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Medicare Made Easy: Questions About Coverage and Customer Care

Your Money

MEDICARE MADE EASY

Black and white portrait illustration of Dena Bunis

Does Medicare pay for second opinions?

Yes. Original Medicare pays for a doctor visit to get a second opinion when your initial doctor recommends surgery, a major nonsurgical therapy or a major procedure needed to diagnose an ailment, such as a heart catheterization or gastroscopy.

Even better: If one doctor suggests one thing and another recommends the opposite, Medicare will cover a third opinion. Just note: You or your supplemental insurance would have to pay the standard 20 percent coinsurance for each doctor visit.

Individual Medicare Advantage plans may have different rules and costs for second and third opinions. So if you’re enrolled in one, check first before booking that second opinion appointment.

When I called Medicare’s hotline on behalf of my mom, they said they couldn’t help me because she didn’t sign some form. What’s that about?

If you put your mom on the phone, she can give verbal authorization for the Medicare representative to help you with her issue. Failing that, yes, your mother needs to submit Medicare’s “Authorization to Disclose Personal Information” form before you can speak for her. That’s true even if you already have your mom’s health care proxy or power of attorney. Once the form is accepted, you’ll be able to talk to an agent about claims, enrollment issues, payments and more.

Even if your mom is fully capable of handling her account, it’s wise for her to fill this form out, since you never know when she might need help. The form will ask your mom to say when and how long to allow Medicare to give you representation rights—a permission she can revoke anytime. Find the form at medicare.gov. Or if your mom has an online Medicare account, she can log in and click on Edit My Account Settings, then on Manage My Representatives.

Dena Bunis is a senior editor and writer for aarp.org and a veteran health policy journalist. Send her your questions about Medicare to medicare@aarp.org. Due to the volume of inquiries, we can’t answer every question.

MEDICARE RESOURCES

MEDICARE HOTLINE:
800-Medicare (800-633-4227)
MEDICARE ONLINE:
medicare.gov

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