Medicare

Your Right to a Second Opinion Under Medicare

If you’re facing a non-emergency surgery or some other significant medical procedure or treatment, Medicare will cover a consultation with another doctor if you want a second opinion. As with most elective surgeries or other major but non-urgent procedure, you can afford to take a little more time to weigh your options.

If enrolled in traditional Medicare, you can ask your primary care doctor to recommend an appropriate but different specialist for a second opinion, or you can go directly to another specialist of your choice. If the first and second opinions don’t agree, Medicare will cover one more opinion from a third doctor. In each case, you pay 20% of the Medicare-approved cost under Part B, providing the doctor you see accepts assignment. However, if I’ve secured a supplemental policy for you, you won’t even pay that 20%.

If you’re enrolled in a Medicare Advantage plan, you have the same rights. However, many Medicare Advantage plans require your primary care physician to make a referral to a second physician within the plan’s provider network. Your copays will likely be different as well.