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Does insurance cover 2nd opinions?

Second opinion coverage Many health insurance plans cover second opinions. But it is good to know if there are restrictions. One example is in-network versus out-of-network options. Review your plan or call your representative to find out what your plan does and does not include.

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Health Insurance Basics

Seeking Second Opinions

Research is critical to the success of any endeavor—especially these days. People explore and compare options for everything from simple purchases to major life decisions. Yet, almost 70% of Americans do not pursue a second opinion when it comes to their health, according to Harvard Health. When a doctor diagnoses a serious condition, recommends surgery or proposes major treatment, it is important to make the best decision for you and your health. In non-life-threatening situations, part of this plan could include looking for a second opinion. But seeking one can be an intimidating prospect. Understanding more about second opinions can help make this process easier.

Will I upset or offend my doctor?

You may feel like asking for a second opinion shows a lack of confidence in your doctor’s diagnosis. But most doctors have no trouble with you gathering as much information as you can. Even the American College of Surgeons notes a competent physician should not be insulted when you get a second opinion.

There are many ways to start this conversation with your doctor:

Ask who they would recommend with special expertise in your condition.

Ask who they would seek out if they received a similar diagnosis.

Let your doctor know you want to learn more about your condition before making a decision. Ask what other treatments are available and who you could discuss them with.

Finding a second doctor

The first step in gaining a second opinion is to do the research. You can: Ask your doctor for a referral, either another doctor’s name or the name of a facility

Ask your family and friends

Ask your insurance company or use a tool like Find a Doctor on the Anthem Sydney app

Check the websites of area hospitals

Research specialty centers

Several top hospitals in the U.S. now offer the option of virtual second opinions. These include: This option eliminates unnecessary travel and related expenses. This also helps reduce in-person interactions, which is important during the COVID-19 outbreak.

Be prepared

You should prepare for your second opinion. Have your reports, test results and any studies ready to share with the second doctor. If the doctor giving the second opinion is in the same hospital or network, they may be able to access these documents. But it is always a good idea to have a copy handy just in case. You might also call the doctor’s office before your appointment to ensure you bring the correct materials. Consider creating a list of notes and questions you want to cover with the second doctor. Let them know what concerns you have with your first diagnosis or recommendation.

Second opinion coverage

Many health insurance plans cover second opinions. But it is good to know if there are restrictions. One example is in-network versus out-of-network options. Review your plan or call your representative to find out what your plan does and does not include. If your doctors agree on the diagnosis and treatment plan, your decision may be easier. If your doctors do not agree, you may want more discussion with one or both, or even visit with a third. Ideally a second opinion will allow you to make an informed medical decision about next steps.

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