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cross-over claim

What is a Medicare cross-over claim?

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Can I be enrolled in Medicare and Medicaid at the same time?

Can I be enrolled in Medicare and Medicaid at the same time?

People with Medicare and Medicaid are known as dual eligibles – and account for about 20 percent of Medicare beneficiaries (12.1 million people). Learn how that status affects your coverage.



A claim is an application for benefits provided by your health plan. You must file a claim before funds will be reimbursed to your medical provider. A claim may be denied based on the carrier's assessment of the circumstance.

What is a cross-over claim?

A Medicare cross-over is a claim that Medicare sends to another insurer for secondary payment.

When a Medicare beneficiary is a dual eligible – meaning they have Medicare and Medicaid – their Medicare claims should cross-over to Medicaid, which would cover Medicare cost sharing (i.e., deductibles, co-pays and coinsurance).

Claims can also cross-over from Medicare to Medigap plans, which pay for deductibles, co-pays and coinsurance.


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