Getting a second opinion

A second opinion is when you consult a different doctor about a diagnosis, treatment plan, or recommended procedure that your current doctor has proposed. It is one of the most important tools patients have for ensuring they receive accurate diagnoses and optimal treatment.

42 steps across 12 sections

1. Decide You Want a Second Opinion

  • You do not need a reason beyond wanting more confidence in your care
  • Do not delay treatment unreasonably, but most conditions allow time for a second opinion

2. Tell Your Current Doctor

  • Frame it positively: "I want to make sure I have explored all options"
  • A good doctor will support this decision — if they react negatively, that itself is a red flag
  • Ask your doctor to recommend a colleague if you want guidance

3. Check Insurance Coverage

  • Verify coverage, referral requirements, and pre-authorization needs (see Insurance Coverage section above)

4. Choose a Second Opinion Provider

  • Prioritize specialists with expertise in your specific condition
  • Choose someone independent from your current doctor's practice/hospital system
  • Consider academic medical centers or NCI-designated cancer centers for serious diagnoses

5. Gather and Transfer Records

  • Request all relevant medical records, imaging, pathology, and test results
  • Have them sent to the second opinion doctor before your appointment
  • Confirm receipt a few days before your visit

6. Prepare for the Appointment

  • Write down your questions in advance
  • Bring a complete medication list
  • Bring a family member or friend to take notes and help remember details
  • Prepare a timeline of your symptoms, diagnosis, and treatments to date

7. Attend the Appointment

  • Be honest and thorough about your history and concerns
  • Ask the doctor to explain their reasoning, not just their conclusion
  • Ask about alternative treatments, clinical trials, and expected outcomes
  • Take notes or ask permission to record the conversation

8. Compare and Decide

  • If both doctors agree: you can proceed with confidence
  • If they disagree: ask each doctor to explain why they differ, or seek a third opinion
  • You can choose to be treated by either doctor
  • Ask your doctors if they would be willing to collaborate on your case

9. What Is Typically Covered

  • Most PPO plans cover second opinions from any in-network specialist without a referral
  • Most HMO plans cover second opinions but may require a referral from your PCP
  • Medicare Part B covers second (and third) opinions for surgery at 80% after deductible
  • Medicaid coverage varies by state

10. What to Do Before Scheduling

  • Call the number on the back of your insurance card
  • Ask: "Is a second opinion covered under my plan?"
  • Ask: "Do I need pre-authorization or a referral?"
  • Ask: "Are there any restrictions on which providers I can see?"
  • Ask: "Is there a dedicated second opinion program through my plan?"
  • Get confirmation in writing (or note the representative's name, date, and reference number)

11. If You Go Out-of-Network

  • You may still be partially covered depending on your plan
  • Some plans have higher out-of-network second opinion benefits than for routine out-of-network care
  • Virtual second opinion programs (Cleveland Clinic, Mayo Clinic) may be covered even if the institution is not in your network

12. How Virtual Second Opinions Work

  • You submit medical records, imaging, and pathology electronically
  • A specialist reviews everything and prepares a written report
  • You may have a video consultation to discuss findings
  • Typical turnaround: 5-14 business days
  • Cost: $500-$2,000+ without insurance; many plans now cover these

Common Mistakes

  • Not getting a second opinion because you do not want to offend your doctor
  • Going to a doctor in the same practice or hospital system
  • Not transferring complete records
  • Waiting too long
  • Not checking insurance first

Pro Tips

  • Start the records request immediately
  • Request a copy of the second opinion in writing
  • For cancer: always get pathology re-reviewed
  • Ask about clinical trials
  • Use your insurance company's second opinion program

Sources

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