A recent survey showed that 22 percent of Americans considered health care the most critical problem facing the United States today. And for good reason. Since 2000, health care costs have nearly doubled, increasing the rate of pay increases five times.

The good news is that there are things families can do to lower those costs.

Enroll in an HMO

If yours is a healthy family that only uses a lot of routine care, you can probably get by with a Health Maintenance Organization (HMO) plan, if such a plan is available at your workplace. If you use doctors within the HMO network, you probably won’t have to pay deductibles and your copays will likely be lower.

Pay less for medications

One area where you could cut health care costs is in medications. Many employers offer financial incentives to encourage the use of less expensive drugs. In fact, nearly nine out of 10 workers are now in some type of plan that has a tiered cost-sharing formula for drugs.

The way they work is that there is a copayment for generic drugs. Then there is generally a higher copayment for preferred brand-name drugs, such as Claritan or Levatol, for which there is no generic substitute, and even higher copays for non-preferred drugs.

Be sure to always check with your doctor or pharmacist to see if there is a generic substitute before filling a prescription. Generics generally cost 30 to 70 percent less than brand name drugs with an average copayment of just $ 10 vs. $ 33 for a non-preferred brand name drug. If there is no generic equivalent to the drug you have been prescribed, ask your insurer or the company’s human resources department if there is a substitute drug that would cost less with your health plan.

Take advantage of a flexible spending account (FSA)

An FSA allows you to deduct pre-tax money from your paycheck to cover out-of-pocket medical expenses. The good news has also gotten even better, as the list of expenses you can pay with FSA dollars has been dramatically expanded. In fact, the list now includes most of the over-the-counter drugs and new services that make it easy to spend on your own. Yet despite all the many benefits of FSAs, only about 20 percent of eligible employees currently take advantage of them.

While contributions vary by employer, you can often contribute up to $ 5,000 per year. Given this, you will save up to 30 percent on your federal income tax. Naturally, this will vary depending on your tax bracket.

You can use FSA dollars to pay insurance deductibles and copayments, and for unreimbursed expenses like acupuncture, contact lenses, flu shots, and LASIC surgery. You can find a list of eligible items at irs.gov.

Be sure to ask your human resources department about the availability of an FSA. You can only choose to contribute to an FSA during a particular calendar year during an open enrollment benefit period or if you have had a life-changing event, such as a marriage or the birth of a child.

Fight against overloads

No one is perfect, including doctors and hospital billing departments. Billing overcharges can occur that cost you literally thousands of dollars.

Consider the case of a patient who received a bill of $ 15,333 for 49 vials of Pepcid. The correct amount: $ 317. Typos like this can happen, and as you can see, they can be very expensive.

Keep a list of all the lab tests, medications, procedures, and specialists you have seen during an illness. Then don’t pay any bills until you see detailed statements. Compare these statements to the list you kept for common errors, such as incorrect dates of service and duplicate or incorrect drug orders. If you find an error, call the hospital billing department or doctor and your insurance company to correct the error.

Play let’s make a deal

While this may seem like a stretch, it is sometimes possible to negotiate lower prices. Some employees have found that they were able to negotiate with their pharmacists. Other employees, although less numerous, have successfully played “let’s make a deal” with doctors, dentists and hospitals. In fact, this can be surprisingly successful, as patients who have negotiated have obtained a lower rate in about half of all cases.

Naturally, you don’t want to try to negotiate emergency care, but you may be able to save money on expensive services like orthodontics or LASIK surgery.

Where can you trade most successfully? Try young doctors who are just starting a practice or doctors with whom you have a long history. Before beginning any negotiation, call your insurance company and see what they consider to be a reasonable and customary charge for the procedure. Then try to have your doctor cap your bill to that amount, as provider prices are typically 25 to 50 percent higher than what the insurance company would pay. If possible, offer to pay part of your bill in cash.

Lowering the cost of your health care is not easy. But if you’re willing to get the job done and see all the options available, you may be able to bring them a scalpel.