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If the person does not have Part B you should call the insurance company to ask how the coverage will coordinate. You may want to request having a social worker or case manager from the insurance company assigned to help navigate this. Also, be sure that what is actually needed is NURSING care and not just the day to day care of assistance with Activities of Daily Living like bathing, dressing, etc. That won't be covered by Medicare. Check the FEHB insurance coverage brochure for 2022 to see if you can figure out what might be covered. If the family member declined Part B due to the cost (bad choice in my opinion), see if the plan has any type of Medicare reimbursement program. I get $800 a year back from Blue Cross because of the specific plan I have. That eases the bite of the cost of Part B Medicare. If the family member did not originally sign up for Part B there may be a penalty for signing up late. However there could be an exception if they waived it and had other equivalent coverage like their FEHB coverage. You need to find out what they did in regards to Medicare Part B for sure and line up proof of the other coverage for the years they did not have Part B, if you intend to get them covered now. And again for your specific question, be sure it is really skilled nursing that is going to be provided.
Note: Page 21 of this year's Medicare book shows how it works with other insurance.
The brochure also explains that after 20 days the person will have a coinsurance cost for days 21-100 and then then they pay all costs after that. If the nursing care is going to be needed for a long time (21 days) it is really important to hear from the private insurance company what they will pay. And start thinking of really long term planning for a possible eventual need for MedicAid.
I'm researching this at a distance; I don't know the particulars of the choice not to enroll in Part B, but I seriously doubt they'd consider enrolling nearly 30 years later. I did learn that Part A alone will cover 100 days of home health care under specific provisions.
And I was wondering if anyone had declined B in favor of an employer plan carried over from employee to retiree to survivor beneficiary coverage.