Anyone can get a second medical opinion.  When you are diagnosed with cancer and need surgery, it can be an important step to:

  1. Answer any questions you may have
  2. Become more informed about your treatment options
  3. Have a greater sense of control
  4. Feel more confident in your decision, knowing you have explored all your options

Research shows that when a hospital or surgeon performs more cancer surgeries, it can lead to a better outcome.  Here are some of the main steps through the process.

Step 1: Starting out

If you are diagnosed with cancer and need surgery, your primary care doctor or oncologist will refer you to a surgeon.  This will likely be a surgeon that is in the same health system as your primary doctor and in your insurance network. You should confirm that the surgeon is in your insurance network by calling your insurance company.  In Dr. Elisa Port’s book, The New Generation Breast Cancer Book, she recommended asking certain questions if you have a choice of breast cancer surgeon.  These questions have been generalized below and could be considered for most types of cancer surgery:

  1. Does the surgeon dedicate most of their practice to the cancer surgery you need?

If a surgeon dedicates their practice to a specific cancer surgery, it is more likely that they are aware of all the new research and techniques that emerge every year.

  1. How many cancer surgeries does the surgeon perform per week, month, or year?

There is strong evidence showing that surgeons and hospitals that perform more of specific types of cancer surgery can have better outcomes.

  1. Has the surgeon completed a surgical cancer fellowship?

A medical fellowship is advanced training in a medical specialty.  During this training, the surgeon can gain even more knowledge and learn from top experts.  Not every surgeon completes a fellowship, so it is worth asking.

Step 2: Finding other surgeons or hospital/cancer centers for a second opinion

If you decide you want a second medical opinion, consider finding 2 or 3 potential cancer surgeons that you would like to get a second opinion from. The following information and resources are helpful as a starting point.

  1. National Cancer Institute (NCI) designated hospitals

These hospitals meet very strict criteria to ensure that the best care and most current treatment approaches are used.  Click this link to find an NCI-designated hospital near you.

https://www.cancer.gov/research/nci-role/cancer-centers/find

  1. If you find a hospital you are interested in, consider calling them and asking for an appointment with the surgeon that perform the most surgeries you are interested in.  Be persistent and don’t give up. You may have to contact the department directly.
  1. If you live in or near California or Pennsylvania, you can search for hospitals that perform the most surgeries for the 11 major cancer surgeries. We combined the data here.
  1. Ask family, friends, or anyone who works in the healthcare field for their recommendations.

Step 3: Second medical opinion insurance coverage

Once you find 2 or 3 surgeons you are interested in, find out if seeing them will be covered by your insurance (if you are insured).  Getting a second opinion covered depends on your health insurance plan.  Here is more information about common health insurance plans:

  1. Medicare:  Medicare Part B may cover second opinions up to 80%.  Second opinion coverage with Medicare Advantage plans vary.  To find out about second opinion coverage, contact Medicare by calling 1-800-Medicare or your Medicare Advantage plan.  The link below is a resource provided by Medicare about getting a second medical opinion.

https://www.medicare.gov/Pubs/pdf/02173-Getting-a-Second-Opinion-Before-Surgery.pdf

  1. Medicaid: To find out about second opinion coverage, contact Medicaid by calling the number on your card.  Coverage may vary depending on the state and the type of health plan you have.
  1. Commercial/Private insurance plans (Blue Cross, Aetna, Humana, etc):

Large employer (self-insured) health plans

These plans are typically offered at larger companies, universities, and other organizations.  State insurance laws do not apply to these plans. To find out about second opinion coverage, contact your plan by calling the number on your card.

Small employer (fully-insured) or individual health plans

These are subject to state insurance laws.  To our knowledge, the following states offer second opinion coverage: Florida, Indiana, California, Louisiana, Montana, New Hampshire, New York.

However, to confirm second opinion coverage, make sure to contact your plan by calling the number on your card.

Step 4: The Second Opinion Appointment

If you see a surgeon for a second opinion, make sure to send any records or imaging to the surgeon’s office if they are requested.  In Dr. Elisa Port’s book, The New Generation Breast Cancer Book, she advises that when you see the surgeon for a second opinion, it may be best not to talk about the recommendations from your first surgeon.  Instead, you can let the surgeon give their recommendations and then discuss any differences between the 2 opinions.  Also, consider asking the questions from above.

  1. Does the surgeon dedicate most of their practice to the cancer surgery you need?
  1. How many cancer surgeries does the surgeon perform per week, month, or year?
  1. Has the surgeon completed a surgical cancer fellowship?