Ombudsman Program
The HHSC Ombudsman is a special office that helps people who have a Blue Cross and Blue Shield of Texas Medicaid plan. Think of them as a "helper" or "problem solver" when you are having trouble getting the health care you need.
What are ombudsmen?
An ombudsman helps resolve issues for Medicaid members. They explore problems and deal with them fairly. They can also speak up for those who can’t speak for themselves.
Why contact an ombudsman?
An ombudsman can help you and your family:
- Get medicine, see a doctor, or get a medical test.
- Review and address concerns about services.
- Understand and receive the benefits of your BCBSTX health plan.
- Understand your rights and responsibilities.
- Get help for people in nursing homes, kids with disabilities, or people who need behavioral health support.
- Look into and address member issues without taking sides.
- Work to resolve your issues following Texas’ Medicaid guidelines and using BCBSTX resources.
- Understand the appeals and grievance process.
Being able to work with an ombudsman empowers members to take a self-directed approach to care.
When would I contact an ombudsman?
If you have worked with BCBSTX to address your concerns and are not satisfied with the solution, then you can contact an ombudsman. We want to make sure your concerns are addressed.
Learn About the Program
The Texas Health and Human Services (HHS) Office of the Ombudsman has a program that offers help when you need it. Find out more about the program at the . Contact HHS using the resources below.
Call
Call 1-866-566-8989
8 a.m. - 5 p.m., Monday – Friday.
If you have a hearing or speech disability, call TTY line at 711.
Write
Mail your inquiry to:
HHS Office of the Ombudsman
P.O. Box 13247
Austin, TX 78711-3247
Fax
Send a fax to:
1-888-780-8099
