Does Medicare cover it? A to Z
Does Medicare cover a second opinion before surgery?
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Short answer
Covered: Part B
Yes, in some cases Medicare Part B covers a second opinion for medically necessary, non-emergency surgery, when another doctor gives their view about your health problem and how it should be treated.
Medicare Part B also covers a third surgical opinion if the first and second opinions are different.
For a second or third surgical opinion under Medicare Part B, you pay 20% of the Medicare-approved amount after the $283 Part B deductible in 2026.
| Fact | Figure | Source |
|---|---|---|
| Second surgical opinion | Covered by Part B, in some cases, for medically necessary, non-emergency surgery | Medicare.gov |
| Third surgical opinion | Covered if the first and second opinions are different | Medicare.gov |
| What you pay | 20% of the Medicare-approved amount after the $283 Part B deductible | Medicare.gov |
| Tests the second doctor orders | Covered just as Medicare covers other medically necessary services | Medicare.gov |
| Referral to a specialist in Original Medicare | Not needed in most cases | Medicare.gov |
When does Medicare cover a second surgical opinion?
Medicare Part B covers a second opinion, in some cases, for surgery that's medically necessary and isn't an emergency. A second opinion is when another doctor gives their view about your health problem and how it should be treated.
With Original Medicare, you can use any doctor who takes Medicare anywhere in the U.S., and in most cases you don't need a referral to see a specialist.
Does Medicare cover a third opinion?
Yes. Medicare also covers a third surgical opinion if the first and second opinions are different. After you meet the Part B deductible, you pay 20% of the Medicare-approved amount for the third opinion.
What do I pay for a second opinion?
After you meet the Part B deductible ($283 in 2026), you pay 20% of the Medicare-approved amount for a second opinion. The second doctor may ask you to get additional tests as a result of the visit, and Medicare covers those tests just as it covers other medically necessary services.
What you owe also depends on other insurance you may have, how much your doctor charges, whether your doctor accepts assignment (agrees to accept the Medicare-approved amount as full payment), the type of facility and where you get the service.
Does Medicare Advantage cover a second opinion?
Medicare Advantage plans must cover all medically necessary services that Original Medicare covers, and some offer extra benefits; rules and costs vary by plan. In a Medicare Advantage plan you may need a referral to see a specialist; in a Medicare Advantage HMO you generally must use doctors in the plan's network and, in most cases, need a referral to see a specialist.
Your plan may not cover your services, or your costs could be higher, if you go to a doctor outside the plan's network for non-emergency or non-urgent care, so check the plan's rules before you see a second doctor. See how HMO and PPO plans differ.
What does Medicare cover if I go ahead with the surgery?
Medicare covers many medically necessary inpatient and outpatient surgical procedures. Part A covers inpatient hospital care when a doctor's order formally admits you as an inpatient, and Part B covers approved outpatient surgery, including the facility fees at an ambulatory surgical center. See what Medicare pays for outpatient surgery.
Good to know
More questions people ask
Is a second opinion covered by Part A or Part B?
Will Medicare pay for tests the second doctor orders?
Do I need a referral for a second opinion with Original Medicare?
Does Medigap help pay for a second opinion?
Related questions
- Medicare.gov: Second surgical opinions
- Medicare.gov: Surgery
- Medicare.gov: Inpatient hospital care
- Medicare.gov: Ambulatory surgical centers
- Medicare.gov: Outpatient medical and surgical services and supplies
- Medicare.gov: Medicare costs
- Medicare.gov: Compare Original Medicare and Medicare Advantage
- Medicare.gov: Health Maintenance Organizations (HMOs)
- Medicare.gov: Understanding health plan costs
- Medicare.gov: What's Medicare Supplement Insurance (Medigap)?
Figures are Medicare’s, set nationally, and were checked against these pages on October 2026. For your own situation, contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048).
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This page was last updated: October 2026.