Getting a Second Opinion With Medicare
In some cases, Medicare Part B covers a second opinion before medically necessary, non-emergency surgery. It also covers a third opinion if the first two differ. After the Part B deductible, you pay 20% of the Medicare-approved amount. Whether to get one is your choice, made with your doctor.
What Medicare Covers
Medicare.gov describes a second opinion as another doctor giving their view about your health problem and how it should be treated.
| Opinion | What Medicare.gov says you pay, after the Part B deductible |
|---|---|
| Second opinion | 20% of the Medicare-approved amount. If the second doctor asks for more tests, Medicare covers them as it covers other medically necessary services. |
| Third opinion | 20% of the Medicare-approved amount, if the second opinion differs from the first. |
What you owe also depends on other insurance, what the doctor charges, whether the doctor accepts assignment, and where you're seen. With a Medicare Advantage plan, ask your plan about its rules, such as a referral or using its network.
This guide explains how to find and check care. It can't tell you which doctor or treatment is right for you. Your doctor or plan can.
Finding Another Doctor
- Ask your doctor which kind of specialist to see. This site can't suggest one.
- Look up that specialty in your city on our lists, or on Medicare.gov Care Compare. Our lists run A to Z and aren't a recommendation.
- Call the office. Say it's for a second opinion, and ask whether the doctor is taking new Medicare patients and accepts assignment.
- If you have a plan, check the doctor is in its network.
Some people look for a doctor in a different group from the first. That is a personal choice, not a Medicare rule.
Getting Your Records There
Ask the first doctor's office to send your records and test results to the second doctor. HHS says you have a right to copies of your records, and you can ask for them to be shared directly. See moving your records for fees and timing.
For coverage questions, call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
Common Questions
Will my first doctor be upset if I ask for a second opinion?
We can't speak for any doctor. Asking for your records is your right under HIPAA.
Does Medicare cover a second opinion for anything other than surgery?
The Medicare.gov page we read covers second opinions for medically necessary, non-emergency surgery. For other cases, ask 1-800-MEDICARE or your plan.
Which opinion should I follow?
We can't say. Talk it over with your doctors.