What is a second opinion?
A second opinion is when you talk with a doctor other than your regular doctor to get another opinion on a particular health problem and their treatment options.
When your doctor advises you that you have a health problem that requires surgery you have the right to:
- Understand your treatment options.
- Have another doctor look at those choices with you. (second opinion)
Remember: Medicare will not pay for any surgeries or procedures that are not medically necessary. As an example, Medicare would not pay for cosmetic surgery.
When should you get a second opinion?
As long as your health problem or surgery is not considered an emergency, you should consider a second opinion. It is your decision if and when to have surgery. You also can get a second opinion if your doctor recommends certain kinds of major non-surgical procedures.
IMPORTANT: Do not wait for a second opinion if you need emergency treatment or surgery.
There are several ways to find a doctor for a second opinion:
- You can visit Medicare.gov/physiciancompare to find doctors.
- You can also call Medicare at 1-800-Medicare. (1-800-633-4227)
- Ask your doctor for the name of another doctor to get a second opinion.
Before visiting the second doctor, you should ask your first doctor to send over your medical records. The second doctor may want you to have additional medical tests performed. Medicare will pay its portion of any services or tests that are medically necessary.
If the first and second doctor’s opinions are different, Medicare will pay its share for a third opinion.
Doctor’s services are covered under Medicare Part B, as well as any tests or related services. Depending on your plan, you may have to pay the annual Medicare Part B deductible, which at the time of this article (2019) is $185.00 annually.
If you have a Medicare Advantage plan, check with your plan, as you may need a referral before getting a second opinion and may have to go to a doctor that is in your plan’s provider network.
Make sure the doctor giving the second opinion accepts Medicare.
If you are unsure how to use the Medicare physician compare tool you can see my article by clicking the link below.
If you are unsure, of what type of plan you have you can call or email me.
Medicare explained in plain English
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