The rising cost of healthcare, as well as the increased costs that employers have shifted to employees, has been a burden for middle-class Americans over the past decade. The trend shows no sign of slowing, with more employers offering only high-deductible health plans to their employees. For 2017, these plans can require that you pay out-of-pocket expenses up to $14,300 (for a family policy, not including insurance premiums) before your insurance company begins paying. One big problem is that few people know what medical care costs. Nobody would buy a car without knowing the cost. So why do we buy healthcare that way? It’s time to stop buying blind and start saving money. Here’s how: 1. See in-network providers. If you have an HMO (health maintenance organization) or a PPO (preferred provider organization), your plan will have negotiated discounts with certain healthcare providers, including hospitals and outpatient facilities. That makes up your network. If you go out of network, the provider can charge you any amount and you usually have a higher copayment. 2. Shop around. Just as you comparison shop for a cellphone or a car, you should comparison shop for major medical expenses. Need a hip replacement (or any non-emergency surgical procedure)? Find out not only what the doctor charges, but what the hospital, anesthesiologist, radiologist, and physical therapist each charge. Some insurance companies, like United Healthcare, offer this information via an app for your phone. Another good option is the Healthcare Bluebook, which gives information on the cost of medical services by ZIP code. 3. Buy your meds in the right place. A 2016 Consumer Reports survey found that a 30-day supply of Cymbalta costs $249 at Walgreens, while the same drug costs $43 at Costco. Also, see if your plan offers a money-saving mail-in prescription option. You can also use the website GoodRx (www.goodrx.com) to compare prices and find the lowest price available. 4. Negotiate. If the doctor charges $1,000 for a hip replacement (and you haven’t met your deductible yet or have a high copayment), ask for a break. It helps if you offer to pay cash up front, too. This saves your doctor’s office the hassle of billing (often several times). Some other tips include discussing the cost of the procedure at other hospitals, or seeing if setting up a payment plan is an option. 5. Ask about less expensive options. Doctors often don’t consider the cost when ordering tests, recommending procedures, and prescribing drugs. So ask whether the MRI is really necessary, or whether a CT scan or X-ray might provide the same information. Could a course of physical therapy or losing weight help you avoid knee surgery? A good question is: “How will the results of this test affect your treatment recommendation?” Another is: “Are there any other options?” You can find lists of tests and procedures that are often unnecessary at Choosing Wisely. 6. Buy a silver plan on the exchanges. Depending on your family size and income, you may qualify for lower out-of-pocket costs, but only if you choose a cost-sharing reduction plan from a government-run insurance exchange. These are only offered as part of a silver plan. A silver plan covers 70% of medical costs. Bronze plans cover less, while gold and platinum plans cover more. The key to choosing the right plan for your family is determining the balance between how many health care services you actually use, and what your monthly premiums will cost. 7. Choose the right level of care. Sprained your ankle and can’t get in to see your doctor? You don’t need the emergency room; an urgent care center or an appointment with another doctor will do just fine and save you hundreds in out-of-pocket costs. If your doctor orders an MRI, see whether you can have it done at a radiology facility rather than the hospital—you may find significant savings. 8. Go generic. For instance, a 30-day supply of the blood thinner Coumadin costs nearly $50, while a 30-day supply of its generic equivalent, warfarin, costs just $5. This price difference is true for a wide variety of drugs. You can also save big with coupons. A good site for more on drug pricing and to find coupons is GoodRx. Key Takeaways Healthcare costs have been rising for decades. One problem is that few people know what medical care actually costs. You can take steps to lower your healthcare costs, including finding out the prices of services and negotiating fees. You can lower your spending on prescription drugs, too, by buying generic drugs at the stores where they are cheapest.