Ombudsman Managed Care Help

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:

  1. 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.
  2. Online: Submit your question or complaint online
  3. Mail: Texas Health and Human Services Commission 
    Ombudsman for Managed Care 
    P.O. Box 13247 
    Austin, TX 78711-3247
  4. 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.