If you get your Medicaid through a health plan or a managed care organization, also called an MCO, and you have questions or complaints, we can help. Complete our online form.
The Ombudsman helps people:
- Navigate the managed care system
- Understand their Medicaid coverage
- Understand their rights
- Advocate for themselves
- Resolve problems, including access to care
How We Can Help
Our team is designed to help people who are already on Medicaid but need help accessing health care services. A priority is placed on individuals who have urgent or complex health care needs.
Help includes:
- Information about your coverage
- How to access services
- Referrals to the right place to get help
- Help resolving a problem
We also provide information about managed care programs to providers, health plans, community based organizations and other stakeholders.
How to Get Help
There are four ways to contact us:
- Call: 866-566-8989, 8 a.m. - 5 p.m., Monday - Friday
If you have a hearing or speech disability, call the toll-free Relay Texas service at 7-1-1 or 800-735-2989. - Online: Submit your question or complaint online
- Mail: Texas Health and Human Services Commission
Ombudsman for Managed Care
P.O. Box 13247
Austin, TX 78711-3247 - Fax: 888-780-8099
Managed Care Resources
Have questions about Medicaid? Read our brochure: Need help with Medicaid? (PDF)
Who can I call to find out which services are paid by Medicaid or if I get a bill from a Medicaid provider?
Call the statewide Medicaid Helpline at 800-335-8957.
Who can help me get a ride to my Medicaid provider?
If you have a health plan visit Medical Transportation Program Health Plan Contact Information and locate your health plan's transportation provider contact information.
If you do not have a health plan call Medical Transportation at 877-633-8747.
Who can I call to change my STAR or STAR+PLUS health or dental plan?
Call the Enrollment Helpline at 800-964-2777.
Who can I call about keeping my Medicaid benefits?
Call 2-1-1 or 877-541-7905.
If I am receiving help paying my medical bills and I need information about my Medically Needy Program spend down case, who can I call?
Call the statewide Medicaid Helpline at 800-335-8957.
Who can I call to find out about nursing home care, adult day care or other long-term care services and supports?
Call your local Aging and Disability Resource Center at 855-937-2372.
Who can tell me about how my other insurance affects my Medicaid benefits?
Call the Texas Medicaid Healthcare Partnership Third Party Resources Hotline at 800-846-7307.
To whom do I report Medicaid fraud, waste or abuse?
Call the Office of Inspector General at 800-436-6184.
Who can I talk to about getting help to pay my private insurance premiums?
Call the Health Insurance Premium Program Hotline at 800-440-0493.
Who can I talk to if I receive Supplemental Security Income and I need to change my address?
Call the Social Security Administration at 800-772-1213.
Who can I call if I have questions about my Medicare Rx Prescription Program?
Call 800-MEDICARE (800-633-4227).
Who can I call if I use equipment for people who are hearing impaired?
Call Relay Texas at 800-735-2989.
Annual Reports
Quarterly Reports
Replaced by Annual Report in December 2023.
- Report from the HHS Ombudsman Managed Care Assistance Team Third Quarter FY 2023 (PDF)
- Report from the HHS Ombudsman Managed Care Assistance Team Second Quarter FY 2023 (PDF)
- Report from the HHS Ombudsman Managed Care Assistance Team First Quarter FY 2023 (PDF)
- Report from the HHS Ombudsman Managed Care Assistance Team Fourth Quarter FY 2022 (PDF)
- Report from the HHS Ombudsman Managed Care Assistance Team Third Quarter FY 2022 (PDF)
- Report from the HHS Ombudsman Managed Care Assistance Team Second Quarter FY 2022 (PDF)
- Report from the HHS Ombudsman Managed Care Assistance Team First Quarter FY 2022 (PDF)
- Report from the HHS Ombudsman Managed Care Assistance Team Fourth Quarter FY 2021 (PDF)