Covid-19 info
Get the care you need from your MassHealth health plan.
What we do
We help MassHealth members of all ages, abilities, and identities access the care they need. We are here and ready to answer your questions about your health plan.
Not sure what plan you belong to? See plans.
HOW WE DO IT
1. We Listen
When you contact My Ombudsman, you’ll speak to a Community Liaison who listens with compassion and respect. (If you’re speaking on someone else’s behalf, we’ll need their permission to talk to you.) The Community Liaison can answer questions about your health plan, your member rights, and connect you to other community resources if you need them.
2. We Gather Information
If you need assistance with a specific issue or complaint, the Community Liaison may ask for more information about you and the situation so that we can open your case and assign it to an Ombudsman.
3. We work together
Your Ombudsman will work with you to discuss the issue in more detail and explore the next steps. With your permission, your Ombudsman may reach out to your health plan, your providers, or anyone else involved to help understand the problem and find solutions. Your Ombudsman will offer you support, expertise, and referrals if needed. They will follow up with you regularly until your case is resolved.
4. Learn About Appeals
If these options haven’t solved your issue, we will show you how to file an appeal and what to expect during the appeal process.
5. Get a Referral
If you decide to go forward with the appeal or grievance, we then refer to information and problem resolution resources, including formal grievance and appeal processes and legal services.
EVENTS
What do I do need to know about MassHealth?
Wednesday, June 16, 2021 at 10 AM – 12 PM
My Ombudsman News
