Getting a Second Opinion before Surgery 

Revised April 2018

What’s a second opinion? 

A second opinion is when another doctor (in addition to 

your regular doctor) gives his or her view about your health 

problem and how it should be treated. Getting a second 

opinion can help you make a more informed decision about 

your care. 

Medicare Part B (Medical Insurance) helps pay for a second 

opinion before surgery. When your doctor says you have a 

health problem that needs surgery, you have the right to: 

• Know and understand your treatment choices 

• Have another doctor look at those choices with you 

(second opinion)

• Participate in treatment decisions by making your wishes 

known 

When should I get a second opinion? 

If your doctor says you need surgery to diagnose or treat a 

health problem that isn’t an emergency, consider getting a 

second opinion. It’s up to you to decide when and if you’ll 

have surgery. 

Medicare doesn’t pay for surgeries or procedures that aren’t 

medically necessary, like cosmetic surgery. This means that 

Medicare also won’t pay for second opinions for surgeries or 

procedures that aren’t medically necessary. 
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Don’t wait for a second opinion if you need emergency surgery. 

Some types of emergencies may require surgery right away, like: 

• Acute appendicitis 

• Blood clot or aneurysm 

• Accidental injuries 

How do I find a doctor for a second opinion? 

Make sure the doctor giving the second opinion accepts 

Medicare. To find a doctor for a second opinion: 

• Visit Medicare.gov/physiciancompare to find doctors who 

accept Medicare. 

• Call 1-800-MEDICARE (1-800-633-4227). TTY users can 

call 1-877-486-2048. Ask for information about doctors who 

accept Medicare. 

• Ask your doctor for the name of another doctor to see for a 

second opinion. Don’t hesitate to ask—most doctors want 

you to get a second opinion. You can also ask another doctor 

you trust to recommend a doctor. 

What should I do before getting a second 

opinion? 

Before you visit the second doctor: 

• Ask the first doctor to send your medical records to the 

doctor giving the second opinion. That way, you may not 

have to repeat the tests you already had. 

• Call the second doctor’s office and make sure they have 

your records. 

• Write down a list of questions to take with you to the 

appointment. 

• Ask a family member or friend to go to the appointment 

with you. 
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During the visit with the second doctor: 

• Tell the doctor what surgery you’re thinking about having. 

• Tell the doctor what tests you already had. 

• Ask the questions you have on your list and encourage your 

friend or loved one to ask any questions that he or she may 

have. 

Note: The second doctor may ask you to have additional 

tests performed as a result of the visit. Medicare will help pay 

for these tests just as it helps pay for other services that are 

medically necessary. 

What if the first and second opinions are different? 

If the second doctor doesn’t agree with the first, you may feel 

confused about what to do. In that case, you may want to: 

• Talk more about your condition with your first doctor. 

• Talk to a third doctor. Medicare helps pay for a third opinionif 

the first and second opinions are different. 

Getting a second or third opinion doesn’t mean you have to 

change doctors. You decide which doctor you want to do your 

surgery. 

How much does Medicare pay for a second 

opinion? 

Medicare Part B helps pay for a second (or third) opinion 

and related tests just as it helps pay for other services that are 

medically necessary. If you have Part B and Original Medicare: 

• Medicare pays 80% of the Medicare-approved amount. 

• Your share is usually 20% of the Medicare-approved amount 

after you pay your yearly Part B deductible. 
CMS Product No. 02173

Do Medicare Advantage Plans cover second 

opinions? 

If you’re in a Medicare Advantage Plan (like an HMO or PPO), 

you have the right to get a second opinion. If the first two 

opinions are different, your plan will help pay for a third opinion. 

Even though you have the right to get a second opinion, keep 

these things in mind: 

• Some plans will only help pay for a second opinion if you have 

a referral (a written OK) from your primary care doctor. 

• Some plans will only help pay for a second opinion from a 

doctor who’s in your plan’s provider network. 

Call your Medicare Advantage Plan for more information. 

Note: If you have Medicaid, it might also pay 

for second surgical opinions. To find out, call 

your Medicaid office. You can get the phone 

number by: 

• Visiting Medicare.gov/contacts.

• Calling 1-800-MEDICARE (1-800-633-4227). 

TTY users can call 1-877-486-2048. 

You have the right to get Medicare information in an accessible format, 

like large print, Braille, or audio. You also have the right to file a complaint 

if you feel you’ve been discriminated against. Visit Medicare.gov/aboutus/nondiscrimination/accessibility-nondiscrimination.html, or call 

1-800-MEDICARE for more information.