Will my insurance cover a second opinion?

More likely than you’ll stop perfectly at all stop signs today. Most insurance plans cover second opinions because they care about you -- and because it makes good financial sense. They’d rather not pay $50,000 for a heart operation when there’s a chance that you need only a $3,500 lifestyle and preventive-medicine and medication program that is actually better for you. And 30% of second opinions change diagnosis or treatment, even on pathology slides of such common things as breast cancer. For this reason, many insurers actually require you to get a second opinion before they’ll pay for certain major procedures. However, not all insurance plans are so forward-thinking. If you have an HMO or managed care plan, it may not cover a second opinion. To find out for sure, contact your insurer directly and check the laws in your state. Some states, including California and New York, have passed laws that guarantee members of HMOs the right to get a second opinion. We believe strongly in them.

Most insurance plans cover second opinions for surgery or other major medical procedures. If you are seeking a second opinion regarding a prescription drug, most providers will not cover that expense. It is important to check with your provider before seeking a second opinion.