Second Opinion

A second opinion is when you consult a different doctor about a diagnosis, recommended treatment, or surgical plan to confirm the original recommendation or explore alternative options. Getting a second opinion is your right as a patient, and your health insurance plan covers it.

ACA-compliant plans cover second opinions as part of your standard medical benefits. You'll pay whatever cost-sharing applies to a specialist visit (copay or coinsurance, depending on your plan), but the visit itself is a covered service. If the second opinion doctor orders additional tests or imaging, those are also covered under your plan's normal terms.

A second opinion is especially valuable when you're facing a major decision: surgery, cancer treatment, a new diagnosis of a chronic condition, or any situation where the treatment carries significant risks, costs, or life impact. Studies show that second opinions change or refine the diagnosis or treatment plan in a meaningful percentage of cases.

Some plans and situations may require a second opinion. For example, your insurer might require a second surgical opinion before approving a non-emergency procedure. In that case, the plan usually directs you to a specific second-opinion provider and covers the visit in full.

To get a second opinion, you typically don't need a referral (unless you're in an HMO that requires one). Choose a doctor who specializes in your condition, ideally at a different practice or health system from your original doctor. Bring your medical records, test results, and imaging so the second doctor has full context.