While the Affordable Care Act (ACA) has given more Americans access to health insurance, many of the plans come with high deductibles. The percentage of insured workers who face a deductible of $1,000 or more grew from 6% in 2006 to 32% in 2014. Today, consumers need to approach medical care as they do other purchases—shopping for both quality and price. Unfortunately, our health care system is not set up for easy comparison shopping. Here are some tips for saving money on health care in 2015.

Check Your Bills and Statements

Know your insurance policy and what it covers before you need to use it. Read the fine print to find out about preapprovals, emergency room visits, copays for doctor visits, and coinsurance for procedures, as well as “wellness” benefits like preventative care screening, gym membership, and weight loss programs.

Always ask for itemized bills and check them, as well as insurance company statements for errors. Was the same procedure covered for one member of your family and not another? Was it covered last time and not this time? Don’t be shy about asking your doctor’s billing office to resubmit a bill to your insurance company for an item you believe should have been covered.

The same goes for calling the insurance company to question why certain items were not covered. Even those with the best insurance policies often get bills for procedures that should be covered. A mistake in coding can mean a difference of hundreds of dollars.

Prescription Medications

Check prescription medications to see if any of them have gone off patent. For medications that are off patent there may be cheaper generic equivalents. Consult your prescribing physician before switching. When a doctor prescribes a new drug, ask if there are less expensive alternatives.

Many pharmacies extend special offers on certain prescription drugs. Shop around for the best discounts. Search web pharmacies and mail order pharmacies for even deeper discounts. Check the website GoodRX.com, which gives price comparisons based on your location.

Live Healthy

Probably the best way to be proactive about health care savings is to be proactive about your health. Eat well, exercise, and steer clear of unhealthy habits like smoking and excessive drinking. According to the Center for Disease Control and Prevention (CDC) it costs 18% more to insure a smoker. Medical costs for people who are obese are also significantly higher.

Many insurance companies now offer good health incentives to clients to maintain or improve their healthy lifestyles. Sometimes they will provide a percentage off the cost of gym membership or weight loss programs.

Preventive care is another key to keeping health care costs down over time. Annual checkups give your doctor an opportunity to recommend screenings, provide medical advice, and identify health concerns before they become major issues. By law, ACA-compliant insurance plans offer a number of screenings with no copays. When possible, also take advantage of free screenings provided at health fairs.

Shop Around and Plan Ahead

If you need to see a doctor after hours, don’t visit an ER unless the condition is truly life-threatening. Consider an urgent care center or convenience-care clinic. You can save hundreds of dollars for relatively minor issues like stitches for minor cuts, a sprained ankle, or routine x-rays. Investigate the facilities near you before you need them so you can make the right choice when you do.

Items like flu shots, physicals, and cholesterol and blood tests may be cheaper at walk-in retail clinics. Blood can sometimes be drawn at a clinical laboratory service. Instead of paying for 20 sessions of physical therapy, pay for one and learn exercises to do at home. Get copies of all your medical test results and records. Bringing them to consultations can cut the number of tests and office visits required.

Be sure to compare prices. Don’t be afraid to ask about prices and discounts for cash payment and express the fact that cost is a concern to you. Ask a lot of questions: Is this test really necessary? Are there less expensive alternatives to this treatment? Is it possible to wait and see if the issue resolves before ordering an expensive test?

Nailing down a price is difficult because there are multiple players involved in most procedures. One clinic’s fee may include the surgeon, anesthesiologist, and facility, while another may bill separately for each. Find out the specifics, make sure they’re all part of your insurance plan, and then compare prices.

Reassess Your Coverage

Hold onto all of your out of pocket health care receipts for the entire year. This includes all medications, deductibles, eyeglasses, and dental care. If you are the primary caregiver for an older relative keep receipts for those expenses as well. A tax preparer or accountant can advise you on possible deductions.

As the year winds to a close and the next open season arrives, it’s time to examine how your insurance policy is working for you. The coverage you selected last year may no longer be the best option. Information online can be incomplete or outdated, so call the your doctors to make sure they’re still participating in plans you’re considering.