updated 3/24/2009 5:30:33 PM ET 2009-03-24T21:30:33

Even in an ailing economy, the one budget item you shouldn't stop nursing is your health.

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It's an oft-repeated sentiment, but easy to forget when copays for doctor visits and medical procedures are piling up. In some cases, past frustrations with the medical profession's often confusing billing process might make you reluctant to throw any more money its way.

Whatever the reason, the numbers show more people are postponing care amid the deepening recession.

In a recent poll by the Kaiser Family Foundation, 53 percent of respondents said they or a family member cut back on health care because of costs.

The most common actions reported were relying on home remedies and over-the-counter drugs rather than visiting a doctor, according to the national poll. Other actions included not filling a prescription or skipping a recommended medical test or treatment.

Your own prognosis — financial and medical — can be improved by knowing how to navigate the system. Here are a few tips.

Save on copays
To cut down on repeated office visits and copays, don't walk into a doctor's office unprepared. Go armed with any past medical records your doctor might want to see.

"If it's a significant medical issue like a heart attack, it doesn't matter if it was five or 10 years ago," said Seth Feltheimer, an internist at NewYork-Presbyterian Hospital/Columbia University Medical Center.

Start collecting your records a month before your appointment, because getting paperwork from hospitals and doctor offices can be a slow process. You might even want request records now even if you don't have any plans to see your physician, so that you'll be ready when the time comes.

Jot down how you've been feeling recently, too. Make a note of any changes in your weight, energy and overall well-being in the past six months. Write down any questions you have so you don't forget anything once in the exam room.

Another way to keep down costs is to follow up on test results over the phone. Most doctors shouldn't have any problems with this arrangement. The doctor should let you know if there is any pressing need to return to the office.

"We're busy and respect that patients are busy as well," said Susan Malley, an obstetrician/gynecologist at Westchester Health, based in Katonah, N.Y.

Some doctors, like Malley, also give out their e-mail address.

Lastly, remember that you can get the most from your health plan by seeing an in-network doctor. If you go to an out-of-network doctor, copays can be up to 50 percent higher.

Tap flexible spending accounts
Consider starting a flexible spending account for health care costs during the next open enrollment period. This lets workers set aside pretax dollars to pay for certain qualified medical expenses, such as copays, deductibles and even over-the-counter drugs.

If you're already enrolled, remember that you can use the account to pay for over-the-counter drugs and in some cases,transportation expenses for a medical visit. That includes parking fees, a bus ticket or miles traveled in your car.

Slideshow: Perspectives on health care Just make sure you spend any money you set aside by the end of the plan year. Otherwise, you forfeit what's left in the account.

Ask about financial health
Hospitals and clinics usually have formal financial assistance programs. But doctors at small practices might be willing to work with patients one-on-one.

For instance, Feltheimer of New York Presbyterian often reduces his fee to about $50 a visit for the uninsured or out-of-work, down from the usual fee of about $100.

"It's all on a case-by-case basis. But most doctors will work out a payment schedule, so it never hurts to ask," Feltheimer said.

At Westchester Health, Malley makes it a point to save free medications from drug companies for patients she knows are struggling financially.

Those with chronic, debilitating diseases can tap the Patient Advocate Foundation, which offers help negotiating with insurers. The nonprofit can help patients ensure they're getting the most out of their plan, said Erin Moaratty, a spokeswoman for the group, which is based in Newport News, Va.

There are no financial requirements to qualify for help. Patients can call (800) 532-5274 to be assigned a case manager.

Its sister organization, Patient Advocate Foundation Co-Pay Relief, also provides monetary assistance for people with a specific chronic disease, such as diabetes, osteoporosis and rheumatoid arthritis.

Consider store-based clinics
If you don't have insurance, consider a clinic based in retailers such as Wal-Mart or Target. Clinics are staffed mostly by nurse practitioners and treat routine conditions such as colds, bladder infections, sunburn.

They typically charge between $40 to $70 for patients without insurance, according to the Convenient Care Association, an industry trade group.

Doctor visits for the uninsured can easily cost twice that. Most in-store clinics also accept insurance co-payments.

The bottom line is that no matter what your financial situation, there are options to ensure your health doesn't take a back seat to your budget. Besides, spending money on care now can stave off more serious, costlier conditions down the road.

Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


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