Healthcare is a basic need for all of us. And it’s an area where costs can often seem high or even unexpected. The trick is finding the right balance between getting the care we need, managing expenses and choosing the insurance coverage that fits our individual needs.

These are vital issues that affect everyone with potentially significant financial impacts. For example, the Kaiser Family Foundation found that more than 25% of adults in the U.S. struggle with their medical bills. And that includes people with insurance. Moreover, medical debt is one of the leading sources of personal bankruptcy filings.

Here are some ways to help reduce health care spending and the cost of staying healthy.

Be Smart About Meds

• Compare alternatives. Find out if there is a less expensive medicine for a given condition. It never hurts to ask.

• Go for generics. Check with your doctor first, of course, but typically it’s fine to take a generic medication rather than a brand-name, which can be much more expensive.

• Buy in bulk. Many medications can be prescribed in 90-day quantities to take advantage of any volume discounts that might be available.

• Find a freebie. Your physician receives lots of promotional samples of various drugs, so don’t be afraid to inquire about obtaining some.

• Look for assistance. If you have problems affording your medications, there are patient assistance programs offered by drug manufacturers and non-profit organizations.

Proactively Manage Services

• Check the bills. A fundamental best practice is to review your bills carefully to make sure you actually received the services and that the coding for the expenses is correct. Watch out for surprises like “balance billing.”

• Try negotiating. Need treatment that isn’t covered under your insurance or don’t have insurance at all? You may be able to arrange reduced rates, discounts or a payment plan.

• Appeal a claim denial. It can be worthwhile to question a denied claim and request reconsideration. You may need the support of the physician involved or a health advocate.

• Save pre-tax dollars. By using what are called flexible spending accounts and health savings accounts, you can put away pre-tax income to help fund future medical expenses.

• Sign up for Medicare. The savings under this longstanding program can be substantial, in terms of both premiums and covered expenses. So make sure to enroll as soon as you turn 65.

• Seek options. Ask about getting treatment at an outpatient facility or urgent care center rather than the hospital. Avoid the emergency room, which can often be the most expensive and difficult way to handle a medical situation.

Some other important steps are staying current on physical exams, routine screenings and other preventive services; asking where tests and procedures are necessary; and shopping around to compare rates.

A Word on Insurance

Don’t necessarily go for the insurance plan with the lowest premium. That’s like always selecting the low bidder for a home construction project. It may look good on the surface, but there can be unexpected costs and other headaches involved in getting the job done.

The basic key is to carefully review various plans so you can determine the best balance between premiums, deductibles/copays, lifetime maximums and details on the services you need, including prescriptions. Amazingly, barely half of employees with health insurance are clear on these factors.

One important example is making sure you understand what constitutes in-network vs. out-of-network services and the status of your current providers. Another is to check the details on referrals and authorizations that may be required in certain situations prior to treatment.

It takes some work, but the optimum result comes from carefully evaluating your needs (as an individual or as a family), paying attention to the details, getting the guidance you need, and then making a truly informed choice.

If you’re not eligible for healthcare coverage on the job, don’t forget that there are many alternatives including the ACA exchanges and professional associations where affordable insurance may be available.

The good news is that you’re not alone. Ask for assistance on how to save on health care costs from the insurance carrier, a broker or human resources department. The latter can be especially valuable in considering the range of options that may be on the menu for employee-sponsored coverage. Knowledgeable friends, family and work associates can also be very helpful.