Talking with your doctor and finding out you have a serious health condition can be overwhelming, especially when there are multiple treatment options. Getting a medical second opinion may help you gain another perspective of your condition and the available treatments. Doctors understand you may want to get a second opinion. It’s not uncommon for a doctor to refer you to a specialist or a different doctor before you even ask. Below we discuss when you may want to get a second opinion, how to get one, and some questions to ask when getting a second opinion.
What Is a Medical Second Opinion?
Getting a second opinion means seeing a different doctor or specialist after you were given a diagnosis or treatment plan from one doctor.
This second doctor will review your medical history, including laboratory and radiology tests, and provide you with their medical opinion of your diagnosis and treatment plan.
It is possible the second doctor may suggest different treatment options.
For a second opinion, it is a good idea to choose a new doctor from a different office or practice.
Medical Second Opinion – When Should You Get One?
Health conditions can be complicated, and many times there are multiple treatment options available.
There are several reasons why you may want to get a second opinion, for example:
- You are not clear about the diagnosis or how well treatment may work
- You want more information about your options
- Your health insurance plan may require a second opinion
- You may have multiple health conditions
- The diagnosis is complicated, rare, or life-threatening
- There are multiple treatment options available, or the treatments are experimental or risky
- The treatments you have been receiving are not working
- You are having trouble talking with your current doctor, or your current doctor can’t help you
- You want confirmation that you have the correct diagnosis and treatment plan
Research shows that second opinions result in changes to diagnoses or recommended treatment. For example, one study found that second opinions resulted in changes in diagnosis in about 15% of the patients and changes in treatment in about 37% of the patients.
If you need emergency surgery or other life-threatening treatment, you should not wait for a second opinion.
How to Get a Second Opinion From a Doctor
Ask your primary doctor for a referral to a specialist.
If you’re already seeing a specialist, ask your primary doctor for a referral to a new specialist (with the right expertise), so you can get a second opinion.
Don’t worry about offending anyone. Second opinions are expected.
Doctors understand that getting other professional opinions is beneficial for you and is common practice.
If you don’t feel you can ask your current doctor for a referral for a second opinion, consider asking
- Your health insurance plan to recommend a specialist
- A local hospital or clinic may help by providing a recommendation
- Searching online or a medical association for a specialist near you
Does Insurance Cover Second Opinions?
Most health insurance plans cover second opinions for major medical procedures or surgery.
However, it’s best to confirm coverage with your insurance plan before you make the appointment.
In addition, there may be restrictions, such as finding a specialist in the network.
Does Medicare Cover Second Opinions
Medicare Part B will usually help cover a medical second opinion as long as it is for a treatment that is considered medically necessary and the doctor accepts Medicare.
Medicare will not pay for procedures or surgeries that are not medically necessary, like cosmetic surgery. This means that Medicare won’t pay for a second opinion for these surgeries or procedures that are not medically necessary.
Therefore, you can use Medicare Part B or Medicare Advantage for coverage of a second opinion if it’s something Medicare usually covers.
In addition, if both doctors disagree, Medicare may cover a third opinion.
Things to Do Before Your Appointment
Before your second opinion appointment with the second doctor:
- You want to make sure this second doctor has your medical information, including laboratory and radiology tests.
- Ask the office of your first doctor to send all of your medical information to the second doctor.
- Call the second doctor’s office and confirm they have your medical records
- Write down questions you have and bring the questions with you to your appointment. Click here for our PDF downloadable Questions to Ask When Getting a Second Opinion.
- Ask someone, whether a friend or family member, to go to the appointment with you.
Questions to Ask When Getting a Second Opinion
Consider asking the following questions during your appointment:
- What is my diagnosis?
- Is it possible my health problem could have a different diagnosis?
- Are there additional tests you think I should have?
- What are my treatment options?
- What treatment do you recommend?
- Are there any other treatments or procedures I should consider?
- What are the risks of each of the treatment options?
- Are there side effects from these treatment options?
- What are the goals of each treatment?
- How long is the treatment recovery period?
- What is the likely result if I do not have treatment or wait to have treatment?
- Ask the doctor for written information, some type of handout, about the diagnosis and treatment plan.
Click here for our PDF downloadable Questions to Ask When Getting a Second Opinion.
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Hopefully, after your second opinion, you feel well-informed and are clear on your diagnosis and treatment options. Consider what doctor best meets your needs, and decide on your next steps, whether it’s treatment, surgery, or medication.