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.
- 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)
|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
|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
|Who can I call to use TDDY for hearing impairment?||Relay Texas||1-800-735-2989|