Second surgical opinions
Medicare Coverage Information
Overview
Medicare provides coverage for second surgical opinions to help patients make informed decisions about recommended surgical procedures. This coverage allows beneficiaries to consult another qualified healthcare professional to confirm or provide alternative perspectives on a proposed surgery.
- Medicare covers second surgical opinions from qualified healthcare providers
- Helps patients understand surgical recommendations and explore alternative treatments
- Typically covered under Medicare Part B
- May require referral from primary care physician
- Designed to support patient decision-making and ensure appropriate medical care
- Medicare Part B beneficiaries
- Patients with a recommended surgical procedure
- Individuals seeking additional medical guidance
- Generally covers 80% of the approved cost after meeting the Part B deductible
- Patient responsible for 20% coinsurance
- No additional cost if second opinion is obtained from a Medicare-participating provider
- Must be deemed medically necessary
- Limited to consultations with qualified healthcare professionals
- Does not cover third or subsequent surgical opinions
- Requires documentation and potential pre-authorization
- Discuss second opinion with your primary care physician
- Verify provider participates in Medicare
- Obtain referral if required by your Medicare plan
- Call 1-800-MEDICARE for specific coverage details
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicaresecond surgical opinionsurgical consultationmedical adviceMedicare Part B
Related Coverage Topics
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