General
Getting a second opinion without your first doctor knowing
Last reviewed July 1, 2026
You are legally entitled to a second opinion, and you don’t need permission from your first doctor to get one. Insurance covers second opinions in almost all circumstances (some plans even require them for major surgeries or cancer treatment decisions). The tricky part isn’t the right — it’s the mechanics of getting your records, scheduling, and not making things awkward with your original team.
The steps
Step 1: Request your records without saying why. Federal law (HIPAA) requires providers to release your records within 30 days of a written request. Ask for: (a) all imaging with the actual images, not just reports (request DICOM discs), (b) pathology slides (not just reports — actual slides that can be re-read at another institution), (c) all clinic notes and test results. You’re allowed to request this without stating a reason.
Step 2: Book the second opinion at a different health system. Major cancer centers (MD Anderson, Memorial Sloan Kettering, Mayo Clinic, Dana-Farber, Johns Hopkins, Cleveland Clinic) all have second opinion programs. Many offer remote/telehealth second opinions where you upload your records and get a written review — no travel required.
Step 3: Verify insurance coverage in advance. Most plans cover second opinions when requested through in-network providers. If the second opinion doctor is out-of-network, some plans will still cover it — call and ask specifically about "second opinion coverage."
You do not need to tell your original doctor unless and until you want to change course based on the second opinion. Records requests are routine and don’t automatically flag "this patient is shopping around."
This applies when
- You’ve been given a cancer diagnosis and want confirmation
- You’ve been given a treatment plan and want to explore alternatives
- Your doctor has ruled out something you’re worried about, and you want independent verification
- You’re considering major surgery or aggressive treatment
- You feel dismissed and want another perspective
This doesn't apply when
- You need emergency treatment and can't safely delay care
- You're seeking additional opinions without new clinical information — insurers may not cover repeated reviews
- Your care team already includes a multidisciplinary tumor board review
- You want a second opinion mainly to postpone a necessary, time-sensitive treatment
Resources
MD Anderson Second Opinion: mdanderson.org (remote and in-person options).
Memorial Sloan Kettering Second Opinion: mskcc.org.
Mayo Clinic Online Second Opinions: mayoclinic.org.
Cleveland Clinic MyConsult: clevelandclinic.org/online-second-opinion.
Dana-Farber Cancer Institute: dana-farber.org.
The Grayzone Cancer Second Opinion Network: for underinsured patients seeking second opinions on complex cases.
If you're denied
Rare, but if a second opinion is denied by insurance, appeal with a letter explaining the clinical rationale (surgery being considered, treatment decision pending, diagnostic uncertainty). Denials for legitimate second opinion requests are almost always overturned.
