STAR Complaints and Appeals Process

Filing a Complaint

If you have a complaint, please call us toll-free at 1-800-431-7798 to tell us about your problem. A FirstCare Member Services Advocate can help you file a complaint. Most of the time, we can help you right away or, at the most, within a few days.


If you don’t get the help you need from FirstCare, you should do one of the following:

• Call the Medicaid Managed Care Helpline at 1-866-566-8989 (toll-free).
• Email your complaint to HPM_Complaints@hhsc.state.tx.us.  
• Write to: Texas Health and Human Services Commission
                Office of the Ombudsman, MC H-700
                P.O. Box 13247
                Austin, TX 78711-3247
• Fax 1-806-784-4319 (toll-tree)

Fair Hearing

You may ask for a Fair Hearing only after exhausting FirstCare’s Internal Appeal process. If you do not agree with FirstCare's decision, you may ask for a Fair Hearing from the State. You have 120 days from the date on the letter to request a Fair Hearing.
 
You can request a Fair Hearing by contacting FirstCare STAR at 1-800-431-7798.
 
If you would like to make your request in writing, please write:
FirstCare Health Plans
Attn: Complaints and Appeals Department
12940 N Hwy 183 
Austin, TX 78750
 
You do not have a right to a Fair Hearing if Medicaid does not cover the service you requested.

Call 1-800-431-7798 if you need any help.