After you get your doctor's diagnosis and cancer treatment plan, it is a good idea to get another cancer doctor's advice before you start treatment. This is especially true if your doctor suggests surgery. This is called a second opinion.
Medicare covers most of the cost of a second opinion before surgery. A second opinion might tell you to follow your first doctor's treatment plan. Or it can suggest that you change the plan. A second opinion can make you feel better that you have explored your treatment options. It also will give you a chance to get all your questions answered.
When will Medicare cover second opinions?
Medicare will cover a second opinion when your first doctor says you need surgery to diagnose or treat a health problem that is not an emergency. Medicare also will cover second opinions for certain types of major procedures that do not involve surgery.
You do not need an order or referral from your doctor to seek a second opinion. But it is a good idea to work with your doctor's office to get a second opinion. Your doctor will need to give your medical records to the specialist. Most doctors welcome another doctor's views. Many people get second opinions.
Second opinions and Medicare Advantage plans
Your Medicare Advantage plan can help you pay for a second opinion too, if you need it. But you may need to follow certain steps. You may have to get a referral from the plan and/or see a plan doctor for a second opinion, for example.
For more tips, check Medicare's Getting a Second Opinion before Surgery.
What will it cost?
Medicare covers most of the cost of second opinions and related tests. It pays the same as it would for other services that are medically necessary. Learn what you pay under Medicare Part B.
How do I find a doctor for a second opinion?
Your own doctor may be able to give you a specialist's name. If not, or if you prefer to choose one on your own, you can:
- Visit www.medicare.gov. Click “Resource Locator,” then “Doctors” to find doctors who accept Medicare.
- Call 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048.
- Call the National Cancer Institute’s Cancer Information Service, at 1-800-4-CANCER (1-800-422-6237). They can tell you about nearby treatment centers.
- Ask your local or state medical society, a nearby hospital, or a medical school for names of specialists.
Be sure the doctor who gives the second opinion accepts Medicare. This will save you money.
What should I do before I get a second opinion?
Ask your first doctor to send your medical records to the second doctor. Then you will not have to get repeat tests. This will save you money.
If you do need more tests, Medicare will cover most of those costs.
Tell the doctor what surgery you are thinking about. Write down any questions you have. Bring a friend or family member with you if you can.
Will Medicare cover a third opinion?
If you have two different opinions from two different doctors, you can:
- Talk with your first doctor, or
- Seek a third opinion.
Medicare helps pay for a third opinion as it does for a second opinion.
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