Second Opinions And Your Medical Insurance

Second Medical Opinion and Your Medical Insurance

In an extremely fast-paced lifestyle, it is quite common to fall sick or sustain frequent injuries. In fulfilling the demands of work and personal life, we may not be able to deal with our medical problems in the most optimal manner. One prominent problem with medical care is the possibility of a misdiagnosis. Misdiagnosis is possible even when you consult a trusted professional as many diseases are multi-factorial and highly unpredictable. Misdiagnosis costs in terms of higher costs and lost time, which explains the need for a second opinion. In many cases, opting out of a second opinion may lead to suboptimal and even adverse outcomes.

Most medical conditions require a second opinion to ensure the diagnosis and treatment plan are accurate and relevant. Despite the value of a medical second opinion, the majority of patients living in the United States (50%-70% Americans) do not seek medical opinion. They may not even have enough information about their condition or its treatment course. There are several reasons why individuals choose not to seek a second medical opinion:

  • Trust in their Care Providers: Most individuals put their trust in their medicinalcare providers and consider them an authority on the subject. Seeking the opinion of another doctor may be associated with feelings of guilt and patients may choose to abstain from approaching them. However, this approach has several disadvantages as it is quite possible even for the best medical professionals to make a diagnosis that is either not backed by sufficient evidence or has some degree of misinterpretation. Besides, most doctors advise their patients to seek a second opinion, which should be sufficient for the patient to override any feelings of guilt.
  • Typical Attitudes towards Seeking Medical Opinion: In many under-developed and developing countries, individuals seek the medical opinion of professionals who they trust. They prefer not to take the advice of another medical professional due to the loyalty they may feel about their attending physician. This attitude also makes it difficult to seek a second medical opinion and has a higher probability of a wrong diagnosis.
  • Lack of Time: In other cases, individuals may not have enough time to address their medical problems by seeking a second opinion. Otherwise, they may be in a hurry to get a medical diagnosis, which in many cases leads to adverse health outcomes.

Patients must understand that there are legitimate reasons in favor of seeking a medical second opinion:

  • Opportunity for an Accurate Diagnosis: It provides a good opportunity for an accurate diagnosis as 12 million Americans receive a misdiagnosis every year, which may reflect in the form of misdiagnosis, diagnostic error, or missed diagnosis.
  • Possibility of a Better Treatment Plan: A second opinion is important when treatment plans vary widely between doctors. Evidence indicates that although there may be a minor change in the diagnosis after a second medical opinion, the treatment may vary in 90% of the cases.
  • Cost Cutting and Enhanced Productivity: Second opinions are associated with cost savings, a more productive workforce, and reduced absenteeism resulting from disability claims. Finally, they provide peace of mind to the patient even when the doctor providing a medical second opinion confirms the previous diagnosis.

While forming conclusions from the information available on the Internet might not help you receive a personalized response, the expert clinical guidance you receive from medical professionals helps you appropriately prepare for a doctor’s visit, collect the required documents, and get the right recommendations to make sure their treatment is on the right track.

Most insurance plans will cover second opinions given the benefits of complex medicinal procedures and surgeries. Sometimes, insurance plans may not cover second opinions for pharmacological interventions. Insurance plans may have different types of coverage for a second opinion. When a second opinion covered by an insurance provider leads you to avert a surgery, the benefits mean volumes to not just the patient, but also the insurance provider. It translates to better outcomes for the patient and a better claims experience from the perspective of insurance management. Regardless of the condition experienced by patients, an insurance plan that provides second opinion services for an uncertain diagnosis or treatment that does not seem to be appropriate is a useful tool. Patients have the privilege of accessing the best doctors and getting answers on their diagnosis and treatment.


“KareOptions does not have any intention to provide specific medical advice, but rather to provide its users and/ or the general public with information to better understand their health. All content (including text, graphics, images, information, etc.) provided herein is for general informational purposes only and is not a substitute for professional medical advice, care, diagnosis, or treatment. KareOptions makes no representation and assumes no responsibility/ liability for the accuracy of the information, advice, diagnosis, treatment provided herein or on its website. NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE OR DELAY IN SEEKING TREATMENT BECAUSE OF SOMETHING YOU HAVE READ IT HERE OR ACCESSED THROUGH THE KAREOPTIONS WEBSITE.”

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