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Understanding Second Opinions FAQs

Updated March 29, 2010

When is it useful to get a second opinion?

Why is a second opinion helpful?

How do I get a second opinion?

Is a second opinion covered by my insurance?

What should I do if the two opinions are different?

Q: When is it useful to get a second opinion?

A: Always! Once you get your doctor’s opinion about your diagnosis and treatment plan, you may want to get another doctor’s advice before you start treatment. Breast cancer is rarely an emergency, so you have time to get a second opinion.

Q: Why is a second opinion helpful?

A: A second opinion can help you confirm your diagnosis and get another doctor’s view on treatment options. It can give assurance that you have looked at all options and lets you ask questions after you have had the chance to think about what your doctor told you. A second opinion can give you peace of mind that you made the best choice for your health.

Q: How do I get a second opinion?

A: Most doctors welcome second opinions, and your doctor should be able to suggest another doctor. However, if you feel uncomfortable asking for a second opinion, it may be helpful to tell your doctor that while you are satisfied with his or her care, you want to be as informed as possible before making any final choices about treatment. You may want to bring a family member for support during this discussion. If your first doctor is unable to recommend a doctor for a second opinion, you may want to try calling your local hospital’s patient referral service.

The doctor’s office where you are getting the second opinion will tell you what needs to be sent to them for your consult. Often they will need mammograms, biopsy slides, and copies and records of other tests or procedures done. You will need to tell your first doctor or healthcare facility what you need sent and where to send it.

Q: Is a second opinion covered by my insurance?

A: Some insurance plans make you get a second opinion, especially if you are going to have surgery. Other plans will pay for a second opinion if your doctor requests one. Before getting a second opinion, you should check with your insurance company to find out if they will cover the cost. If your plan does not cover it, consider if you can pay for it yourself.

If you have Medicaid, coverage of a second opinion will depend on your state’s program. Contact your state’s department of medical assistance or department of health to find out about coverage. Visit the Centers for Medicare & Medicaid Services for contact information.

Medicare will pay for a second, third or fourth medical or surgical opinion, as long as the opinion is medically necessary and is for the treatment of a condition covered by Medicare. Depending on the format of your Medicare plan, you may need a referral from your primary care doctor. To find out if you need a referral or to obtain information about Medicare’s coverage of second opinions, call (800) 633-4227.

Q: What should I do if the two opinions are different?

A: If your doctors do not agree on the same treatment, you may want to get a third opinion from another doctor.

It is not uncommon for doctors to disagree on courses of treatment, and choosing between different recommendations can be tough. Consulting a third doctor may ease concerns about treatment choices. This doctor may help you weigh the benefits and risks of each treatment and help you choose. Comparing first, second and third opinions on your own or with your family or friends also may help you feel certain about your decision.

You also may want to speak with another woman who has gone through what you are experiencing. Our Breast Cancer Helpline at (888) 753-LBBC (5222) is staffed by trained volunteers who have had breast cancer. We can match you with a woman who had a similar diagnosis or experience. She will listen and help you think through your questions and concerns.

All FAQs reviewed by Carolyn Weaver, RN, MSN, AOCN