A second opinion is when you ask a doctor other than your regular doctor for their view on symptoms, an injury, or an illness you are experiencing in order to better help you make an informed decision about treatment options.
Medicare covers second opinions if a doctor recommends that you have surgery or a major diagnostic or therapeutic procedure.
Note: Medicare does not cover second opinions for excluded services, such as cosmetic surgery.
Medicare will also cover a third opinion if the first and second opinions are different from each other. The second and third opinions will be covered even if Medicare will not ultimately cover your procedure (unless it is an excluded service).
If the first and second opinions were the same but you want a third opinion, you may be able to see a third doctor for a confirmatory consultation. Medicare may cover a confirmatory consultation if your doctor submits the claim correctly and the services are reasonable and necessary (even if Medicare will not ultimately cover them).
Note: If you are in a Medicare Advantage Plan, your plan may have different cost and coverage rules for second and third opinions. Contact your plan for more information.
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