My Ombudsman is an independent program operated by the Disability Policy Consortium (DPC) through a contract with MassHealth.
Our program serves MassHealth members of all ages, abilities, and identities who are currently enrolled in MassHealth, including those found here.
Any MassHealth member can reach out to My Ombudsman when they have questions about their health plan benefits, when they have been denied a benefit or a service, or when they need help understanding their rights. We are passionate about using our skills, expertise, and personal experience to help members get the care they need. We have a “no wrong door” approach, so even if the issue is outside the scope of My Ombudsman’s expertise, we will try to provide referrals to other organizations that can help.
What does an Ombudsman do?
Problem-solver: An ombudsman helps people with health insurance problems.
Neutral advocate: They don’t work for the insurance company or the person, they’re on everyone’s side.
Investigator: They look into complaints about denied claims, billing errors, and access to health care and wellness.
Communicator: They talk to both the person and the insurance company to find solutions.
Educator: They help people understand their health insurance rights.
Resource: They’re a good place to go when you can’t solve a problem with your insurance company yourself.