HELPING YOU GET THE CARE YOU NEED FROM YOUR MASSHEALTH PLAN
Mission
Our mission is to ensure that MassHealth members understand their healthcare rights and health plan benefits so they can get the care they need.
Who We Are
My Ombudsman is an independent program operated by the Disability Policy Consortium (DPC) through a contract with MassHealth.
My Ombudsman staff come from culturally and linguistically diverse communities and have experience in areas such as advocacy, social services, and healthcare, to name a few. My Ombudsman is committed to promoting health equity by working to ensure all MassHealth members can access the care and services available to them through their plans.
What we do
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.
Who we help
We serve anyone enrolled in MassHealth, including members enrolled in:
Members who get their MassHealth Limited via Fee for Service (FFS), such as members who have both Medicare and MassHealth
Members who have MassHealth Limited or Children’s Medical Security Plan
Members enrolled in:
Accountable Care Organizations (ACOs)
Managed Care Organizations (MCOs)
One Care
Senior Care Options (SCO)
Program of All-Inclusive Care for the Elderly (PACE)
Primary Care Clinician (PCC) Plan
Massachusetts Behavioral Health Partnership (MBHP)
How we do it
When a case first comes to us, we listen without judgment.
Then, we provide support, which could include answering questions, helping to identify barriers or address confusion, investigating complaints, mediating between parties, explaining member rights, and making referrals. While My Ombudsman cannot represent a member when they file a grievance or appeal, we can explain the process and what to expect.
How to contact us
You can reach us by phone or email. Our staff speak Spanish and Haitian Creole. We also have a phone interpretation service available for over 165 languages. If you email us or leave a voicemail, a Community Liaison will reply within 24 business hours. If you use American Sign Language, please call us via videophone.
Where to find us
Our office is located in Boston at 25 Kingston Street 4th Floor.
We are wheelchair accessible. Our staff speak Spanish, Haitian Creole, and use American Sign Language. We also have a phone interpretation service available for over 165 languages. We can meet with you at our office on Tuesdays and Thursdays by appointment between 10am-3pm.
*Please kindly note that masks are a mandatory requirement for all staff and visitors at our office.
Our Values
We listen to you with compassion and respect. We value your knowledge and life experience. We will never share your information without your permission. We stay neutral – we do not judge, we do not decide who is right or wrong, and we do not represent members or insurance plans.