This is an opinion provided by a second physician, when one physician recommends surgery to an individual. Most health insurance policies cover second surgical opinions. This is a cost-management strategy that encourages or requires patients to obtain the opinion of another doctor after a physician has recommended that a non-emergency or elective surgery be performed. Programs may be voluntary or mandatory, in that reimbursement is reduced or denied if the participant does not obtain the second opinion. Health Insurance plans usually require that such opinions be obtained from board-certified specialists with no personal or financial interest in the outcome.