Menu
Simpson Estate and Elder Law
  • Home
  • Our Services
  • Videos
  • Articles
  • Directions
  • Contact

417-256-1968

naela

Close Menu
December 5 2022

Does Medicare Cover the Cost of Getting a Second Opinion?

Marty Simpson Articles

Female doctor sits in her office with senior female patient.You may be nervous about whether Medicare will cover a second opinion if you wish to confirm whether a medical treatment or surgery is right for you. Given the cost of doctor visits today, the prospect of an out-of-pocket expense for a second opinion is understandably concerning.

Under Medicare Part B…

Medicare Part B will help pay for a second opinion if a doctor recommends that you pursue a medically necessary surgery or another major procedure. In fact, the Department of Health and Human Services recommends that a person get a second opinion when their doctor tells them surgery is needed to diagnose or treat a nonemergency but medically necessary health issue.

However, “medically necessary” is a significant component of coverage. Medicare won’t pay for second opinions for surgeries or procedures that aren’t medically necessary. These include cosmetic procedures, alternative medicine, most dental care, nonmedical services, some vision, and other excluded services.

Remember, before seeking any second opinion on a procedure, confirm that the doctor accepts Medicare. Third opinions may also be covered if the first two opinions are different from each other.

If the second doctor orders additional tests, as long as they are medically necessary, Medicare will also help pay for these expenses. The payment structure will be the same as for the first opinion. After you meet your yearly Part B deductible, Medicare pays 80 percent of the approved amount, and you pay 20 percent, plus any copay.

What About Medicare Advantage?

You should also be able to get coverage for a second opinion if you have a Medicare Advantage Plan. Just remember that some Medicare Advantage Plans will only cover a second or third opinion if you have a referral from your primary care doctor and the second doctor is in-network.

Readers should also remember that just because Medicare may cover a second or third opinion, coverage of the therapy, surgery, or procedure is not guaranteed. Find more answers to your Medicare questions on ElderLawAnswers.com.

What Is the Difference Between Medicaid and Medicare? Protecting Spouses of Medicaid Applicants: 2023 Guidelines

Related Posts

Articles

5 Reasons for Seniors to Celebrate in 2023

Articles

Protecting Spouses of Medicaid Applicants: 2023 Guidelines

Articles

What Is the Difference Between Medicaid and Medicare?

Recent Posts

  • 5 Reasons for Seniors to Celebrate in 2023
  • Protecting Spouses of Medicaid Applicants: 2023 Guidelines
  • Does Medicare Cover the Cost of Getting a Second Opinion?
  • What Is the Difference Between Medicaid and Medicare?
  • Does Medicare Pay for Assisted Living?

Archives

  • December 2022
  • October 2022
  • August 2022
  • May 2022
  • March 2022
  • February 2022
  • January 2022
  • November 2021
  • October 2021
  • July 2021
  • May 2021
  • February 2021
  • January 2021
  • December 2020
  • November 2020
  • October 2020
  • September 2020
  • August 2020
  • July 2020
  • June 2020
  • April 2020
  • March 2020
  • February 2020
  • January 2020
  • December 2019
  • November 2019
  • October 2019
  • January 2019
Back To Top

facebook

Contact

417-256-1968

844-273-2923 fax

Address

303 Aid Avenue
West Plains, MO 65775, USA

© Simpson Estate and Elder Law - A web solution by CHVentures     Login