5 Questions to Ask Before a Major Elective Healthcare Procedure

By Meredith Singer, FNP-C, BCPA

Making healthcare decisions can feel overwhelming—especially when you’re told you may need surgery or another major procedure. For many patients and families, the hardest part isn’t the operation itself; it’s deciding whether to have it at all.

In healthcare, the term “elective” often causes confusion. It doesn’t mean optional or cosmetic—it simply means non-emergent. In other words, the procedure can be scheduled in advance, and there’s time to weigh your options. This is very different from an emergency procedure, which must be done urgently to prevent serious harm or loss of life.

While elective means there’s time to plan, it also has implications for insurance coverage. Most elective procedures are covered if they’re deemed medically necessary—but coverage levels, pre-authorization requirements, and out-of-pocket costs can vary widely. In contrast, emergent procedures are almost always covered because delaying care could endanger your health. Understanding how your insurance classifies your procedure can prevent surprise bills and help you make informed financial decisions. I’ll be expanding on elective vs. emergent coverage in more detail in an upcoming post.

Having that extra time is an opportunity—to gather information, ask thoughtful questions, and make sure any decision aligns with your goals, values, and resources. Here are five key questions to guide those conversations.

1. What exactly is my diagnosis, and what does it mean in plain language?

Start by making sure you truly understand your condition. Ask your provider to explain the diagnosis in clear, everyday terms. You might say, “Can you explain what’s happening in my body and why this procedure is being recommended?” Understanding the why behind a recommendation is the foundation for an informed decision.

2. What are all of my treatment options, including non-surgical or less invasive choices?

Surgery is often just one option- ask if there are other treatment options. For example, less invasive approaches for many spine and orthopedic conditions can include:

• Physical Therapy 
• Epidural Injections (generally performed by a Physiatrist)
• Lifestyle Changes (reducing heavy lifting, reducing BMI if overweight)
• Medication Management (non-opioid medications)

Each carries different risks, benefits, and recovery times. Knowing your full range of options helps you choose what best fits your health goals and circumstances.

3. What are the risks, benefits, and likely outcomes of each option?

Every procedure involves some risk and it is important to ask:

• What are the most common complications?
• What are the risks (or, chance of the complication happening)?
• What is the recovery timeline? Will my symptoms get worse before they get better?
• How much long-term pain (or other symptom) relief can I realistically expect after recovery?
• Will it ultimately increase my quality of life?

Discuss how each choice might affect your comfort, mobility, and quality of life in both the short and long term.

4. How much will this cost me out-of-pocket, and does my insurance cover it?

Financial clarity is part of good healthcare. Before scheduling anything, contact your insurance company to confirm coverage. Ask your doctor’s office for the procedure codes (CPT codes) so you can verify:

• Which portions of the procedure are covered
• What your deductible or copay responsibilities are
• Whether all providers involved – surgeon, anesthesiologist, hospital, radiologist – are in-network

Getting cost information in writing helps avoid stressful surprises later.

5. What happens if I choose to wait, get a second opinion, or do nothing for now?

Unless a condition is urgent, it is often reasonable to pause and think. Ask what might happen if you delay treatment or seek another opinion. Sometimes “wait and watch” brings valuable perspective. A trusted healthcare team will respect your need to feel confident in the decision.

Don’t Forget About Post-Procedure Care

If you do move forward, ask detailed questions about what recovery will involve. Post-procedure care can be as important as the operation itself. Clarify:

• How long will I be in the hospital?
• Will I likely go home or to inpatient rehabilitation?
• What are the warning signs that require a call?
• What support will I need at home? For example: equipment to help with mobility, home health, assistance with medications, and transportation
• What activities shouldn’t I do after? And when can I safely drive afterwards?
• Is outpatient physical therapy recommended?  When do I start?
• Date and time of follow-up visit(s)

Planning ahead helps reduce stress and improves recovery!

The Takeaway

When it comes to elective procedures, informed decisions are better decisions. Taking time to ask the right questions—and making sure you understand both the medical and financial aspects—can help you feel prepared and supported every step of the way.

Thoughtful preparation protects your health, your finances, and your peace of mind.