Short answer: To get a second opinion, tell your doctor you want one, choose a specialist in the same field at a different practice, have your records, imaging and pathology sent ahead, and check your insurance rules first. Medicare Part B covers a second opinion for medically necessary non-emergency surgery, and a third if the first two differ.
A serious diagnosis or a major treatment recommendation is a good time to get another qualified view. Asking for one is a normal part of care. This guide covers when it is worth it, how to do it step by step, what it costs, and how to vet the doctor you choose.
Why do second opinions matter?
Diagnoses often change when a specialist takes a fresh look. In a Mayo Clinic study of 286 patients referred from primary care to its general internal medicine practice, the final diagnosis matched the referral diagnosis in 12 percent of cases, was refined or better defined in 66 percent, and was distinctly different in 21 percent (Van Such et al., Journal of Evaluation in Clinical Practice, 2017). That was a referral population at one academic center, so it does not mean most diagnoses are wrong, but it shows why a second look can change a plan.
When should you get a second opinion?
- A cancer diagnosis, before treatment starts, including a review of the pathology.
- A recommendation for major non-emergency surgery, such as spine, joint replacement, heart or weight-loss surgery.
- A serious, rare or hard-to-diagnose condition, where a high-volume specialist may see more cases like yours.
- Long-term treatment with significant risks or costs.
- Treatment that is not working as expected.
- You feel unsure or your questions have not been answered.
A formal second opinion is usually not needed for routine minor illnesses, standard preventive care, or emergencies where waiting would be unsafe. In an emergency, get care first.
How do I ask my doctor for a second opinion?
Be direct and polite: "Because this is a big decision, I would like a second opinion before we go ahead. Can you help me send my records?" Many doctors expect the request and some will suggest colleagues. You have a right to your medical records under HIPAA, so you can also request them yourself; see how to request your medical records.
How do I get a second opinion, step by step?
- Check coverage first. Call your plan to ask whether a referral or prior authorization is needed and which specialists are in network.
- Pick the right specialist. Choose someone in the same specialty, ideally at a different practice or health system, with experience in your condition.
- Verify credentials. Confirm board certification at CertificationMatters.org and check your state medical board; see how to check a doctor's license and what board certification means.
- Send records ahead. Include notes, test results, imaging files (not only reports) and, for cancer, the pathology slides if the second doctor asks for them.
- Prepare questions. Bring a symptom timeline, a medication list with doses, and someone to take notes.
- Compare the opinions. If they differ, ask each doctor to explain the reasoning behind their recommendation.
Does insurance or Medicare cover a second opinion?
Medicare Part B covers a second opinion for medically necessary, non-emergency surgery, and a third opinion if the first two differ; you pay 20 percent of the Medicare-approved amount after the Part B deductible (Medicare.gov). The 2026 Part B deductible is $283 (Medicare.gov). Medicare Advantage and private plans set their own rules, including referrals and networks, so call your plan before booking. Some employers also offer a second-opinion benefit; check your benefits portal.
How much does a second opinion cost?
With insurance, an in-person second opinion is usually billed like any specialist visit, so your normal copay, coinsurance and deductible apply. Some academic centers sell virtual record-review second opinions directly to patients. For example, Cleveland Clinic lists $1,690 for a written report and $1,990 for a report plus a virtual visit, and says insurance does not typically cover that service (Cleveland Clinic, retrieved October 7, 2026). Prices change, so confirm directly.
What questions should I ask at the second-opinion visit?
- Do you agree with the diagnosis? If not, what do you think it is, and why?
- Do you agree with the treatment plan? What would you do differently?
- What are the likely outcomes with treatment, and if I wait or do nothing?
- How many patients with this condition do you treat each year?
- Are there clinical trials I should consider?
- What would tell us the treatment is not working?
For a longer list, see what questions to ask your doctor.
What does it mean when an agency requests a second opinion?
A letter saying an agency "would like to request a second opinion" usually comes from a disability program or an insurer, not from your own doctor. In a Social Security disability claim, the agency may ask you to attend a consultative examination when your own medical sources cannot or will not provide enough evidence to decide whether you are disabled. Social Security pays for these examinations and tests, and it must give you reasonable notice of the date, time and place and the name of the doctor or facility doing them (20 CFR 404.1517).
Take the appointment seriously. If you are applying for benefits and miss or refuse the exam without a good reason, Social Security may find that you are not disabled, and if you already receive benefits it may decide your disability has stopped (20 CFR 404.1518). The rule lists examples of good reasons, including illness on the exam date, not receiving timely notice, being given incorrect information about the doctor, time or place, and a death or serious illness in your immediate family. If you cannot attend, contact the office that sent the letter before the date and ask to reschedule.
This kind of exam is different from a second opinion you arrange yourself. The examiner reports to the agency and does not take over your care, and Social Security will not pay for an examination you or your representative arrange without its advance approval. Insurers and workers' compensation carriers can also ask for an exam by a doctor they choose, often called an independent medical examination; the rules depend on your policy and your state, so read the letter and ask the sender what authority it relies on. You can still get your own second opinion from a doctor you choose, and sending those records to the agency can add to the evidence in your file.
Bring a photo ID, a list of your medications and doctors, and any recent test results to the appointment, and keep a copy of the notice.
What if the two opinions disagree?
Ask each doctor to explain the evidence behind their recommendation and what they make of the other view. You can share the second opinion with your original doctor, move your care, or seek a third opinion; for surgery, Medicare covers a third opinion when the first two differ. Choose the plan and team whose reasoning you understand and trust.
Find a second-opinion doctor
Use Find a Doctor to search by specialty and location, or read our companion page on getting a second medical opinion. If cost is the concern, see what a doctor visit costs without insurance.