Maine Hospice Care

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Maine Hospice Care: How to pay for Hospice Care, Licensing and Regulations, and Questions to ask

Maine hospice care is a concept of care, not a specific place of care. It is for those who have been living with a terminal illness or only recently received a serious diagnosis of six months or less life expectancy. This specific type of care is there to ease the burden of 24-hour care. Hospice provides a respectful, comfortable care setting for your loved one’s final months and weeks or days. It is an option to consider and can be especially helpful for families, or those seniors without family to provide end-of-life care.

Signs it may be time to look into hospice care

  • Your loved one has made multiple trips to the emergency room. 
  • The condition continues to progress, affecting quality of life. 
  • The individual has been admitted to the hospital several times in the last year with the same or worsening symptoms. 
  • Does loved one wish to remain at home, rather than spend more time in the hospital. 
  • Your loved one has decided to stop receiving treatment.

What is Palliative care and respite care and how are they different from hospice?

Let’s discuss what makes them different:

Palliative Care

Palliative care refers to any care that alleviates symptoms, whether there is hope of a cure by other means or not. Both palliative care and hospice care are intended to provide comfort for the individual and family. This care focuses on easing pain and discomfort to help people have the highest possible quality of life. It is appropriate at any stage of life, not just end of life. 

Respite care

Taking care of a loved one who is terminally ill can be exhausting and emotionally draining for family members, and especially if family members are the caregivers. Respite care provides relief for those looking after the terminally ill individual. They may be checked into temporary hospice and provide a much needed break for family caregivers.

Hospice 

Hospice care is an option for people who have a life expectancy of six months or less. In place of ongoing curative measures, hospice involves palliative care (pain and symptom relief), enabling the individual to live their final days with purpose, grace, dignity, and support from family and staff. The purpose is for the individual to spend their final days in a comfortable, familiar environment, with their loved ones enabling them to focus their attention with help of staff. Some hospitals, nursing homes, and other health care facilities offer hospice care on-site – however, it is most often provided in the person’s home. 

Laws and regulations for hospice care in Maine

The Maine Department of Health and Human Services licenses and monitors hospice care services. Regulations address requirements for hospices contracting with state Medicaid programs and the rules pertaining to patients. Visit https://www.hospicealliance.org/ to see each states codes and how they apply to care regulations.

Federally, Medicare’s benefit regulations incorporate the following ideals:

  • Must be licensed in the state they operate. 
  • The person receiving care and their family know of their terminal condition. 
  • Additional medical treatment and intervention only on a supportive basis. 
  • Pain control should be available to the person as needed.  
  • Trained volunteers should provide additional support as required.

State regulations

Regulations address requirements for hospices contracting with state Medicaid programs and the rules pertaining to patients. Visit https://www.hospicealliance.org/ to see each states codes and how they apply to care regulations.

How to pay for Hospice Care?

Medicare, private health insurance, and Medicaid (in 43 states) covers hospice care for patients who meet eligibility criteria.

Private insurance and veterans’ benefits may also cover hospice care under certain conditions. In addition, some hospice programs offer healthcare services on a sliding fee scale basis for patients with limited income and resources. To get help with your Medicare questions call 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov. Additional information about how to pay for hospice care can be found at the Public Policy Institute of the AARP.

Who Pays for Palliative Care?

Medicare, Medicaid, many insurers, and healthcare plans will cover the medical portions—physician and nurse services—of palliative care.

Veterans may be eligible for palliative care through the Department of Veterans Affairs. Check with your doctor and healthcare plan to see what insurance will cover in your particular situation. Unlike the comprehensive hospice benefit, there is no comprehensive palliative care benefit.

Questions and inquiries

Is Hospice only for those who have cancer? 

No. It is for anyone with a terminal illness who has been given a prognosis by their doctor of six months or less.  

Do only elderly people use these services.  

It is for all age groups during the final stages of their life. The intention is to allow people to enjoy the closeness of family and a comfortable environment in the last stages of their life.  

Do people on hospice die immediately? 

This care does not hasten death. Though, studies have shown people often live longer than those with the same or similar illnesses who do not choose hospice. 

Are all hospices the same? 

The United States offers thousands of hospices. Most engage in Medicare, which requires certain services for the person in care. So, there is a standard operating procedure.  

How can I afford Hospice care? Is it expensive. 

Hospice care is covered by Medicare Part A, and your personal insurance. 

Is Hospice is only provided in the individual’s home? 

NO, Care is provided wherever the person is, which could be a long-term care facility or a hospital. Being take care of at home is always an option. 

Legal Services for the Elderly of Maine  Maine residents age 60 and older can call the statewide Legal Helpline to get free and confidential help with legal problems. The Helpline Attorneys provide information and advice on a wide variety of non-criminal legal problems including elder abuse and protection orders, housing issues including eviction and foreclosure, consumer debt, public assistance benefits, guardianship, Medicare/MaineCare, Powers of Attorney, Health Care Advance Directives, and health care coverage disputes. LSE also has attorneys located in offices across the state that provide legal representation in some situations. If LSE can’t help, callers are offered referrals to private attorneys, potentially at reduced fees.

Office of Aging and Disability Services The Office of Aging and Disability Services (OADS) supports Maine’s older and disabled adults by providing Adult Protective, Brain Injury, Other Related Conditions, Intellectual and Developmental Disability, Long Term Care, and Aging and Community services to the people of Maine.

Adult Protective Services Intake The Office of Aging and Disability Services provides or arranges for services to protect incapacitated and dependent adults age 18 and over. If you or someone you know is being abused, neglected, exploited or is unsafe, call Adult Protective Services to make a confidential report

Maine State Health Insurance Assistance Program (SHIP) The Maine SHIP grant is administered by the Office of Aging and Disability Services (OADS) and is a partnership between OADS, five area agencies on aging (AAA), the Bureau of Insurance, and the Legal Services for the Elderly (LSE). The Program Director is responsible for program administration, training activities and project coordination among the partners. Counseling and outreach activities are performed primarily by staff and volunteers at the AAAs. Staff attorneys at the LSE Hotline counsel beneficiaries by phone and refer them to AAAs if face-to-face assistance is required while the Department of Insurance furnishes relevant publications and offers consultation and training support.

Eldercare Locator This is a great resource to search for specific care in specific counties and cities. This database is a nationwide resource that connects older Americans and their caregivers with trustworthy local support resources. Connect with services such as meals, home care or transportation, or a caregiver education or respite from caregiving responsibilities. The Eldercare Locator is a public service of the Administration on Aging (AoA), an agency of the U.S. Administration for Community Living.

Medicare provides a search feature to find & compare providers near you, most senior housing and care providers are included on CareAvailability.com. Find & compare plans in your area. Determine if you qualify for premium savings

Medicaid offers information on how to apply for Medicaid, eligibility criteria, links to local state offices, and additional resources

The Alzheimer’s Association is the leading voluntary health organization in Alzheimer’s care, support, and research. Whether you are living with Alzheimer’s or caring for someone with the disease, information and resources are available.

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Written by The Care Availability Team
Experts in the senior care & retirement living industries

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