Medicaid Managed Care

The Health and Human Services Commission's Office of the Ombudsman helps people with Medicaid managed care coverage:

  • 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 with urgent or complex health care needs.
Help includes:

  • Information about the client’s coverage.
  • Guidance on how to access services.
  • Referrals to the right place to get help.
  • Direct assistance from staff to resolve a problem.

Our team also provides general information about managed care programs to providers, health plans, community based organizations and other stakeholders.

How to Get Help

Call us at 1-866-566-8989 (toll-free)

Find the list of health plans and phone numbers available in your county online.

Other Places to Get Answers to Your Questions
Question Contact Phone
Who can I call to find out which services are paid by Medicaid or if I get a bill from a Medicaid provider Statewide Medicaid Helpline 1-800-335-8957
Who can help me get a ride to my Medicaid provider? Medical Transportation 1-877-633-8747
Who can I call to change my STAR or STAR+PLUS health or dental plan? Enrollment Helpline 1-800-964-2777
Who can I call about keeping my Medicaid benefits? 2-1-1 Information and Referral 211 or 
1-877-541-7905
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? Statewide Medicaid Helpline 1-800-335-8957
Who can I call to find out about nursing home care, adult day care or other long-term care services and supports? Aging and Disability Resource Center  1-855-937-2372
Who can tell me about how my other insurance affects my Medicaid benefits? Texas Medicaid Healthcare Partnership Third Party Resources Hotline 1-800-846-7307
To whom do I report Medicaid fraud, waste or abuse? Office of Inspector General 1-800-436-6184
Who can I talk to about getting help to pay my private insurance premiums? Health Insurance Premium Program Hotline 1-800-440-0493
Who can I talk to if I receive Supplemental Security Income (SSI) and I need to change my address? Social Security Administration 1-800-772-1213
Who can I call if I have questions about my Medicare Rx Prescription Program? Medicare 1-800-MEDICARE
(1-800-633-4227)
Who can I call to use TDDY for hearing impairment? Relay Texas 1-800-735-2989

How to Contact Us

The Office of the Ombudsman is ready to assist the public with issues or complaints about health and human services programs, agencies or personnel.

If you have a problem or complaint about a health and human services program or service, we encourage you to first discuss it with the person, program or office involved. Many times they can explain a specific policy or correct the problem immediately.

If your problem or complaint is not resolved to your satisfaction, there are 4 ways to contact our office.

1. Call us toll-free

General issues
1-877-787-8999

Medicaid managed care
1-866-566-8989

Youth in foster care (up to age 18)
1-844-286-0769 or visit our website.

People with a hearing or speech disability
7-1-1 or 1-800-735-2989 (Relay Texas)

2. Complete an online form

Online Question or Complaint Form   

3. Mail it to us

Texas Health and Human Services Commission
Office of the Ombudsman, MC H-700
P O Box 13247
Austin, TX  78711-3247

4. Fax it to us toll-free

1-888-780-8099