Texas community resource
Medicaid Managed Care Ombudsman Assistance
Texas Health and Human Services Commission
Ombudsman help understanding Medicaid managed care rights, navigating coverage, and escalating unresolved access-to-care or health-plan complaints.
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How to get help
Complete the health plan's complaint process first. If the outcome is unsatisfactory, call the Managed Care Assistance Team, submit the online HHS question or complaint form, or send the complaint by mail or fax. Include member and plan information, the issue, prior complaint steps, dates, and requested help.
Who this service helps
Texas Medicaid managed care members with questions or unresolved plan complaints, including STAR, STAR+PLUS, STAR Kids, and STAR Health. Members should first contact their managed care organization's Member Services complaint process.
Where this service is available
Service area: Statewide Texas Medicaid managed care assistance, including STAR, STAR+PLUS, STAR Kids, and STAR Health members in the Central Texas counties.
A service area describes where help is offered or who may be served. It is not necessarily the organization’s physical location.
About this service
The Managed Care Assistance Team helps Medicaid members understand coverage and rights, advocate for themselves, navigate managed care, and resolve problems such as access to care. It may investigate a complaint after the member has used the health plan's complaint process.
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