With health care costs soaring through the roof, the cost of health insurance premiums are increasing as well. Health insurance is a necessity, however, when you consider the costs of one visit to the emergency room, surgery to set a broken bone, scans, lab and other costs. When your budget is limited, how can you keep the costs of your health insurance premiums down? There are several steps you can take to reduce your health insurance costs and still maintain adequate medical coverage when you need it.First step is to consider what health insurance options you have. Does your employer offer a group medical benefit? Many employers (and/or labor unions) offer health benefits to full-time employees. Group health insurance is usually the cheapest way to get medical coverage; an employer can negotiate with health insurance companies to get a group health plan at cheaper rates. In addition, many employers will pay part of the premium, reducing your health insurance cost even further. Another consideration is whether your spouse has health coverage available through their employer? If so, compare your health benefits plan to that of your spouse, and decide which health plan is the better buy. It may be possible to have one spouse carry family health insurance coverage and the other drop their health benefits. Many employers have multiple health insurance options, so review these plans as well. Choose the health plan that best meets your needs at the cheapest rate.If no health insurance coverage is available through your employer, there are other ways to obtain health insurance coverage. Individual and family private health insurance policies are available. Shop and compare benefits and premiums from each health insurance plan. If you and your family are generally healthy, the new Health Savings Account (HSA) may be worth consideration. The HSA is an account that allows you to save tax-free dollars for your medical/health expenses. Similar to an Individual Retirement Account (IRA), you are limited in the amount that you are allowed to contribute each year; however, with the HSA, withdrawals for health expenses are not penalized, and no tax is paid on the withdrawal. When paired with a health insurance policy that has high deductibles and low rates, the HSA may be ideal for you. Save money in the HSA for deductibles and co-pays, and you’re set.For those over 65 or permanently disabled, Medicare is available through the federal government. The original Medicare is an 80/20 plan (they pay 80% of eligible expenses and the insured pays 20%) with an annual deductible and a monthly premium. Supplemental health plans are available to cover this deductible and co-pay. These supplemental health plans are usually private and the insured pays a premium. In addition to the original Medicare plan, there are Medicare HMOs. In these Medicare HMO health plans, the Medicare premium is paid to an HMO to provide benefits to the insured. HMO plans are more restrictive in that patients must get care through a network provider, but often these plans cover more prescription drugs and preventive care than original Medicare does.Recently some employers have offered lower premiums to employees who do not smoke cigarettes. This is currently a controversial topic for some, but it certainly may begin a trend. In the future, employers and their health insurance providers could offer reduced premiums for employees who maintain normal weight, exercise regularly, and receive certain wellness benefits. Maintaining a healthy lifestyle lowers the risk to the health insurance company that they will be paying big bucks in health care down the road. And health insurance, as any other insurance, is all about risk.Bottom line: going without health insurance coverage is a big risk for you. Find health coverage that you can afford just in case Murphy comes knocking at your door!