Living Healthy

Medicare Part B medical insurance can help pay for second opinions.

Make Decisions with Second Opinions

For all the decisions you make in a lifetime, the biggest ones are probably best arrived at when all the facts, options and answers are available. It's rare for an individual to make a big purchase, for example, without gathering information and shopping around for the best value. And when it comes to health care decisions, the approach should be no different.

When is a second opinion appropriate?

Any time is a good time for a second opinion if it makes the patient feel more confident about a diagnosis, a course of treatment or the cost of medical care. However, a second opinion is essential "when your illness is serious and there is great uncertainty about the course of action," says Elissa Clayton, ARNP, manager of clinical operations at Moffitt Cancer Center's Lifetime Cancer Screening and Prevention Center in Tampa, FL.

Second opinions also should be considered for patients who live in rural areas, have been diagnosed with rare diseases, have been given little hope for improvement in their medical condition, or simply have nagging doubts about their first opinions.

What are the fears?

"Patients are so worried about offending their primary care physicians," says Clayton. "They really shouldn't be. A patient has a right to a second opinion, and it has become a very common practice. With the increase in medical knowledge and new treatment options, it is a challenge for any one physician to stay current with every change.

"However, don't hide the second opinion from your primary care physician. That information needs to be sent back to your regular doctor. It's more beneficial to the patient for the primary care physician to have this information, because your regular doctor really knows you best."

How to prepare

Prior to setting an appointment, obtain all medical records, tests and x-rays pertaining to that first opinion. That allows the second physician to review your records before examining you, which can eliminate delays, duplication of tests and additional unnecessary costs.

Does insurance cover second opinions?

"No one physician can be all and know all," says Dave Maberry, Moffitt's director of managed care. "Most managed care organizations recognize this and, consequently, cover second opinions. Also, conceptually, every managed care organization should be a patient advocate."

Medicare Part B medical insurance also helps pay for second opinions if the surgery is medically necessary. Maberry advises Medicare patients to make sure the doctor giving the second opinion accepts Medicare. "You also can call 1-800-MEDICARE and ask for information about participating physicians or visit www.medicare.gov and select 'Find a Doctor' under 'Search Tools,'" he added.

What if the two opinions are different?

If the second doctor doesn't agree with the first, you may want to talk more about your condition with your first doctor or consider talking with a third doctor. "Getting a second, or even a third, opinion doesn't mean you have to change doctors," Clayton says. "Getting more information will make it easier for you to decide which doctor you want to perform your surgery, for example."

Selecting a physician

Second opinions by a specialist are helpful in many areas of health care, but they are particularly critical in the diagnosis and treatment of cancer at an early stage.

Clayton advises a patient to ask if his or her surgeon performs a lot of lung surgery, for example.

If you seek a second opinion, Clayton recommends asking these questions:

• Is the physician a specialist?
• Is the physician associated with a facility that also specializes in the treatment?
• Is the physician associated with a facility that conducts research?
• How frequently is the procedure performed by the physician and/or the facility?

Information courtesy of Moffitt Cancer Center. For more information about second opinions, cancer, prevention, screening, clinical trials or support groups, call Moffitt's toll-free Cancer Answers hotline at 1-888-MOFFITT (1-888-663-3488).
Or visit www.Moffitt.org and click on "Cancer Answers" to submit your questions online.

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