Sometimes, the decision your doctor makes isn't as clear cut and easy as you would like to believe. So you may consider the value and benefit of getting a second opinion. No matter what factors have you facing this decision, one thing is for sure; if you do not feel as though this is the right decision, the only decision or even an option, you should take the time to talk to other doctors. As you do so, you may wonder if your health insurance provider can cover the cost of a second opinion.
One of the key determining factors over whether or not your health insurance covers certain screenings and/or treatments is determining if they are medically necessary. In short, the procedure that you plan to have must be necessary in order to maintain your health. If that is the case, you may have coverage under your healthcare plan.
If treatment is considered medically necessary, your health insurance plan is likely to pay for at least a portion of the cost. How much of the cost that is paid by your health insurance provider is directly dependent on the type of plan you have and the amount of coverage you've purchased. If you have Medicare on the other hand, it often pays about 80 percent of many of your healthcare expenses. In fact, if the two doctors’ opinions differ, your health insurance plan may even cover a portion of a third doctor's opinion to help you to make the best decision.
It is a good idea to contact your insurance company first before seeking out a second or third opinion to find out what can be covered. You do not want there to be confusion that leads to a denial of your bill. You should also learn if additional tests, lab work or other types of procedures to make such a decision will be covered a second time. In most cases, you will not need to stay with the same medical office, but you may still need to remain in plan.
When it comes to your health insurance plan, don't assume your carrier will not provide you with the support you need for a second opinion. Instead, give them a call and ensure that all of your questions are answered, or seek out a new plan that offers more protection.
Get the medical care you need. Call General Insurance Services at (800) 766-4478 for more information on Michigan City health insurance.