I’ll be honest — I’m just as surprised as you are to be wading into the murky waters of U.S. health care. Specifically? Health insurance. It’s a tangled mess. Even if your coverage comes neatly wrapped in your job’s benefits package, it’s still messy. Premiums keep climbing, deductibles are sky-high, and somehow we’re paying more for less.

And let’s not even start on wait times for specialists, tests or surgery. They’re stretching longer than a DMV line on a Monday morning.

Now, I’m no insurance expert. But here’s what I know: Whether we like it or not, we have to become our own health care advocates. That means paying attention, asking questions and managing things we once trusted our doctors and their office staff to handle.

Not good with numbers? Doesn’t matter. These days, we all need to be part-time medical bill auditors. That means understanding those explanations of benefits, poring over bills and doublechecking the fine print. Long gone are the days when insurance paid for everything and employers picked up the tab.

The good news? There are ways to cut costs — without compromising care. Here are six simple steps you can take:

1. STAY IN-NETWORK OR PREPARE FOR STICKER SHOCK

When Brian and Cindy’s newborn needed urgent blood work, the lab in their network couldn’t manage a successful draw. Their pediatrician sent them straight to the nearest children’s hospital. Problem solved … until a $2,000 bill arrived. Turns out that hospital — and its lab — was out-of-network. Insurance wouldn’t touch it.

Networks are shrinking, and some plans cover almost nothing out-of-network unless it’s a true emergency. So before you agree to anything — even in the hospital — ask every single person who walks through your door: “Are you in my network?” Yes, even the guy delivering your lunch tray. You never know.

2. AVOID THE ER (UNLESS YOU ABSOLUTELY MUST GO)

Emergency rooms are where medical needs meet financial heart attacks. The average ER visit costs $1,553. Urgent care? Around $135. Telehealth? Closer to $40-$50.

If you’re dealing with something non-life-threatening — like a sore throat, earache, sinus trouble or stomach bug — consider your options. Urgent care clinics, convenience care centers (like those in big drugstore chains) and telehealth services are often faster, cheaper and more convenient.

Look up your local options now — before you’re sick. Keep phone numbers handy. Know how to access virtual visits. That way you’re not googling “urgent care near me” in the middle of a child’s fever spike.

3. CHOOSE GENERIC MEDS WHENEVER POSSIBLE

Generic drugs can be up to 80% cheaper than their brand-name twins. They’re made with the same active ingredients (cue the emails from folks who’ll say otherwise — but yes, by law they must be).

If you’re paying out-of-pocket during your deductible period, generics can mean big savings. Many insurance plans have lower copays for generics too. Some big-box stores (Walmart, Target) even offer a 30-day supply for just $4 or a 90-day supply for $10. That’s cheaper than lunch.

4. USE YOUR FREE PREVENTIVE CARE

Thanks to the Affordable Care Act, most insurance plans must cover certain preventive services at no cost to you — no copay, no deductible — as long as you use an in-network provider. These services include:

— Mammograms

— Colonoscopies

— Blood pressure and cholesterol screenings

— Diabetes checks

— Flu shots and routine vaccinations

— Well-baby and well-child visits

For a comprehensive list tailored to your age and gender, visit HealthCare.gov. Take advantage of these benefits and schedule your checkup — you’ve earned it.

5. SAY YES TO WELLNESS INCENTIVES

If your employer offers rewards for participating in wellness programs — take them up on it! About a quarter of large companies hand out gift cards, cash, merchandise or even travel perks just for participating.

We’re talking simple stuff here: health screenings, online courses or a step-tracking challenge. You don’t need to become a triathlete — just show up and collect your reward.

6. GET CREDIT TOWARD YOUR DEDUCTIBLE

If you’ve got a high-deductible plan and you’re paying out-of-pocket, make sure those payments are being counted toward your deductible. File every claim — even if you paid in cash — so you get credit and your insurer’s negotiated rate.

And here’s a tip: Try to schedule big procedures at the end of the year if you’ve already met your deductible. That way, you won’t be hit with another round of full-price bills in January.

There you go — six ways to hold the line on health care spending. There are more, of course, and I’d love to hear yours. What are you doing to keep your costs in check — and how are you staying healthy? Let’s swap notes. Misery may love company, but I think frugality prefers community.

Mary Hunt

Mary invites you to visit her at EverydayCheapskate.com, where this column is archived complete with links and resources for all recommended products and services. Mary invites questions and comments at https://www.everydaycheapskate.com/contact/, "Ask Mary." Tips can be submitted at tips.everydaycheapskate.com/ . This column will answer questions of general interest, but letters cannot be answered individually. Mary Hunt is the founder of EverydayCheapskate.com, a frugal living blog, and the author of the book "Debt-Proof Living."

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