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.