One of the most important benefits employed people enjoy is health insurance coverage. It is also the single most costly expense for self-employed entrepreneurs. So what can you do to reduce ever increasing costs of health care coverage? Here are a few tips.

1. If a medical bill seems excessive, try negotiating

Your doctor or the office manager who handles billing will probably be flexible, provided you make a valid case. When one woman in Texas was charged $900 for surgery and "consultation," she explained that she had visited the hospital just once, for surgery; her bill was promptly cut by $370.

2. Contact a medical bill "auditor"

Several services have a medical bill "auditing" system that evaluates your medical bills to determine if errors occurred in the billing process. Considering that 97 percent of hospital medical bills contain errors, it's no wonder why out-of-pocket medical expenses are on the rise for consumers. Because the typical hospital bill is extremely complicated, often containing several hundred line-item charges, there is ample opportunity for computer mistakes and accidental human error. Do a Google search for medical bill auditors to find companies offering this service.

3. You may get a tax break on your medical bills

Keep all your medical bills together and add them up at tax time. If they exceed 7.5 percent of your adjusted gross income, you may deduct the excess. Please note that these items also may be included in the total: the cost of eye glasses, contact lenses, physical therapy, x-rays, hearing aids, psychiatric care, insurance and transportation to the hospital or doctor's office (at 30 cents a mile). There are phase-outs in some cases based on adjusted gross income. Check with your professional tax adviser.

4. Deduct 100% of your healthcare costs from your taxes

The IRS allows all self-employed to deduct 100% of health care costs from their taxes by using Section 105 of the Internal Revenue Code. To receive this deduction, you must do the following:

a) Hire your spouse as an employee of your business.

b) Have your spouse receive health insurance in his or her name, and include the family on the policy.

c) Pay your spouse a salary that will cover the costs of the insurance.

d) Talk to your tax professional about planning for Section 105 on your taxes.

We all know your spouse is active in your business. Now, you can equally recognize their contribution he or she makes ? and get Uncle Sam to give you a tax break.

5. Help for families with kids -- CHIP

All states have established new programs that help lower income families with children to pay for health insurance for their kids. Financed partly by the federal government, the Children's Health Insurance Programs (CHIP) operate either as an expansion of the state's Medicaid program or a subsidy for basic private health insurance. Eligible families may be able to access coverage for their children at greatly reduced premiums which will vary depending upon family income. Contact your state Department of Health or Insurance for more information.

6. Shop around

Hospital costs vary widely, especially between urban and rural facilities. If your doctor has admitting privileges at more than one hospital, find out if you can be admitted to the one that's less expensive. Keep in mind that hospitals operated by non-profit foundations are usually less expensive than investor-owned, for profit hospitals. To find out how much your local hospitals charge, ask your doctor. Many states have Health Services Cost Review Commissions, which compile such data.

7. Check for free clinics in your community

You and your entire family can save hundreds of dollars by taking advantage of the many free screenings, immunizations, and other health clinics offered by your local community or a town near you. Numerous community hospitals and social services can provide blood pressure checks, shots for your children, free contraceptives and/or advice, and other preventative health care at little to no cost.

8. Get a second opinion out of town

Believe it or not, your chance of undergoing an expensive surgery or preventative procedure may depend solely on where you happen to live. Statistics show that the frequency in which certain medical procedures are performed varies widely from location to location. For example, residents of New Haven, Conn., are twice as likely to undergo a coronary bypass operation as residents of Boston, Mass. What's the reason for this discrepancy? One Dartmouth Medical School expert, John E. Wennberg, M.D., M.H.P., explains that certain operations are simply more fashionable in some parts of the United States than others. So, if you plan to get a second opinion prior to surgery, consider going to a specialist in another city. In addition, try to find out what the surgery rates for your procedure are in different cities. HealthAllies.com also offers this service online at www.healthallies.com. To get the names of second-opinion doctors in your region, call the U.S. government's toll-free second-opinion hotline at 1-800-638-6833.

9. Don't pay double for a second opinion

As you make arrangements for a second opinion, ask your doctor to send copies of your medical records, x-rays, and lab tests to the second-opinion doctor. These tests don't need duplication; your second doctor will have the information he or she needs ? and you don't pay double.

10. Emotional stability

Your mental health is equally important as your physical health. Do you have blue days once in awhile, or struggle with gray winters? St. John's Wort, an over-the-counter herbal supplement, has been proven to increase positive moods. Before rushing to your family physician for medication to make you feel better, try supplements with a combination of expressing your feelings with friends and a healthy lifestyle. Mood stabilizers are some of the most costly medications on the market today. However, you should be aware of the signs of stress or even depression. Give yourself a simple screening test:

Do you have feelings of sadness and/or irritability?

Has there been a loss of interest in pleasure activities you once enjoyed?

Have there been changes in your weight or appetite?

Have you noticed changes in your sleeping pattern? Are you feeling guilty?

Do you have the inability to concentrate, remember things or make decisions?

Are you fatigued or have a loss of energy?

Do you experience restlessness or decreased activity noticed by others?

Do you have feelings of hopelessness or worthlessness?

Do you have thoughts of suicide or death?

