Picking the right healthcare plan can save your family money. The process can be confusing - even for us professionals! If you're like many people, you made a choice when you were first hired and haven't looked at it since.

It's important to assess what you currently spend on healthcare. Add up last year's premiums, copayments and deductibles. Now, think about what in your situation will change this year. Are you expecting a baby? Will a child come off your insurance? Do you wear glasses? Does a child need orthodontia?

Consider all of these things before making decisions. Choose intelligently. The following sections describe some things to consider.

Prescription Coverage
Prescription coverage is a common health insurance benefit. This is important if you have a chronic condition. It's critical to read the fine print of the plan. Does it require mail order only? Must you use generics at all times? If you are in good health and rarely use prescription drugs, this may be a benefit that you can handle in another way, for example, with a flexible spending account.

Flexible Spending Accounts
Flexible Spending Accounts (FSAs) may be funded with pretax dollars, exempt from federal, state (in most cases) and Social Security taxes. By reimbursing yourself from your pretax savings account, you are able to pay these expenses tax-free. Some of the eligible expenses for the Health Care Reimbursement Account FSA include out-of-pocket healthcare expenses such as deductibles, copayments and certain over-the-counter medications, weight-loss programs and smoking cessation products. Funds placed in the Child and Elder Care Reimbursement Account can be used for daycare expenses, nursery school, care for an elderly dependent or summer camp tuition.

One caveat with FSA is that it is "use it or lose it." Each year 14% of consumers leave an average of $723 in their flexible spending accounts.

Health Savings Accounts
Health Savings Accounts (HSAs) allow consumers to pay for qualified medical expenses with pretax dollars - meaning income-tax free - and save for retirement on a tax-deferred basis. An HSA is tax-favored savings account that is used in conjunction with a high-deductible HSA-eligible health insurance plan to make healthcare more affordable and to save for retirement. HSAs are similar to individual retirement accounts (IRAs).

Pretax money is deposited each year into an HSA and can be easily withdrawn at any time with no penalty or taxes to pay for qualified medical expenses. Withdrawals can also be made for nonmedical purposes, but these will be taxed as normal income and are subject to a 10% penalty if done prior to age 65. Any HSA funds not used each year remain in the account and earn interest tax-free to supplement medical expenses at any time in the future. Like an IRA, the account belongs to you, not your employer. But unlike an IRA, your employer can contribute to your HSA.

Typically, an HSA will provide you with a checkbook or debit card. When you pay for a qualified medical expense, use the debit card or check to make the payment. HSAs can be used to pay for many types of medical expenses, even some that are often excluded on health insurance plans. These include health insurance plan deductibles, copayments and coinsurance; prescription and over-the-counter drugs; dental services, including braces, bridges and crowns; vision care, including glasses and Lasik eye surgery; psychiatric and certain psychological treatments; long-term care services; and medical-related transportation and lodging.

Dental Coverage
Dental insurance is usually separate from basic healthcare insurance plans. Most dental policies cover basic preventive and diagnostic services. Orthodontic benefits are available for dependent children at an additional charge. Newer types of fillings (e.g., tooth-colored composite material) are usually not covered.

If you have no chronic dental conditions, the cost of yearly professional cleaning and a set of x-rays for each family member may be less than the cost of a full year of dental insurance. A review of dental studies from the University of North Carolina did not identify an advantage to more frequent visits. It may be worth calling your dentist and asking the cost of a year's worth of visits and comparing that to the cost of dental insurance.

Vision Coverage
Do not give up the benefit of yearly exams if a family member wears glasses or has a family history of eye disease, diabetes or high blood pressure. If you don't fit into any of those categories and you are younger than 65, you do not necessarily need annual checkups. The American Academy of Ophthalmology recommends an eye exam once during your 20s, twice during your 30s, at age 40 and thereafter as needed.

Other Ways to Save
It is in your healthcare plan's best interest to keep you in top shape. Many insurance plans include discounts on "healthy living" products. These can vary from fitness club memberships to massage therapy.  Many now provide low-cost smoking cessation and weight loss programs. Alternative therapy and senior services may be available. The Web site for your healthcare plan has a wealth of information about these services. Investigate before spending out-of-pocket for anything related to health.

Always take a close look at medical and hospital bills. Review each charge. Errors are common, from transposed coding numbers to double billing. It pays to check. The same way you would not pay your credit card bill without making sure each charge was appropriate, you should not OK an insurance payment without making sure that it is accurate.

Final Words
Read the fine print of your plan. Recently, we got nailed with a large bill because my son needed a procedure at college, which was "out of network." Even though it was considered an emergency, we were told he had to pay up front because we didn't have a referral. Six weeks later, after some complaining, letter writing, documentation and an appeal, I was reimbursed. Pay attention, and be persistent. Be a respectful, squeaky wheel.

Laurel Halloran is a family nurse practitioner with a PhD. She is a professor at Western Connecticut State University in Danbury and practices in the pulmonary department at Danbury Hospital. She is a member of the ADVANCE for Nurse Practitioners editorial advisory board.