Q: My employer is asking me to contribute a lot more to my health insurance plan for 2018. Is there anything I can do to mitigate the cost?

A: You aren't the only one feeling sticker shock now that it's time to choose a health insurance plan for 2018. 

As health insurance premiums have skyrocketed over the last years, so has the employee share of the cost. Employees are being asked to kick in an average of 3 percent more this year for a family plan, according to the 2017 Employer Health Benefits Survey by Kaiser Family Foundation, a nonprofit organization focused on health policy issues.

Over the past five years, premiums employees pay are up an average of 19 percent, says Kaiser. They're up 55 percent since 2007.

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In addition to higher premiums, people are paying more out of pocket for their healthcare. Half of workers with individual coverage have an annual deductible—what you must pay before insurance starts to foot some of the bill—of $1,000 or more, up 34 percent from five years ago. Even after meeting the deductible, most workers also pay a portion of the cost for doctor visits and treatments through copays (a flat fee) or co-insurance (a percentage of the covered amount).

The good news is that employers still pay the bulk of the cost of insurance for workers, and there's lots you can do to reduce the pain of paying for your medical needs. Now that open enrollment is in full swing, here are six strategies to save money without sacrificing the quality of care you get.

Confused about choosing a health insurance plan for 2018? Send us your questions about signing up for job-based insurance, Medicare or a plan sold on the ACA exchanges. 

Don't Renew Last Year's Plan by Default

There’s a lot more to consider than premiums when choosing a healthcare plan. More than 90 percent of people pick the same plan—medical, dental, vison—as the year before and 57 percent spent less than 30 minutes researching their options, according to a survey by Aflac, an insurance benefits provider.

Don't automatically renew the plan you have just because it's the option with the lowest monthly cost. Plans change every year and so do the doctors who take them.

A plan with low premiums will have higher out-of-pocket costs in terms of copays, co-insurance, and deductibles. That can make sense if you didn’t spend a lot on copays or come close to meeting your deductible last year.

But if you expect to quickly hit your deductible (perhaps because of a chronic health condition that requires frequent doctor visits), choosing a plan with a higher premium and a lower deductible could save you money overall.

Use Price-Shopping Tools

Figuring out what your future health expenses might be isn’t easy. But most insurance companies offer tools to help you do this.  An estimated three in four privately insured consumers have access to a cost-estimator tool through their insurer.

Yet a CR Health Ratings Center Study found that just 13 percent of people used their insurer's cost-estimator tool, one main reason being that they didn't know it was there. So explore your insurer’s website or call to ask if a cost-estimator tool is available to you. If your insurer doesn’t offer one, you can find one online.

There are over 60 standalone and publicly available websites that can help you compare costs. Consumer Reports ranked Amino the highest in an analysis of 8 standalone sites last year, based on qualities like ease of use, functionality, and reliability.

Using these tools can save you thousands of dollars. According to Guroo.com, another standalone website, a hip replacement in New York can cost you anywhere from $29,990 to $59,729 depending on the doctor and facility you go to. Follow our six steps to using cost-estimator tools effectively.

Take Advantage of What's Free

Thanks to provisions put in place by the Affordable Care Act, you are entitled to a number of preventive services at no charge, as long as you stay in your insurance network.

The range of no-cost services may surprise you, from colonoscopies and vaccinations to depression screening and nutrition counseling. Check out the full list of eligible services here. Taking care of yourself now could prevent needing expensive care later.

Consumer Reports is working with WNYC-New York Public Radio to make sure We’ve Got You Covered during open enrollment. We’ll help you find the best health-insurance plan to fit your needs, answer your questions and explain the challenges consumers face choosing health insurance for the coming year.

Choose Your Primary Care Doctor Wisely

There can be a correlation between what your primary care doctor charges and what you pay for other specialized services you may need.

Finding a primary care doctor who charges less for an office visit can help you realize big savings when you need him or her to refer you to other doctors and services, says Ateev Mehrotra, M.D., M.P.H., associate professor of health care policy and medicine at Harvard Medical School.

Research led by Mehrotra in 2016 found that total annual spending for patients who chose a lower-cost primary care physician was $690 less than for those who chose a doctor who charged more for office visits.

Compared to patients with a higher-priced physician, patients who used primary care doctors who charged less also found cheaper prices for almost all other outpatient services, including specialist visits and common lab tests.

Avoid the Hospital

If you have to get lab work done or need an imaging test like an MRI, avoid a hospital-based practice, and consider using an independent lab like Lab Corp or Quest Diagnostics. 

The hospital price for a urinalysis or CT scan, for example, can be twice that of a freestanding facility, according to the Healthcare Financial Management Association, a membership group of healthcare finance leaders. 

“There’s a huge markup for being affiliated with a hospital,” Mehrotra says.  Go to an independent provider for tests, and “you’ll save a ton.”  Ask your doctor to recommend a facility.

Leverage Tax Breaks

You can ease the pain of high out-of-pocket medical costs by putting money into a flexible spending account (FSA) or a health savings account (HSA). Both allow you to set aside tax-free dollars to cover costs that your insurance doesn’t.

You can put up to $2,550 into an FSA annually and $3,400 into an HSA ($6,750 if you have family coverage). Go here for details on how they work.