Medicare covers second opinions, but only from doctors in the Medicare network

Yes, Medicare will pay for a second opinion from a physician who accepts Medicare. You do not need special permission beforehand, and you do not pay extra out of pocket beyond your normal deductible and coinsurance. The catch is that the second opinion must come from a doctor enrolled in Medicare — if you see an out-of-network provider, Medicare will not cover the visit.

The second opinion itself is treated like any other office visit. If you have Original Medicare (Part A and B), you pay 20 percent of the approved amount after you meet your annual Part B deductible. If you have a Medicare Advantage plan, your copay or coinsurance depends on your specific plan's rules, and some plans cover preventive visits at no cost.

There is no limit on how many second opinions you can get, and no requirement that your first doctor refer you. You can straightforward call a different doctor's office, mention you want a second opinion, and schedule an appointment.

Key Takeaways

  • Medicare covers second opinions from any doctor who accepts Medicare, with no advance permission needed.
  • You pay the same cost-sharing (deductible and coinsurance) as you would for a regular office visit.
  • If you use an out-of-network provider, Medicare will not cover the visit, so confirm the doctor accepts Medicare before scheduling.
  • Your first doctor does not need to refer you for a second opinion — you can seek one independently.
  • Some Medicare Advantage plans may cover preventive second opinions at no cost, so check your plan documents.

How to find a Medicare-accepting doctor for a second opinion

The easiest way to find a participating doctor is to use the Medicare Provider Search tool on Medicare.gov. Enter your location and specialty (for example, "cardiologist" or "orthopedic surgeon"), and the tool will show you doctors and hospitals that accept Medicare in your area. You can also call 1-800-MEDICARE and ask for a list of doctors in your network who handle the condition you need a second opinion on.

When you call the doctor's office to schedule, tell them upfront that you are seeking a second opinion. This helps the office staff understand why you are coming and ensures the doctor sets aside enough time to review your medical history and any test results you bring. Ask whether the office needs you to request your records from your first doctor in advance — some offices will do this for you if you sign a release form.

If you have a Medicare Advantage plan, use your plan's provider directory instead of the Medicare search tool, because not all Medicare doctors participate in every Advantage plan. Your plan's website or member handbook will list which doctors are in-network for your specific coverage.

What to bring to your second opinion appointment

Bring copies of any test results, imaging reports, pathology reports, or lab work related to the condition you are getting a second opinion on. If your first doctor performed imaging (X-rays, MRI, CT scans), ask whether you can get a copy of the actual images on a CD, not just the written report — many specialists prefer to review the images themselves rather than rely on someone else's interpretation.

Also bring a list of all medications and supplements you are currently taking, and a summary of your medical history, including any surgeries, allergies, or chronic conditions. If your first doctor gave you a written diagnosis or treatment recommendation, bring that too. The second opinion doctor will want to see exactly what was recommended so they can compare it to their own assessment.

You do not need a referral from your first doctor, but if you have one, bring it — it can speed up the process of getting your records transferred and shows the second opinion doctor that your first doctor was aware you were seeking another view.

Cost differences between Original Medicare and Medicare Advantage plans

Under Original Medicare, you pay 20 percent of the Medicare-approved amount for the office visit after you meet your annual Part B deductible (which is $240 in 2024, though this amount changes yearly). If the doctor charges more than Medicare approves, you may owe the difference — this is called "balance billing" — unless the doctor has agreed not to do so.

Medicare Advantage plans vary widely. Some charge a flat copay for specialist visits (often $30 to $75), while others use coinsurance (a percentage of the cost). A few plans cover preventive second opinions at no cost. Check your plan's Summary of Benefits or call the plan's customer service line to find out what you will owe before you schedule.

If cost is a concern, ask the doctor's office what the visit will cost under Medicare before you go. Many offices can give you an estimate based on your coverage type.

When Medicare will not cover a second opinion

Medicare will not pay if you see a doctor who does not accept Medicare, even if that doctor is highly regarded. You will be responsible for the full bill. Some patients choose to pay out of pocket for a second opinion from a specific specialist they trust, but this is your choice and your expense.

Medicare also will not cover a second opinion if it is for a service that Medicare itself does not cover. For example, if Medicare does not cover a particular treatment or procedure, a second opinion about whether you should have that treatment will not be covered either. However, the second opinion doctor can still discuss the treatment with you — you just pay for the visit yourself.

If you are unsure whether a specific doctor accepts Medicare or whether a particular service is covered, call 1-800-MEDICARE before you schedule. They can confirm both in a few minutes.

Second opinions for surgery and major procedures

If your first doctor recommends surgery or a major procedure, getting a second opinion is especially common and Medicare covers it the same way as any other office visit. Some surgeons expect patients to seek second opinions before major operations and will not be offended if you do.

When you see the second opinion doctor, bring all imaging, test results, and the written surgical recommendation from your first doctor. The second opinion doctor may want to examine you and may order their own tests, which Medicare will also cover under the same cost-sharing rules.

If the two doctors disagree significantly about whether surgery is needed, you may want to seek a third opinion before deciding. Medicare will cover that visit too. The goal is to make sure you understand all your options before committing to an irreversible procedure.

Second opinions for cancer diagnosis and treatment

Medicare recognizes that second opinions are especially important in cancer care and covers them without hesitation. If you have been diagnosed with cancer, you can see an oncologist at a different hospital or practice for a second opinion on your diagnosis and treatment plan. Bring all pathology reports, imaging, and your first oncologist's treatment recommendation.

Some cancer centers have tumor boards — groups of specialists who review complex cases together — and you may be able to present your case to a tumor board at a different institution for a second opinion. This is also covered by Medicare. Ask your first oncologist or call the cancer center directly to find out how to request a tumor board review.

Frequently Asked Questions

Do I need to tell my first doctor that I am getting a second opinion?

No, you do not have to tell them. However, many patients do because it helps the second opinion doctor understand the full context of your care. If you do tell your first doctor, most will not be offended — second opinions are routine in medicine.

What if the second opinion doctor disagrees with the first one?

This happens sometimes, especially for complex conditions or when treatment options are not clear-cut. If the two doctors disagree significantly, you may want a third opinion to help you decide. Medicare covers that visit too. You can also ask each doctor to explain their reasoning in detail so you understand the differences.

Can I get a second opinion before my first appointment with a specialist?

Yes. If your primary care doctor refers you to a specialist and you want another specialist's view before you go, you can schedule a second opinion visit first. Medicare will cover it the same way. This is less common but entirely allowed.

Will getting a second opinion delay my treatment?

A second opinion typically takes one to three weeks to schedule and complete. If your condition is urgent, tell both doctors so they can prioritize your appointment. In emergencies, you should seek when ready care rather than wait for a second opinion.

What if I want a second opinion from a doctor outside the United States?

Medicare does not cover care outside the United States except in very limited circumstances (such as emergency care in Canada or Mexico near the U.S. border). If you want a second opinion from an international doctor, you will pay for it yourself.