The year is 2014, and health insurance is more affordable. It's a reality that seems a lifetime away for some.
The bulk of the historic health care law signed by President Barack Obama this week won't be rolled out for another three years. That's when states will be required to set up exchanges for those without access to employer-based plans. Insurance companies will no longer be able to charge women more, and pre-existing conditions won't prevent anyone from getting coverage.
Some provisions of the new law will come much quicker, however, and you can likely trim expenses on your own with a little research. A look at what you can do now to cut health care costs, regardless of whether you're insured:
Saving on coverage
Starting this fall, parents will be able to keep adult children on their plans until they turn 26, even if the children are married.
That's a big deal, since young adults often have jobs that don't offer health insurance, noted John McDonough, a visiting fellow at Hunter College who worked as an adviser on the Senate Health Committee in crafting the reforms. Still others may be struggling to find any work in today's economy.
Annual premiums for individual policies averaged nearly $3,000 last year, according to America's Health Insurance Plans. By comparison, those on employer-based plans might pay around $1,000 a year for much more complete coverage.
Anyone who can't obtain coverage under a family member's plan should check to see what type of state aid is available. In Massachusetts, for example, medical coverage is fully subsidized even if you earn as much as $32,500, which is about three times the federal poverty level. Above that, the state covers a percentage of premiums depending on how much you earn.
Massachusetts is an unusually generous example, but it's still worth checking what's offered in your state.
If the only option is to buy private insurance, keep in mind that individual plans usually aren't as comprehensive as employer-sponsored group plans. So be sure the necessary services are covered.
If you have a job that offers insurance, don't passively accept the default coverage option. Recently married couples should evaluate both plans to see if it's cheaper for one spouse to piggyback on the other's coverage.
When open enrollment comes around in the fall, see if there are any options that could boost savings. Flexible spending accounts, for example, let you set aside money before taxes for health-related expenses. Starting in 2013, contributions will be capped at $2,500 a year. The threshold for claiming itemized tax deductions for medical expenses will rise to 10 percent, from 7.5 percent.
Saving on office visits
Don't be shy about asking at your doctor's office about monetary assistance. Even if there isn't a formalized program, you might be able to negotiate if you can show you're in a tough situation.
And since repeated visits can add up even for the insured, make every trip worthwhile.
Have a clear idea of what you expect from an appointment, and bring a notepad listing all the questions you want answered. Be prepared with any past medical records that might be requested.
If the doctor suggests a follow-up appointment for something minor, ask if it can be addressed via phone or e-mail.
Don't automatically agree to any test or procedure either. Ask why it's necessary and if there are any alternatives.
Be especially diligent in questioning any screening tests when you're not experiencing any symptoms, said Art Levin, director for the Center for Medical Consumers.
In such scenarios, "screening is vastly oversold, to put it mildly," he said.
This isn't to say you should cut corners on your health. But your doctor may suggest a routine test that you might not feel is necessary.
Individuals with specific chronic diseases, such as diabetes, osteoporosis and rheumatoid arthritis, may be eligible for monetary assistance from The Patient Advocate Foundation Co-Pay Relief program.
Finally, if you're in a PPO plan, go to an in-network doctor. Otherwise, copays can be as much as 50 percent higher.
Saving on drug costs
Research any prescription drug your doctor recommends. Not only can the costs add up, but you might have concerns about some of the risks or side effects.
The Food and Drug Administration and the Mayo Clinic have comprehensive Web sites explaining drugs on the market.
Most people already know that generics cost significantly less, with $4-a-month programs growing increasingly popular with big box retailers. But even if a generic isn't available, there could be a cheaper, over-the-counter alternative. As a starting point for considering any changes, check .
In addition to its $4-a-month generics program, Target also offers a 3-month supply of generics for $10. Walmart's discount program includes some brand-name and over-the-counter drugs.
Comparison shopping is important too, especially for brand-name drugs such as Ambien or Prevacid. Several states run Web sites that let consumers browse prices at area drug stores. In New York, is updated every Monday.
As with health insurance in general, several states also have prescription drug discount programs for the uninsured.