Yes, Medicare covers a second opinion before major, non-emergency surgery, and a third if the two doctors disagree. So when your doctor recommends an operation and something tells you to get another set of eyes on it first, that's exactly the situation this benefit is built for.

In This Guide

Does Medicare Cover a Second Opinion Before Surgery?

Yes. Medicare Part B helps pay for a second opinion before you have medically necessary, non-emergency surgery or another major medical procedure that a doctor has recommended.

The coverage reaches past the visit itself. If the second doctor orders additional tests to weigh in properly, Medicare covers those medically necessary tests too. That means a real, independent look at whether you need the operation, not a quick skim of your chart.

One more thing worth knowing up front: the second opinion stays covered even if the surgery or procedure, once it's actually done, turns out not to be something Medicare pays for. The opinion itself is a covered service on its own.

This benefit is for planned, non-emergency care, the kind where you have time to sit with the decision.

What Will a Second Opinion Cost You?

So what does it actually cost you? For the second-opinion visit, you generally pay 20% of the Medicare-approved amount after you've met your Part B deductible, which is $283 in 2026.,

That 20% coinsurance is the same share you'd pay for most other Part B outpatient services. If you've already met the deductible earlier in the year from other care, you're just looking at the 20% for this visit.

If you carry a Medigap (Medicare Supplement) policy or other secondary coverage, check whether it picks up that 20% coinsurance. Plans differ on this. In most states, Plan G pays the Part B coinsurance, while Plan K pays only 50% of it and Plan L 75%, so it's worth a quick look at yours before you assume.,

When Medicare Covers a Third Opinion

If your first and second doctors disagree about whether you need the surgery or procedure, Medicare will help pay for a third opinion to break the tie.

The cost works the same way: after your Part B deductible, you pay 20% of the Medicare-approved amount for that third visit. So a split decision doesn't leave you choosing between two doctors on your own.

Does Medicare Cover a Second Opinion for Non-Surgical Procedures?

This benefit isn't only for surgery in the operating-room sense. Medicare's second-opinion coverage applies to the medical need for surgery and for major nonsurgical diagnostic and therapeutic procedures. The Medicare rules point to examples like a cardiac catheterization or a gastroscopy, the kind of invasive procedure that carries real risk even though no one is technically cutting you open.

This isn't meant for a routine test or a minor office procedure. If a doctor has recommended something significant and invasive and you want a second view before agreeing, ask whether it counts as major, and check with Medicare if you're unsure.

How Do You Get a Second Opinion on Medicare?

Asking for a second opinion can feel awkward, like you're doubting your surgeon. It's a normal request, and good doctors expect it. The mechanics are simple, and there's no special form to file.

  1. Tell your doctor you want a second opinion. A good one won't blink. Ask them to send your records, imaging, and test results to the second doctor so nothing gets repeated for no reason.
  2. Find a second doctor who takes Medicare. Pick a provider who accepts Medicare assignment, which keeps your costs to the standard 20% coinsurance after the deductible., Medicare's provider search at medicare.gov can help you find one.
  3. Bring your records with you. The more the second doctor has in hand, the more useful the opinion, and the fewer tests you'll repeat.
  4. If the two disagree, ask about a third opinion. You're covered for it, so use it. A tie between two doctors is the exact case the third opinion exists to settle.

If you're in a Medicare Advantage plan instead of Original Medicare, your second-opinion coverage runs through your plan, which sets its own network and referral rules. Call the member services number on your plan card before you book, so you use an in-network doctor and follow any referral steps. Otherwise you could pay more than you need to.

Frequently Asked Questions

Does Medicare cover a second opinion if it's not about surgery?

Yes, as long as it's a major procedure. The benefit covers the medical need for surgery and for major nonsurgical diagnostic and therapeutic procedures, like a cardiac catheterization or a gastroscopy. A second opinion on a routine test or a minor office visit is a different situation and isn't what this specific benefit is about.

Do I need a referral from my first doctor to get a second opinion?

You can ask for a second opinion yourself, and it helps to have your records sent over. Medicare Advantage plans set their own network and referral rules, so check your plan before you book.

How much does a second opinion cost with Medicare?

For the visit, you generally pay 20% of the Medicare-approved amount after you've met the Part B deductible, which is $283 in 2026. If a Medigap policy or other secondary insurance covers your Part B coinsurance, it may pick up that 20%. Check your specific policy.

What if the two doctors disagree?

Then Medicare helps pay for a third opinion. You pay 20% of the Medicare-approved amount for that visit after the deductible, the same as the second one. The third opinion is there specifically to help settle a split decision.

Does Medicare Advantage cover a second opinion?

Your coverage runs through your plan, which sets its own network and referral rules. Call the member services number on your plan card before you book, so you know which doctors are in network and what you'd pay.

Is the second opinion still covered if I decide not to have the surgery?

Yes. The second and third opinions are covered even if the surgery or procedure ends up not being done, or turns out not to be something Medicare would pay for. The opinion is a covered service in its own right.

Learn More

MedicareWhat Medicare Actually Costs You in 2026How much does Medicare cost in 2026? Part A, B, C, and D premiums, deductibles, and coinsurance, plus IRMAA and ways to lower your Medicare costs. MedicareOriginal Medicare vs. Medicare Advantage: How to ChooseCompare original Medicare vs Medicare Advantage on cost, networks, the $9,250 cap, and switching back. A neutral 2026 side-by-side to help you choose. MedicareMedicare Preventive Services: What You Get for FreeMedicare preventive services are mostly free: two wellness visits, screenings, and vaccines at $0, plus the billing trap that can turn free into a charge. MedicareDoes Medicare Cover Weight-Loss Surgery?Medicare covers weight-loss surgery if your BMI is 35+, you have an obesity-related condition and other treatment failed. Procedures, sleeve caveat, costs.

Find personalized help deciding whether to get a second opinion before your Medicare-covered surgery at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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