Medical bills and health-related expenses can really take a bite out of any family's budget. Medical bills are one of the leading causes of bankruptcy in the U.S. In fact, I was forced to file for bankruptcy at the age of 25 because my son needed surgery and my health insurer refused to pay for it. That, coupled with a six-month stint of unemployment, drained my finances and led to the bankruptcy filing. It was one of the most shameful moments of my life, but I had no other choice.

Had I known then what I know now, I may have been able to pay off my medical debts, or avoided some of them altogether. You can't avoid medical expenses. Everyone, at one point or another, needs to see a doctor, get a vaccination or buy prescription medications. However, there are ways of trimming your medical costs. Here are 10 lessons I learned the hard way:

1. The emergency room is the biggest rip-off at the hospital. By all means, if you have a true medical emergency, like a serious injury, go to the emergency room. Don't go to the ER for things like the flu, an ear ache, or anything else that probably could wait a day or so until you can go to your regular physician. Avoiding the ER like the plague will save you a ton of dough...unless you actually have the plague.

2. Shop around for prescription drugs. The pharmacy at the hospital must be a serious money-maker, because drugs there cost much more than drugs you will find at an outside pharmacy. Shop around a little before getting your prescription filled. You'll be surprised at how much the price varies. Don't forget, Walmart offers many generic drugs for only $4.

3. Always ask for generic drugs. There is little to no difference at all between name-brand drugs and the generics. This goes for the over-the-counter medications, too.

4. Find out if your health insurer offers a mail-order prescription plan. If you regularly use prescription drugs, you can usually get big cost savings by having your drugs sent right to your door step through the health insurer's mail order plan.

5. Check out the local public health clinic. For things like flu shots, check out your local city or county public health clinic. These vaccinations are usually much cheaper than getting it done at your doctor's office.

6. Keep an eye out for public health fairs. You can usually get routine exams for your eyes, cholesterol and blood pressure done at a health fair...for free. Don't replace your annual physical exam with a health fair, but the free or low-cost exams can give you an idea of where you stand, and could possibly alert you to something that needs further medical attention.

7. Build an emergency health fund. There are Health Savings Accounts available at many banks. These allow you to stash cash away for medical expenses not covered by your insurance. Of course, you could put your money in any kind of high-interest savings or money market account and earmark it for medical expenses. You will spend it one day, so you know that it's not money that's just going to languish around in an account doing nothing.

8. Don't buy "reading glasses" at an optometrist's office. I had an eye exam two years ago after I realized I had a problem reading small type in books and on the computer screen. I had been using a cheap $4 pair of reading glasses I bought at Dollar General. The optometrist told me I did need reading glasses, and asked if I would like to pick out a pair at his office. They all cost in the $120 range. I showed him my "over the counter" readers and said "well, I've been using these". He said "if you're happy with those, you're fine. They're basically the same thing. We just have fancier frames." I was floored, but at least he was honest. I stuck with the $4 glasses.

9. Ask your doctor for a discount. Your doctor is like every other business you deal with...they just want to get paid. Ask if they'll give you a discount if you pay in cash. If your insurance covers most of the cost, this won't save you much money. But, if you are underinsured or uninsured, this could save you some money...and many doctors are willing to do it. After all, getting some money is better than not getting any. Also, ask your doctor if they have samples of any prescriptions they write for you. They usually do.

10. Don't get sick in the first place. Let's face it, some of the stuff we go to the doctor for is preventable. If you smoke, stop. If you are overweight, eat less and move more. Avoid people who have the flu. Wash your hands, and do it often. Eat the right kinds of foods. Take your vitamins. It's cheaper to take care of yourself and keep from getting sick than to be treated once you do get sick.


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