How to trim your health bills

FLEXIBLE SPENDING ACCOUNTS

Save by reducing taxable income

Surprisingly, these accounts, offered by many companies, even small ones, are often not used by consumers -- so if you didn't sign up for 2009, consider it next time around. Employees of companies that offer the accounts can have set amounts (minimums and maximums are set by each company) taken from their paychecks pretax and put into these accounts to be used for health expenses as major as brain surgery or minor as contact lens solution. (Each company can decide what it will allow in its specific plan; you can get a good idea of allowed expenses under the federal government's flexible spending program at www.fsa feds.com/fsafeds/eligibleexpenses.asp. According to Laurie Brubaker, a benefits expert with Aetna, which administers some of these accounts for businesses, setting aside $2,000 from a salary of $25,000 will create a tax savings of $450. Use Aetna's calculator to match your allocation with your salary at www .aetnafsa.com/fsa/index.php.

Spend it or lose it

Many people often don't open an account because any money left at the end of the year is forfeited. Cathy Tripp, a senior consultant in the Minneapolis office of benefits consulting firm Watson Wyatt, suggests making a list of medical needs for the year, including prescription sunglasses and new contact lenses or a visit to the doctor to check on an allergy, and making those appointments before the benefit year ends. And remember: The money is deducted over the course of 12 months, but the full amount you choose to set aside is available to you from the first day of your benefit year.

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DRUGS

Review what you take with a doctor

Shopping for lower prices isn't necessarily the first step you need to take if you want to lower your prescription drug bill, says Michael Cohen, president of the Institute for Safe Medication Practices in Horsham, Penn. First, review the drugs you take (a good practice once each year regardless, doctors say), to determine whether you still need the drug or that dose and whether you could safely substitute a less expensive option for the drug.

A visit with your doctor to review the drugs is your best bet. If you're concerned about the cost of the visit, you can ask if the doctor will go over your list by phone. (And see below for strategies to reduce the cost of an office visit.) A local pharmacist can also review your drug list and make suggestions to your physician for changes, but never stop taking a drug unless the doctor has specifically given you the OK.