Should I get a second opinion?

When you are diagnosed with a serious condition or receive a recommendation for surgery, it is important to make the best decision for you and your health. Part of your health care journey might be seeking a second opinion. Seeking a second opinion is an important decision, and you should understand the process and know your options. If GEHA is your primary medical plan, we are here to help you along the way.

(If GEHA is not your primary medical plan, please contact your primary plan for information on getting a second opinion.)

When is a second opinion helpful?

1. You need more information, or you are unsure about your options.
2. You are not clear about how well a test or treatment may work.
3. If you’re struggling with a chronic disease that requires surgical interventions.

Will I offend my provider if I seek a second opinion?
Some members worry that they might offend their current provider by seeking a second opinion. There is no need to worry, as second opinions are now considered normal and encouraged by many doctors.

Be prepared
Before visiting your second opinion provider, you should be prepared. Collect test results and medical records before your appointment. In some instances, the provider will collect the medical records for you.

Prepare a list of notes and questions you would like to cover during your appointment.

Coverage
Your insurance plan does not require prior approval to seek a second medical opinion. Your applicable copays and coinsurance for an office visit will apply. Your costs may be lower by using in-network versus out-of-network providers. Certain restrictions may apply for diagnostic lab work and tests. Review your plan brochure or call a GEHA Customer Care Representative at 800.821.6136 to find out what your plan does and does not cover.

What are some of the steps toward gaining a second opinion?

1. Start a conversation with your doctor:
   • Discuss how you would like more information about your condition before making any decisions.
   • Ask what other treatment options are available and who can provide them.
   • Ask who they would recommend that specializes in your condition.
2. Start researching other providers:
   • Ask your doctor for a referral to another doctor or facility.
   • Ask your family or friends about any doctor or facility that they recommend.
   • Contact GEHA Customer Care at 800.821.6136 for help locating a provider, or locate a provider online.
   • Consider if reaching out to one of our MDLIVE medical or behavioral telehealth providers may be an option for you.