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Don't automatically sign up for the same employer health insurance plan you've always had. Employers have been making big changes to their health insurance options in attempts to lower their costs, such as raising premiums, cutting back coverage, and boosting deductibles and other out-of-pocket expenses. The policy with the lowest premiums may end up costing you the most by the end of the year. You need to run the numbers through your potential expenses for the upcoming year to determine which policy is best for your family.

Many employers are offering incentives to encourage you and your family to get your health insurance elsewhere, such as offering bonuses if you don't sign up for your employer's plan or surcharges if your family could get coverage somewhere else but signs up for your policy instead. Check out all of your coverage options, such as insuring your whole family on your employer's policy, switching everyone to your spouse's employer plan, or staying on your employer's plan yourself while your spouse and kids go elsewhere. You need to run the numbers for each of your options and can mix and match to get the best deal.

You may get an even better deal by foregoing your employer's plan and buying health insurance on your own, or staying on your employer's plan yourself but having your spouse and kids sign up for their own policy. If they're healthy and live in a state with a competitive health insurance marketplace, they could reduce their premiums significantly.

Don't automatically keep COBRA health insurance coverage with your former employer after you leave your job or get divorced. If you're healthy, you could find a better deal on your own.

Raising your deductible to at least $1,000 for singles and $2,500 for family policies can save you a lot of money and help you qualify for a health savings account, which provides big tax benefits. The money you contribute lowers your taxable income, grows tax-deferred, and can be used tax-free for medical expenses at any age. Unlike flexible-spending accounts, which your employer may already offer, you don't have to use up the money by the end of the year.

Maximize the tax benefits of your health savings account by not using the money for your current medical expenses. If you can afford it, pay your medical bills with other cash and leave the HSA money in the account to grow tax-deferred (or tax-free if used for healthcare costs). Shop for an HSA with low fees and good long-term investing options.

Because higher deductibles and copayments mean you'll be paying a larger portion of your healthcare costs yourself, you need to become a smart healthcare shopper. Ask your doctor or pharmacist if you can switch to any lower-cost medications, shop for basic medical supplies on your own, make most of free preventive care, and take advantage of your employer's tools to help minimize costs.

If you don't have health insurance through an employer, buying an individual policy may cost a lot less than you'd expect, especially if you're healthy and live in a state with a competitive health insurance marketplace. Shop around online and through an agent, comparing premiums as well as overall costs, and raise your deductible to qualify for an HSA.

Recent graduates who are healthy can generally get a much better deal by buying their own health insurance policy, keeping the deductible high, and qualifying for a health savings account, which can help them build a giant tax-free fund for future medical expenses. A short-term policy may be a cost-effective way to find coverage for just a few months. All of these options tend to be less expensive than staying on their parents' policy through COBRA, unless they're in poor health.

Health insurance prices vary a lot from company to company, especially if you have any medical problems. One insurer may reject you while another offers a great rate. It helps to work with an agent or broker who knows which insurers tend to be most competitive for people with your condition and the best strategies for strengthening your case. Shop around again if your health improves.

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