Partners

Report an issue

Are you a Medicaid member and have a complaint or issue?

The HHS Office of Ombudsman can help current Medicaid members resolve problems with their individual Medicaid cases. Since Texas Medicaid is provided through health plans, also called managed care organizations or MCOs, the state has a special Ombudsman for Managed Care to help Medicaid members. They can help people understand their Medicaid coverage, navigate the managed care system, and resolve problems. You can contact them several ways:

  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

Note: The Ombudsman may not be able to help with every complaint. For example, they cannot resolve a YourTexasBenefits website or YTP app issue. Families would need to call 2-1-1 or 1-877-541-7905 for assistance. After you choose a language, press 2.


Do you need to escalate a Medicaid member’s issue?

Sometimes the ombudsman is unable to fully resolve a Medicaid member issue. If this happens or the member issue is time sensitive, such as a patient needing health coverage immediately, Texas state representatives and senators might be able to help or direct you to other resources.

  • To find out who represents you, enter your information on this page and click on your representatives to contact them directly.

Do you have questions or concerns for HHSC about the process of rechecking eligibility?

HHSC has created an email address specifically for issues concerning the state’s process of rechecking eligibility. This is not a place to get specific member issues addressed, but rather a place to notify the state of issues or concerns.


Do you have a system issue to report?

As you help families in Medicaid during this process, you might start seeing systemic issues or tech glitches. For example, you might see glitches with the YourTexasBenefits.com website, routinely have trouble uploading documents on the YTB website or app, or face wait times on 2-1-1 that are more than an hour. We want to know this kind of information to alert state leaders and help get fixes implemented as soon as possible. Please use the Google form below to report the systemic issue. We cannot guarantee resolution, or that we can work with you one-on-one about the issue, but will review the information and escalate as appropriate for a solution.