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Will Medicare pay physicians giving second opinions?

A second opinion is when a doctor other than the patient’s regular doctor gives his or her view about patient’s health problem and how it should be treated. Getting a second opinion can help patients make a more informed decision about their care. Medicare Part B (Medical Insurance) helps pay for a second opinion before surgery if initiated by the patient.

Patient-initiated second opinions that relate to the medical need for surgery or for major non-surgical diagnostic and therapeutic procedures (e.g., invasive diagnostic techniques such as cardiac catheterization and gastroscopy) are covered under Medicare. In the event that the recommendation of the first and second physician differs regarding the need for surgery (or other major procedure), a third opinion is also covered. Second and third opinions are covered even though the surgery or other procedure, if performed, is determined not covered. Payment may be made for the history and examination of the patient, and for other covered diagnostic services required to properly evaluate the patient’s need for a procedure and to render a professional opinion. In some cases, the results of tests done by the first physician may be available to the second physician.

Please note:

Medicare doesn’t pay for surgeries or procedures that aren’t medically necessary, such as cosmetic surgery.

Don’t wait for a second opinion if you need emergency surgery. Some types of emergencies may require surgery right away, such as acute appendicitis, Blood clot or aneurysm and Accidental injuries

*Medicaid does not reimburse visits for second opinions*

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