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From routine physicals to prescription drugs, medical expenses add up faster than you can say “Ahhh.” In fact, more than half of women surveyed by the nonprofit research foundation the Commonwealth Fund said the rising costs of health care were keeping them from getting the procedures and medications they need.

Receiving quality care costs quite the pretty penny, whether you’re insured or not. And while doctors may know what’s best for your health, they may not be as concerned with your wallet. So before you swipe that credit card, make sure you’re following these money-saving rules to cut back on medical expenses.

1. Choose lifestyle changes over new medication.
Don’t feel like adding to costs by filling a new prescription? Before your doctor signs the script, ask if there are any lifestyle changes that might have the same effect.

For example, losing weight can sometimes make diabetes or cholesterol drugs unnecessary, relaxation techniques often work better than sleeping pills, and keeping your home free of dust and mold might just liberate you from allergy meds.

2. Reevaluate your vitamins.
Taking a daily multivitamin may not be worth it in the long run—if your diet covers all the recommended daily nutritional bases. (This requires a diverse mix of fruit and veggies, lean meats, legumes, and whole grains, so if you’re a picky eater, a vegetarian, or have a food allergy, you may need a daily pill.)

Don’t bother with extra supplements, such as calcium, vitamin C, or vitamin D, unless your doctor recommends them for a specific reason. And you can ditch the vitamin-infused waters and beverages: They’re usually high in calories and chemicals, and can do more harm than good.

3. Ask your doctor: Do I really need that test?
A 2006 study in the American Journal of Preventive Medicine found that 43% of patients underwent unnecessary tests at simple, routine checkups. If your doctor orders an MRI, CT scan, or other medical exam, speak up: Besides the medical concerns of unnecessary testing, like additional exposure to harmful radiation, you could be billed for these extra procedures. Ask why it’s being ordered, whether it will cost you extra money, and what will be done afterward if the results are positive (or negative). If the answer is simply “routine screening,” the test may be unnecessary.

4. Get your regular meds on the cheap.
Continuously shelling out for a regular prescription (we’re lookin’ at you, birth control) can be a real drag. Find out if there are cheaper options, like ordering from legitimate, safe online vendors, or thriftier pharmacies with low-price plans. You can also try money-saving strategies such as buying the generic version of the medication, buying pills in bulk, and splitting higher-dose pills.

Next page: Don’t procrastinate

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More insurers are covering alternative therapies like acupuncture.

Although it may seem obvious that acupuncture helps relieve, say, your chronic back pain, insurance companies often consider such therapies—from massage to herbal supplements—outside the medical mainstream. They are, after all, still referred to as complementary and alternative medicine (CAM). However, many insurers do cover selected therapies on a case-by-case basis, depending on the way you request reimbursement.

“If you talk to insurance people, they quote you by the book and say massage is not covered. Yet, I would say one-third of our Blue Cross Blue Shield patients are getting some reimbursement,” says Paul Rubin, a chiropractic physician at WholeHealth Chicago, a medical center that integrates traditional and alternative medicine. And even if your insurance company refuses to cover alternative treatments, there are ways you can reduce your out-of-pocket expenses.

Insurance coverage
The best way to get reluctant insurers to cover alternative therapies is by making a good case that your treatment is medically necessary. The simplest way to do this is to get a prescription. Ask your primary care doctor to write one that includes the diagnosis and the frequency and length of treatment. Although they may not advertise the fact, some insurers will rubber-stamp CAM treatments if they are prescribed by a physician. Some of the most frequently covered therapies include chiropractic care, massage therapy, acupuncture, herbal remedies, homeopathy, and mind-body stress management.

One of Rubin’s patients, a woman in her mid-50s, came to his office with fibromyalgia; she had chronic pain and fatigue. She was treated by an internist, who prescribed the pain medication Lyrica, and she also saw an energy healer, an acupuncturist, and a massage therapist on staff. WholeHealth Chicago submitted a detailed claim to the insurer that included a prescription for the CAM treatments and receipts that used standard diagnostic and treatment codes. Her insurance paid for the internist and therapeutic massage, says Rubin, although the acupuncture and energy work were denied.

Another strategy is to convince the insurance company that covering alternative treatments may save them money in the long run. Some conventional treatments for chronic back pain, for instance, cost far more (and in some cases may be less effective) than alternative options such as acupuncture and biofeedback. “To a certain extent, it’s playing the insurance game,” says Rubin. “I would never ask anyone to not tell the truth, but if you can make the case clearly that what is being done is clinically necessary as an alternative to pharmaceuticals or surgical procedures, the insurance company can see, ‘Gee, this treatment is $200, while medication would be $600 and surgery would be $10,000.’”

Next page: Get a receipt

In 1999, Susan Sheridan’s husband, Pat, went in for surgery to remove a tumor in his neck. After the surgery, the neuro­surgeon gave the Eagle, Idaho, couple great news: The mass was benign—a fact the neurosurgeon confirmed after looking at the pathology report two weeks later.

“Little did we know that the pathologist had been conducting ongoing stains on the tumor and had released a final pathology report 21 days after the surgery,” says Susan, now 48. “It said ‘malignant sarcoma.’” Cancer. But the Sheridans never got this critical update because it was mistakenly filed away at Pat’s doctor’s office without the physician or patient ever seeing it.

Within six months, Pat’s cancer had spread dramatically; he died of it in 2002, at the age of 45, leaving behind two school-age children. Had Pat’s malignancy been aggressively treated after that first surgery, he would likely be alive today. “There was no system in place to make sure a life-or-death document was read,” explains Susan, who discovered the error after requesting Pat’s medical records.

The mistake that cost Pat Sheridan his life took just seconds. Even if most errors don’t have such tragic consequences, the circumstances that prompt them are everywhere—and screwups happen often. In fact, 95% of physicians report having witnessed a serious medical mistake, and 56% say they’ve personally been involved in a serious preventable error, says Sanjaya Kumar, MD, author of Fatal Care: Survive in the U.S. Health System. And these mistakes kill. “To Err is Human: Building a Safer Health System,” the Institute of Medicine’s 1999 seminal report that first brought to light the problem of medical mistakes, noted that up to 98,000 preventable deaths happen each year in hospitals. But deaths in other settings, including doctor’s offices, were about three times that.

Next page: Why the doctor’s office is so risky

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