What Could I Expect From Insurance Coverage If I Combined Septoplasty and Tip Rhinoplasty?

It might benefit you to do both procedures together from both a cost and recovery perspective. Since many of the incisions can be combined and breathing will be difficult right after either procedure, it makes sense to do them together.Also, many surgeons may discount the procedure to you so you should inquire about that as well.

It sounds like there is plenty of agreement among my colleagues that the tip-plasty is a cosmetic procedure and insurance will not cover any portion of the procedure. I totally agree. In cases such as yours we will often perform the procedure in our office operating room and perform the septoplasty at no charge (no co-insurance, co-pays, etc) as part of the tip-plasty. I would recommend that you discuss this issue with your surgeon to see what your options are. One thing to be aware of is that many, many surgeons perform septoplasty procedures and do them well. However, since you are considering your nasal tip, make sure that you are working with a Facial Plastic Surgeon or Plastic Surgeon who is well versed in both cosmetic rhinoplasty and septoplasty. Your surgeon needs an additional skill set if you're seeking both procedures as opposed to a septoplasty alone.
Thank you for your question.Stephen Weber MD, FACS

Prices for tip rhinoplasty with or without septoplasty will definitely vary with geographic location and with the level of training of your surgeon.  There are serious advantages both in terms of cost and post-operative healing to combining procedures into a singe surgery.  If you are having trouble breathing or recurrent sinusitis related to a deviated septum, I would STRONGLY recommend that you see a board certified ENT prior to undergoing surgery.  You are correct that insurance will cover the cost of septoplasty (you may require turbinate reduction as well- this will have to be determined on examination) and the anesthesia time associated with the septoplasty and turbinate reduction. The cost of the tip rhinoplasty and cosmetic operating room and anesthesia fees are the fees that you will need to pay out-of-pocket, and these fees can vary greatly depending upon the subspecialty training of the surgeon you choose and the facility in which they operate.
In terms of healing, it is easier to have a single surgery to recover from than multiple surgeries. 

Technically, if you are thinking about having a rhinoplasty, you should definitely wait to do your septum until you do both procedures at the same time.  Properly performed rhinoplasty often requires multiple cartilage grafts to reinforce the new structure for your nose.  The easiest place to obtain these cartilage grafts is from your own septal cartilage.  If you were to go ahead with a septoplasty, and then decide to do your nose in a few years, your surgeon would lose the ability to use your own septal cartilage for these grafts and would have to seek out other sources for cartilage, such as your ear cartilage.  It is definitely best to do both septoplasty and rhinoplasty at the same time.

While cost can vary, in my practice (upper east side of Manhattan), the cost is approximately $4000 surgeon's fee, and $2,000 to the operating room and anesthesia, for a total of around $6000 out of pocket.  Please bear in mind that this is just an estimate based on the information you provided.

I will end by saying that while cost is a consideration for almost everyone, I counsel my patients that the most important thing in choosing a surgeon, assuming that you are choosing among equally qualified and capable surgeons, is choosing a surgeon who's aesthetic and opinion you trust.  Aesthetic surgery is a little bit science and a little bit art.  Inevitably, your surgeon will need to make decisions for you while you are asleep that will impact your final result, and you need be comfortable that you and your surgeon are on the same page in terms of the goals of surgery and what you consider to be a beautiful result.  I find that pre-operative imaging really helps make sure that me and my patient are indeed on the same page. 

Once upon a time, insurance companies paid a reasonable figure for your septum. Now they reimburse the Doctor about $600 for the septum. A drop in the bucket when it comes to a good, skilled rhinoplastic surgeon who you would want to do your nose.

Either way, you will have to pay for the tip plasty and you may have to pay a portion of the facility fee and anesthesia based upon the cosmetic portion.