Two related but different types of support
Hospice and palliative care are related but not the same. Understanding the difference helps families have more informed conversations with medical providers and make decisions that reflect their goals.
At any stage of serious illness
Palliative care may be introduced at any point during a serious illness — it does not require a terminal prognosis and can be provided alongside curative or life-prolonging treatment.
- Symptom management — pain, breathlessness, nausea, fatigue
- Care coordination across multiple providers
- Clarifying goals of treatment
- Supporting complex medical decision-making
- Emotional and spiritual support for patient and family
When comfort becomes the focus
Hospice care is typically introduced when a medical provider determines that life expectancy may be six months or less and the focus shifts from curative treatment to comfort-centered care.
- Skilled nursing visits at home or in a facility
- Medication management for comfort and symptom relief
- Medical equipment and supplies provided
- Social work and counseling support
- On-call clinical response — available 24 hours
- Bereavement follow-up for families after death
Hospice services may be delivered in the home, in assisted living or nursing facilities, or in dedicated inpatient hospice settings depending on need and availability in Maine.
Signs that hospice or palliative support may be appropriate
These transitions are often guided by physicians and hospital discharge planners. Families commonly begin exploring hospice or palliative support when:
- Serious illness progresses despite treatment and symptom burden is increasing
- Hospitalizations are becoming frequent and the individual has expressed a preference to remain home
- A medical team has raised the question of goals of care or comfort-focused treatment
- The individual or family is seeking to understand what hospice involves before a decision is made
- An advance directive or healthcare proxy has expressed comfort-focused preferences
- Caregiver strain is high and additional support — including respite care — is needed
- Death is anticipated within weeks or months and planning for end-of-life care is needed
How hospice is typically funded in Maine
The majority of hospice care in Maine is funded through the Medicare Hospice Benefit. Understanding how this benefit works helps families access care without delay.
Medicare Hospice Benefit — key points
Medicare Part A covers hospice care when a physician certifies that life expectancy is six months or less if the illness runs its normal course, and the individual elects to receive comfort-focused care rather than curative treatment.
Under the Medicare Hospice Benefit, Medicare covers nursing visits, medications for the terminal diagnosis, medical equipment, aide services, social work, chaplain support, and bereavement services. There is generally no cost-sharing for these services.
Hospice does not mean giving up — it means shifting the focus. Individuals may choose to leave hospice and return to curative treatment at any time. The six-month prognosis is a certification requirement, not a prediction or a deadline.
MaineCare (Maine's Medicaid program) also covers hospice services for eligible individuals. Private insurance coverage for palliative care and hospice varies — contact your insurer or the hospice agency directly for benefit verification.
Hospice & palliative providers across Maine's five regions
Hospice and palliative care providers are organized by region. Most hospice providers serve a defined geographic area. Contact providers directly to confirm their service area, referral requirements, and current capacity.
The referral and enrollment process
Hospice in Maine is accessed through a physician referral, though families may also contact hospice agencies directly to ask questions or initiate the process. The hospice agency will coordinate the certification and enrollment process with the physician.
- Ask the primary care provider or specialist whether hospice is appropriate and request a referral if so
- Contact a hospice agency directly — most agencies welcome calls from families exploring options before a formal referral
- The hospice agency will conduct an intake assessment and coordinate physician certification
- Services typically begin within 24–48 hours of enrollment
- Families may change hospice providers at any time
Maine's Assessing Services Agency
For questions regarding MaineCare-funded hospice services or other publicly supported care, Maine's Assessing Services Agency can help identify eligibility and available pathways.
What families across Maine should know
Hospice options in Maine — the landscape
Maine has a mix of nonprofit, community-based, and larger regional hospice organizations serving its five regions. Some are affiliated with hospital systems; others are independent community hospices with deep local roots. The size, staffing model, and services available vary by organization and geography.
In rural areas of Maine — including Washington County, Aroostook County, Piscataquis County, and the western mountains — hospice availability may be more limited. Some providers serve very large geographic areas with smaller nursing staff. Families in these regions should ask about average visit frequency, response times, and after-hours coverage when evaluating providers.
Inpatient hospice — where a patient is admitted to a dedicated hospice facility or inpatient unit for intensive symptom management or when home is not a safe setting — is available in some Maine hospitals and hospice facilities, primarily in the southern and central regions. Availability in rural areas is limited.
Families considering hospice are encouraged to ask questions early. Many hospice agencies report that families most commonly wish they had called sooner. Hospice is not about giving up — it is about ensuring that the time that remains is as comfortable and well-supported as possible.
The Maine Hospice Council is a statewide organization that supports hospice and palliative care in Maine and may be a resource for families with questions about the hospice system.