If you answer "yes" to any of these questions, consider consulting your family physician. If they recommend mental health treatment, it is more cost-effective to have your family physician prescribe mood stabilizers instead of seeing a psychiatrist. However, follow your doctor's instructions on counseling and referrals to mental health professionals.

11. Order your prescription drugs by phone, web or mail

There are many discount prescription drug benefits available for a modest cost. Communicating for Agriculture and the Self-Employed offers a free prescription card through PCS. This program saves its members up to 40 percent at over 55,000 pharmacies nationwide. On average, CA members save $9.39 per prescription order. You can enroll free on their Web site at www.selfemployedcountry.org.

12. Ask your doctor to prescribe generic drugs

Medicine marketed under its scientific name is usually 50 percent cheaper and just as effective as brand-name versions. In addition, look for generic drugs in the medicine you purchase over the counter. For example, 100 generic aspirin may cost $1.79; the same ingredients packaged under a well-known brand name can cost more than $5 for 100 tablets. Consider, also, just how important the new easy-to-swallow products are to your comfort. The lesser price of some medicines may be comparably easier to swallow when thinking about your budget.

13. Get enrolled in a group plan

For self employed people including those involved in small businesses, individual health insurance can be extremely costly ? sometimes as much as 30 percent of your take home pay. By joining associations like National Association for the Self Employed (www.nase.org), you have the opportunity to enroll in a group insurance plan with unique built-in cost controls.

14. Choose a higher deductible

Often for the healthy family, the number of visits to the doctor totals less than $250 a year, a normally low deductible rate. This low deduction rate, however, can end up costing you more in the form of higher premiums. If your family has enjoyed good health for a number of years, you may want to switch to a higher deductible of $500 or $1000. You'll notice greatly reduced premiums.

15. Pay premiums annually

You avoid the service fee and may also receive a discount from your insurance carrier. Check with your insurance agent about how much money you can save if you pay your premium one time during the year.

16. Make sure there's a ceiling for out-of-pocket expenses for catastrophic illnesses

About half of individual policyholders lack this important provision, according to insurance experts, who recommend a major medical policy with a stop-loss clause limiting policyholder payout to $2,000 or $3,000.

17. Get educated about your health

Invest in your health by becoming information-rich. Read publications about health care. Pay special attention to free wellness publications like Inside Mayo Clinic at www.mayo.edu/healthinfo/public.html or have on hand a book on medical self-care, like The AAFP Family Health and Medical Guide and The Merck Manual of Diagnosis and Therapy. A wealth of information is also available on the Internet.

18. Take advantage of free health advice

For free information booklets from the U.S. government about nearly every health care topic you can imagine, simply write to the Consumer Information Center in Pueblo, Colorado. The government offers several dozen booklets on topics ranging from nutrition, medical problems, mental health, to drugs, exercise and weight control. To receive a catalog explaining these booklets, write to:

Consumer Information Center
PO Box 100
Pueblo, CO 81009
www.pueblo.gsa.gov (you can download booklets from this site)

Once again the U.S. Government comes through by providing a number of toll free health care information phone services. Topics are numerous, including hearing aids, cancer information, Alzheimer's disease, drugs and pregnancy issues. For information on the health topics and phone numbers, call the National Health Information Center at 1-800-336-4797.

19. Brush up on first-aid skills and become CPR certified.

Proper treatment of various accidents may reduce the number of visits to the doctor, and can save lives in an emergency. It's important to always keep an updated medical kit in your home or office.

Here are the basics for your first-aid kit:

bandage supplies, including a roll of 3 inch wide gauze, individually packaged 4 inch sterile gauze pads, a roll of 1 inch bandage tape, butterfly bandage tape, and scissors elastic bandages cotton swabs sterile dressings or towels pain reliever (acetaminophen or ibuprofen) anti-inflammatory medicine (ibuprofen) ipecac syrup (for use on advice of medical professional to induce vomiting) tweezers hydrogen peroxide skin creams, including hydrocortisone cream, calamine lotion and antibiotic creams an antihistamine (diphenhydramine for allergic reactions) flashlight eye patch arm sling tongue depressors (to be used as a finger splint) ice pack re-hydration fluids (such as Pedialyte or Infalyte)

20. Take a lifestyle approach to wellness ? every day

Take charge of your health by making simple changes in your lifestyle. By following these seven basic rules of good health, you'll improve your chances of living a long, healthy, active life.

Get eight hours of sleep per night.

Eat breakfast every morning.

Cut down on snacks between meals.

Keep within 10 pounds of your recommended weight range. If you're unsure what your weight range should be check with your doctor.

Exercise aerobically for at least 30 minutes three times per week.

Don't smoke.

Don't drink more than two alcoholic beverages per day.

Take recommended dosages of vitamins and supplements.

Copyright 2004, Monikah Ogando, Ogando Associates, Inc.

Monikah Ogando is a highly skilled facilitator and charismatic speaker. She continues to inspire her audience through her expertise in Business Development, leadership effectiveness, individual accountability and the values that guide excellence.

She practices what she speaks: an entrepreneur, Monikah leads her own two companies, consulting firm Ogando Associates and Exodus House Publishers and is a Team Member of Solo-E.com.