Many people feel that, between their employer choosing their insurance provider and their insurer and doctor working out the price of care, they have no control over what it costs to stay healthy.

But you can take control of your out-of-pocket expenses.

"People spend more time shopping for cars than they do for their health," said Michelle Katz, author of "Health Care For Less" and "101 Health Insurance Tips."

Katz said health care costs aren't set in stone. People can negotiate for the best price their doctors can offer and shouldn't be afraid to shop around, she said.

"I called a surgeon, he quoted one price. I asked for a deal. He was able to negotiate a lower price," Katz said, recounting her own experience with back surgery.

If you're uninsured, or have to pay a high deductible before insurance kicks in, consider offering cash.

"Your best bet is to pick up the phone," Katz said. "Go to Medicare.gov and see what the rock-bottom prices are. If you are offering cash, offer the Medicare price up front and the doctor won't have to deal with insurance."

Get Right Care At Right Time

Wayne Sensor, the chief executive officer of Alegent Health, said emergency rooms are overused by people who don't need the highly specialized and most expensive care a hospital has to offer.

"(Ask any) ER physician, 'How many of the people you've seen in last 24 hours were there because they're in a truly emergent condition?' The figure would be 10 to 15 percent," he said.

People who aren't experiencing a true emergency have many other options for care, even after 5 p.m. or on weekends. Outpatient clinics, ambulatory care centers and clinics located in grocery stores are available. There are also 24-hour nursing hot lines that can help you make a decision about the right kind of care for your condition.

Alegent.com offers the My Cost calculator, which Sensor said allows consumers to research more than 500 procedures online and find their out-of-pocket expense before they schedule a procedure with one of the network's hospitals or clinics.

Do I Need That Procedure?

Katz said you can't expect your doctor to understand everything about your insurance plan. It is the physician's job to get you well, not save you money.

"Doctors are now practicing defensive medicine," Katz said.

The patient needs to be armed with what is covered, then challenge the doctor to make sure his recommendations are really necessary.

These kinds of questions are likely to increase as more and more Americans sign up for health savings accounts, which offer consumer-driven health care options. Consumers generally pay a higher deductible and a lower premium. Since out-of-pocket expenses are higher, consumers shop around more.

Sensor said 6 percent of all insured Americans are on a consumer-driven plan. The U.S. Treasury estimates that up to 45 million consumers will be in an HSA by 2010.

Pick Right Plan For You

Scrutinize your options each time you sign up for insurance, the experts said. Options change, and you want your plan to match your needs. If you have a favorite doctor or a chronic disease, choose the plan that covers them.

"Some employees might like acupuncture," said Katz. "If you have, say, Crohn's disease, you want to designate your primary care physician as your specialist in your HMO, if you can."

"Although employer coverage usually is still your best bet, you may do better on your own," wrote Kipplinger.com columnist Kimberly Lankford. "You can compare rates for individual policies at eHealthInsuance.com or find a broker at the National Association of Health Underwriters."

Don’t Get Sick

You can't avoid all illness or injury, but you can make the effort to avoid chronic disease.

Sensor said diabetes and heart disease are often the result of what we've done to ourselves by how we eat, live and exercise. A study published in the Archives of Internal Medicine shows that overweight study subjects spent 25 percent more on health care than people with a normal body-mass index, or BMI. Obese participants spent 44 percent more than those with a normal BMI.

"Americans spend three hours a day, on average, watching TV," Sensor said. "Including sports, recreation and exercise, we average 30 minutes a day. Think what would happen if we spent half as much time taking care of our bodies as we do watching television. We'd be incredibly healthier and spend less on our health care."

Staying healthy also means learning your risk factors early. Preventative annual checkups and participation in screenings, such as mammograms and colonoscopy, can find health issues before they require major, expensive procedures.

Do The Right Drugs

The first place to save at the pharmacy is by getting the generic version of brand-name drugs when possible.

"A prescription filled with a generic drug will cost, on average, $40 less per prescription," according to Blue Cross Blue Shield of Oklahoma.

Even if you pay a copay, many pharmacy benefit programs charge a lower or no copay for generics compared to brand names.

A host of retailers, including Wal-Mart, Target and Costco, now offer flat fees for generic drugs.

A study from Omaha's Creighton University found that not all mail-order drug programs are alike. Robert Garis said his research found that employers assume mail-order programs are better, so they encourage workers to get drugs by mail. But while some pharmacy benefit managers slash brand-name prices for mail-order drugs, they then mark up the cost of generics.

"What pharmacy card companies' salespeople do is convince the employers that the brand drug discount is so much better and don't talk about generics. There is extra markup on generics," Garis said.

It may not affect the employee's out-of-pocket expense on the drug, but it drives up overall health-care costs that make premiums higher. As such, it may be worth a chat with your human resources manager to make sure mail-order generics really are a better deal.

Scrutinize Your Bill

Whether it's a pharmacy, clinic or hospital, make sure your bill reflects the services you got. Katz said she went over a hospital bill for her husband and found an erroneous miscellaneous charge, a pharmacy charge and a wrong date. She had them corrected, and the bill was reduced.