First Lesson: Medicaid Doesn’t Have to Stop at State Lines
Here’s the first big lesson we learned — and it’s one I wish someone had told us right from the start:
As an American with disabilities (or a parent/caregiver of one), you are not limited to the services that exist in your home state. If services are needed and only available in another state, you have every right to take advantage of these services; but it is a bit of a pain.
Sounds obvious, maybe. But it’s not. And almost no one talks about it.
Why This Matters
Our son Willy has complex needs — including severe OCD. After years of trying everything in New Jersey, we found one program that could actually help. It was out of state, in Massachusetts. Problem was, insurance wouldn’t cover it, and state Medicaid services wouldn’t transfer — or so we thought.
We were suddenly facing $1,000 a day for inpatient care. Six weeks minimum.
That’s not a bill most families can take on — and one we really couldn’t afford to ignore. So I made it a mission to figure out how this actually works. What if we couldn’t pay? Were we out of options?
There had to be a better way.
And there is!
What We Found
Under federal law — especially the Americans with Disabilities Act (ADA) — a person has the right to access care in the most appropriate setting, regardless of state lines. That includes:
The right to move freely to another state
The right to pause Medicaid and disability services in your current state
The right to establish residency in a new state where care is available
And the right to re-enroll in Medicaid there — where the services actually exist
This isn’t a loophole. It’s the way the system is supposed to work — but no one tells you.
Summary
Issue: Willy needed inpatient care that didn’t exist in NJ.
Cost: $1,000/day, 6+ weeks.
Barrier: Medicaid doesn’t cover out-of-state residential programs.
What Worked:
✔️ Establishing residency in Massachusetts
✔️ Pausing NJ Medicaid and DDD services
✔️ Applying for MassHealth (Medicaid in MA)
✔️ Citing ADA protections and care necessity
Result
Willy is now officially a Massachusetts resident — and he’s about to start receiving the care he needs, fully covered.
It took weeks of research, rejections, and pushing through, but we got here. And if you're in a similar spot, know this: you have more options than you think.
