Want to know the best way to dramatically reduce your health care costs over your lifetime? Choose healthy parents. Wake Forest Univ. researchers suggests genetic influences are as powerful, or even more so, than blood pressure level, age, gender, weight, where you live or whether you have diabetes or such illnesses such as coronary artery disease.

OK, don't get discouraged. There are realistic ways to improve both your health and cut your health care costs that have nothing to do with who your parents are.

According to Milliman, a consulting and actuarial firm, a typical American family of four with a Preferred Provider Organization (PPO) plan will have total average medical spending on $15,609 in 2008. That's an increase of $1,109 from the previous year. Milliman estimates that employees' share of health insurance premiums increased 10.1 percent just from 2007 to 2008.

1. Know your health insurance plan's rules and follow them.

There are thousands of different health insurance plans nationwide, each one as different as the insurer or employer that sponsors them. If you don't have a clue whether you need a pre-authorization for outpatient surgery or whether you need to pick an allergist from the insurer's network of providers, you can wind up paying significantly more money than you should for your health care.

Never rely on what you think is true about benefits or providers that are covered under your plan — even if they are stated in your most recent benefits handbook. Always double-check whether the benefits, services or providers you need are covered under your plan before you receive treatment. Do this by calling your plan's customer-service department. Then follow through by obtaining any necessary authorizations or by scheduling treatment with a doctor within your insurer's network of providers.

If you don't follow the plan rules for receiving health care, your insurer can deny your claim or pay only a portion of the bill.

2. Buy a "lite" health insurance policy.

All states impose health insurance mandates on policies, requiring that they include coverage for a variety of benefits, procedures and health care providers. That raises premiums for everyone, whether or not you intend to ever use the benefits. Perhaps you don't need or want coverage for maternity stays or chiropractors or mental health treatment. So why pay for a policy that includes those?

According to the Council for Affordable Health Insurance (CAHI), 10 states allow health insurers to offer "mandate-lite" policies, which can be tailored to your own health care needs and more affordable due to the reduced benefits: Arkansas, Connecticut, Georgia, Kentucky, Louisiana, Minnesota, Montana, North Dakota, New Jersey and West Virginia.

3. Coordinate your family's health insurance plans.

Dual coverage can be expensive. If both you and your spouse maintain coverage, make sure it makes financial sense to pay premiums for both. You don't want to pay more than you'll ever get back in benefits by having duplicate coverage.

If you do decide to maintain both plans — as an added safety net or because the benefits in one plan are needed and not offered by the other — make sure you understand how the benefits in each plan will coordinate with the other.

Coordination of benefits (COB) can be complicated, especially if you have one type of plan, such as an indemnity plan, and your spouse has an HMO.

4. Plan ahead for emergencies.

Midnight, when your baby has developed serious croup, is not the time to educate yourself about which nearby hospitals belong to your health plan's network of providers. Learn this information ahead of time, write it down, and keep it someplace handy. If you can't find this information during an emergency, call the 24-hour help line number listed on the back of your membership card.

5. Cut your pharmacy costs.

According to a March 2008 report issued jointly by USA Today, the Kaiser Family Foundation and the Harvard School of Public Health, four in 10 adults (41 percent) say it is at least somewhat of a problem for their family to pay for prescription drugs they need, including 16 percent who say it is a serious problem. That leads to personal strategies for cutting back: Three in 10 (29 percent) say that they have not filled a prescription because of the cost in the last two years, and 23 percent say they have cut pills in half or skipped doses in order to make medication last longer.

There are ways to stretch your drug dollar:

• Ask your doctor for free samples of any drugs prescribed. Most physicians have closets full of them.
• Major store chains offer low flat-rate prices for generic prescription drugs: Wal-Mart and Target have lists of prescriptions available for $4.
• Most drug manufacturers provide medications for free or at a reduced cost to people who qualify for their patient assistance programs. There are hundreds of these programs and many drug makers operate multiple programs, depending on the medicines involved. Eligibility rules for patient assistance programs vary considerably, but often you must be without insurance coverage for prescription drugs (including Medicaid and Medicare), meet low-income guidelines and be unable to afford your medicine on your own. For more, read Drug makers offer medications to people who can't afford them.

6. Take advantage of tax breaks.

Consumer-driven health plans, flexible spending accounts (FSAs), health reimbursement arrangements (HRAs) and medical savings accounts (MSAs) — known collectively as health care spending accounts — are becoming more popular. One of the most popular is the FSA, an employer-sponsored account that offers you a way to pay for certain out-of-pocket health care or dependent care costs on a pre-tax basis. To get the tax advantages, though, you must open and fund your health care savings account.

Also, dental and vision care count as reimbursable medical expenses under FSA arrangements, so don't forget to save your receipts for these services.

7. Quit smoking.

This can immediately save you $175 a month if you are a New Yorker with a one-pack-a-day habit, according to the Campaign for Tobacco-Free Kids. Additionally, if you apply for life insurance as a smoker, you'll pay a hard-to-swallow smoker rate. You'll need to quit for at least three years in order to qualify for the better nonsmoker rates.

8. Lose weight.

According to a March 2002 Rand Corp. study, being obese adds $395 each year to your average $1,500-per-year health care costs, more than smoking (an addition of $230), aging 20 years ($225) and problem drinking ($150).

You could also have trouble securing life insurance and individual health insurance if you are obese.

9. Exercise more.

It's harder to quantify what you'll save in health care costs by exercising more since this number is also linked to losing weight through dieting. But generally speaking, exercising not only improves your health, it also saves you money when you purchase life insurance because healthy people live longer, and longer life expectancies mean better life insurance rates. Many studies show it's never too late to start exercising and that even small improvements in your fitness level can improve your health and longevity.

10. Seek out free or low-cost health screenings, checkups and services.

Does your HMO offer free blood pressure checks? Low-cost flu costs or nutrition, dieting and physical fitness classes? Take advantage of these lifestyle programs to help you stay healthy and reduce your doctor visits and medications.

11. Raise your deductible or co-payment.

Whenever possible and financially practical, lower your monthly health insurance premium by raising your deductible or co-payment. But make sure that you can pay these potential out-of-pocket costs should you have to.

12. Haggle with your doctor.

There's nothing new about people asking for discounts on medical treatments — there's a long history of patients negotiating with their providers for lower prices on elective procedures, such as laser vision surgery or psychotherapy. So establish the price you believe is reasonable and go for it.

13. Investigate your State Children's Health Insurance Program.

The State Children's Health Insurance Program (SCHIP) is a federally funded program designed to provide health and dental coverage for children whose parents can't afford private health insurance. Every state has its own SCHIP program and is allowed to make its own rules regarding policies and eligibility, within certain parameters. Families that do not currently have health insurance are likely to be eligible, even if parents are working. For little or no cost, SCHIP pays for doctor visits, immunizations, hospitalizations and emergency room visits.

In addition, some states have expanded SCHIP and Medicaid in order to cover pregnant woman and other adults who might otherwise go uninsured.

If you think your child might be eligible, you can get more information about SCHIP in your state by calling the nationwide toll-free hotline, (877) KIDS-NOW, or visiting the InsureKidsNow.gov Web site, which offers information about eligibility in your state and applying for coverage. For more, see State Children's Health Insurance Program.