1. Stay healthy

Yes, this is easier said than done, but staying healthy goes a long way toward controlling health insurance costs. If you're buying an individual health plan, you'll be charged based on your health, including weight, cholesterol, blood pressure and other pre-existing health conditions.

The uninsured provide a good snapshot of what happens when routine medical care is overlooked or delayed. An October 2007 report by the National Coalition on Health Care pointed out the uninsured receive less preventive care and thus aren’t diagnosed until they are more advanced disease stages. Once diagnosed, they tend to receive less care and suffer higher mortality rates than insured individuals.

Many insurance plans cover 100 percent of wellness care for routine checkups, immunizations and diagnostic tests.

2. Stop smoking

You've heard all the reasons why you should quit smoking, but it's also bad for your health insurance premium.

"If you use tobacco, quit — smokeless or any other type," says Laden. "This can result in savings in your health insurance after a period of time, generally a year, depending on the insurance company. The reduction is significant, so it's definitely something to consider."

Health insurers may pay for smoking-cessation programs. At renewal time, having quit smoking can amount to substantial savings.

3. Increase your deductible

Whether you are enrolled in a group or individual plan, the more you pay out of pocket, the less you will have to pay in premiums. You may want to think of your insurance as a safety net for major health disasters rather than a payer of all routine medical costs.

According to the National Association of Insurance Commissioners, the lower your deductible, the more likely you will make a claim with the health insurance company. Health insurance companies compensate for this by increasing the premium on low-deductible plans. In order to get more bang for your buck, set your deductible at $1,000 or higher.

If you like this strategy, consider a Consumer-Driven Health Plan (CDHP) or a High-Deductible Health Plan (HDHP). These plans have high deductibles.

Employers could also offer a HDHP option at open enrollment time.

4. Change your co-insurance ratio

Your co-insurance ratio is how much you will pay after you have met your deductible.

A common ratio is 80/20. This means that after you pay your deductible toward health care expenses, your insurer pays 80 percent of the bill and you pay 20 percent. Changing this ratio so you pay more will mean a lower health insurance premium. Just as with raising your deductible, you have to weigh the costs versus risks.

5. Pair a high-deductible health plan with an HSA (Health Savings Account)

Often high-deductible plans are paired with a health savings account. Pre-tax contributions can be rolled into your plan each year. Employers and their employees may contribute to this account. Then you pay health care expenses from your Health Savings Account until it’s exhausted.

"HSA plans can help you save on both your health care needs and your taxes," says Laden. "Our customers typically save 50 percent on HSA-plan premiums when you compare them to more traditional plans."

Compare your anticipated health expenses with potential savings. The young and healthy could fare well with an HDHP paired with an HSA. HSAcenter.com, a site from Golden Rule, provides a calculator for comparing a traditional health care plan with an HSA to estimate cost savings.

For more on health care savings accounts, read health care account comparisons: FSA, HRA and MSA.

6. Consider a major medical health plan

Major medical health plans, sometimes called catastrophic health insurance, offer limited insurance coverage with a high deductible, typically $1,000 for an individual and $2,000 for a family. Premiums are low because the insurance is intended for medical emergencies. It does not pay for regular doctor visits but will cover major hospital and medical expenses including hospital stays, X-rays and surgery.

7. No "extreme" anything

Abandon dangerous hobbies and recreational activities such as skydiving, mountain climbing or NASCAR. Anything that poses a significant injury risk will super-charge your insurance premiums.

8. Is your doctor in or out?

If the doctor you like is already in-network and the lab he works with is also in-network, an HMO can be as adequate as a PPO and offer lower premiums.

No matter what plan type you have, "make sure you do business with an insurance company that has a strong national network," advises Laden. "Networks provide substantial savings on health care because they negotiate lower rates that can result in substantial savings on your health care, even before you meet your deductible." She notes that Golden Rule's network discounts generally save customers 30 to 40 percent.

9. Trade up group insurance plans

If both you and your spouse have group health insurance plans available through work, calculate which one will cover both your needs at the lowest cost.

For some people, group rates might not offer the best value. "If you are fairly young and healthy, you could pay far less in premiums for a private health insurance policy rather than a group plan," says Robert Zirkelbach of America's Health Insurance Plans, a health insurer trade group.

10. Regularly reassess your insurance needs

You may be missing out on savings simply because you've stuck with the same plan year after year while your situation has changed.

"You should periodically reassess your insurance needs," suggests Laden. "Things you should think about include: Do you have children that go to the doctor often? Do you take a lot of prescription drugs? Are tax breaks important to you? Are you willing to assume the cost of routine health in exchange for much lower premiums?"

If you’re in the market for a new plan, Laden recommends making sure the companies are reputable. Ask friends, family members and colleagues about their experiences. Check financial strength ratings to make sure the company is financially sound. In addition, many state insurance departments publish consumer complaint rankings of the insurers doing business in their state.

11. Lobby for group plan savings at work

If you buy a group health plan through work, you may think you're stuck with whatever is offered every year.

But employees, especially those in smaller companies, can rally for better coverage options. There may be numerous "optional" benefits tacked on to your group health plan that are causing your group rate to skyrocket. If you and your co-workers agree that some coverage options are unnecessary (for instance, infertility treatment, mental health treatment and even dental), ask your employer drop them at renewal time.

12. Evaluate the road ahead

Zirkelbach advises that you consider your future health care situation when you buy a policy, so the coverage will be there when you need it.

For example, if you are planning to start a family, secure maternity coverage now; it will be impossible to buy maternity insurance once you are pregnant.

And finally, "Never go without health insurance coverage," says Laden. "I can't emphasize this enough. This is never a good idea. In times of economic strife, I understand where it can be tempting, but it you were in an accident, injured or are struck with a major illness, the cost of medical care can wipe you out financially. People rarely go into medical bankruptcy when they have health insurance; they do go into bankruptcy when they are not covered and have to go to the hospital."