
• https://www.nia.nih.gov/health/medical-care-and-appointments/how-prepare-doctors-appointment
• https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2793359
• https://www.nia.nih.gov/research/blog/2023/12/dont-call-me-old-avoiding-ageism-when-writing-about-aging
• https://www.ecfr.gov/current/title-24/subtitle-B/chapter-I/part-146
• https://www.law.cornell.edu/cfr/text/24/146.1
• https://www.hud.gov/helping-americans/fair-housing-act-overview Cross reference Understood Care pages‍
• https://understoodcare.com/care-types/care-coordination
• https://understoodcare.com/care-types/communication
• https://understoodcare.com/care-types/appointments‍
• ‍https://understoodcare.com/care-types/transportation-help
• https://understoodcare.com/care-types/analyze-bills
• ‍https://understoodcare.com/care-types/lower-costs-of-medication

This content is educational and is not a substitute for medical advice. Always consult your healthcare provider for personalized care.