Hospice of Martha’s Vineyard announced this week that it will join forces with a leading Cape Cod hospice organization, a move that will lead to expanded services including those covered by Medicare, Medicaid and other insurance carriers.

The plan calls for Hospice & Palliative Care of Cape Cod to become affiliated with the Vineyard hospice, which will retain its independence. An independent nonprofit based in Hyannis, Hospice & Palliative Care of Cape Cod is the largest hospice organization on the Cape, with a $12 million annual operating budget.

The announcement appears to come as an answer to an announcement three months ago by the Vineyard Nursing Association that it would expand its services to include Medicare and Medicaid-certified hospice care. At the time the nursing association said it has approached the Vineyard hospice about a merger but had been unsuccessful.

The 28-year-old Vineyard hospice, which operates entirely on donations, has historically offered free care unfettered by the constraints of insurance regulation. Executive director Terre Young said this week none of that will change.

The arrangement is planned as an administrative affiliation, where the Vineyard hospice will remain as an independent entity. Free care will be offered, and if a patient decides also to use insurance-backed services, the Cape Cod Hospice will take over the administrative portion of the work, doing business as Island Hospice. The clinical staff will remain the same, but they will sometimes work for the Vineyard hospice and sometimes for the Cape Cod hospice, depending on the stage of patient care.

Ms. Young said the Cape Cod hospice will open a satellite office on the Island. She said a memorandum of understanding was signed on May 21 between the two organizations, with the affiliation to become effective in September.

“It really feels like a great match,” Ms. Young said. She acknowledged the change in philosophy on the part of the Island hospice which has long operated on a model that stayed outside the confines of insurance rules, allowing a freer rein for care. For example, care from the Vineyard hospice is not limited to a diagnosis by a doctor that the patient has six months or less to live. Ms. Young said this will not change, but she said internal discussions have been going on for a long time at hospice about whether to expand coverage to allow patients to receive the benefits of insurance coverage, which pays for things like medication, hospitalization and equipment. She also said bluntly that the decision by VNA early this year to become a hospice provider forced the hand of the Vineyard hospice.

“I would say that choice was a greater factor than force, but yes it is true that part of this was driven by VNA’s plan to provide hospice care. I think they had very good motives and we did talk with them but they wanted a merger and we did not want that. The affiliation with Cape Cod hospice will allow us to remain independent and that is important,” she said.

She said that while no money will change hands, the affiliation will mean some relief for the Vineyard hospice because the Cape Cod hospice will pay clinical staff salaries, freeing up limited funds for more direct care. “We hope to enhance our services, such as expanding our support system for bereavement,” she said, adding: “We will of course still continue to fund-raise and rely on the generosity of the Vineyard community.”

In a press statement announcing the affiliation, Ms. Young said: “This is not a change, it’s an enhancement. We will continue to serve all patients without charge, just as we have done for over 28 years. The difference is when — and if — a patient wants to access insurance benefits, we now have a way for him or her to do so.”

Meanwhile, Robert Tonti, chief executive officer of the Vineyard Nursing Association, said yesterday that the announcement caught him off guard.

“We were surprised,” said Mr. Tonti, who learned about the hospice announcement on Wednesday this week. He added: “We had continued to talk; we had been having meetings once a month for the last three months, and while I know they were not in favor of a merger, I’m an optimist, and now I am surprised — that they would choose to do this and that they would bring an off-Island organization onto the Island. So we’ll see. It’s not changing our plans; we are moving forward.”

He said the VNA recently secured a contract with the Martha’s Vineyard Hospital to provide a space for respite care and acute care in certain situations, a step that allows the organization to complete a hospice license application for the state Department of Public Health. “We are hoping to have a license in 90 days and certification six months after that,” Mr. Tonti said.