A front-burner issue around the country right now is health-care expenses, which are beginning to increase this time of year with seasonal influenza, the pandemic H1N1 virus, and simple colds and respiratory illnesses that can be found throughout the Quad-City area.

But there are ways to stretch your medical expense dollars these days, according to experts at the Mayo Clinic in Rochester, Minn. The key is to work closely with your care providers, your insurance carrier and pharmacies to avoid unnecessary hospital visits and, hopefully, stay well in the first place.

Here is a list of tips, broken down by category, from the Mayo Clinic, Genesis and Trinity Health centers and the American Cancer Society:

Providers

* Ask in advance about fees, including an estimate of the total expenses for your care. Check with the insurance company about what's covered.

* Ask the doctor to be a partner in reducing costs. Your care provider might avoid duplicating tests or suggest lower-cost treatment options.

* Use nursing advice hotlines. Many health plans, hospitals and some medical practices offer services that allow patients to call for medical advice. Talking with a nurse first may be especially helpful when it's unclear whether a medical appointment is needed.

Locally, such a service is Trinity's My Nurse. "Typically, callers ask about symptoms," said Michele Gogerty, the director of health and wellness programs for Iowa Health System, the parent company of Trinity Regional Health System in the Quad-Cities.

The program has experienced a substantial increase in use, she said. It tallied 431,972 calls in 2008, a record. The

telephone service (309-779-2000 and 877-242-8899) covers Iowa, parts of Illinois and Nebraska.

"A lot of people don't have health insurance anymore," she said, a reference to the recession's impact.

Callers may decide whether they can handle their problems at home or not. Trinity's My

Nurse also refers callers to various resources,

such as Community Health Care centers in the Quad-Cities, where clients use a sliding fee schedule to pay for medical services.

Insurance

* Pay premiums annually. Many policies offer discounts when premiums are paid on time and in full.

* Read the benefits information to make sure the insurer is paying for everything that's covered. If it appears a claim has been denied in error, appeal the decision.

* Look for special services and extras such as discounts on a gym membership, a weight-loss program or medical equipment rental.

Medications

* Choose generic. They have the same active ingredients as brand-name drugs and cost less.

* Shop around. Prices vary from one pharmacy to another.

* Split pills if possible. The co-pay may be the same for a higher-dose prescription as for a lower dose. Check with the prescribing physician about this option.

Hospital care

* Avoid the emergency department unless it's absolutely necessary. Instead, consider a nursing advice hotline or an urgent-care center.

For those without insurance, try a clinic with a sliding-fee scale payment plan such as Community Health Care, which has offices in Davenport, Rock Island and Moline. (Telephone 563-322-8995 and 888-498-7224.)

Half of all emergency room visits could be treated in a doctor's office or urgent-care setting, said Dr. Randel Cardott, the medical director for the Genesis Convenient Care Clinics in Moline, Bettendorf and Davenport.

"One key is having a doctor-patient relationship so that patients can get some help to decide where the appropriate place to access health care is," he said. "Kids with sore throats don't need to be in an emergency room."

* Use outpatient services when possible. Tests and procedures that can be done without an overnight hospital stay cost less.

Stay well

* Maintain a healthy weight to prevent and control serious and costly health conditions, including diabetes and heart disease.

* Give up expensive, unhealthy habits. Drink in moderation, if at all. Smoking is the single greatest cause of preventable death and illness in the United States.

However, the smoking rate in Iowa has decreased 39 percent since 2002, according to Chuck Reed of the American Cancer Society office in Des Moines.

"The two biggest factors in reducing that rate were to increase the tax on tobacco products and the smoke-free air legislation," he said. Studies show that the way to decrease smoking rates is to make it more expensive and more difficult to do. Also, children who do not smoke before the reaching the age of 19 are much less likely to take up the habit later in life, he added.

* Make the basics of good health a priority. Floss and brush your teeth daily. Use safety belts and bike helmets. Wear sunscreen. Wash your hands frequently with soap and water.