For millennials with chronic medical conditions – or those raising children with chronic conditions – health care can be an enormous monthly expense. About 44% of older millennials born between 1981 and 1988 have at least one chronic health condition, including migraines, major depression and asthma, reports a 2021 survey of over 4,000 adults conducted by The Harris Poll on behalf of CNBC Make It. And many millennials are also caring for children with complicated medical needs.

Expenses can include doctor’s visits, tests and prescription drugs, plus indirect costs that may result from missing work.

But there are ways to keep health care costs lower, including taking advantage of a flexible spending account or health savings account, comparing pharmacy prices on medications and using a care manager through your insurance. Here are some strategies to try.

Ask questions

If you have a chronic condition, be an active participant in your care. “Too many people go to the doctor and the doctor says, ‘We’re ordering this test; we’re doing this medicine,’ and they don’t inquire as to why,” says Carolyn McClanahan, a certified financial planner and physician in Jacksonville, Florida. “When you need bloodwork, ask the doctor, ‘How is this bloodwork going to change what we do for me?’”

If the answer is essentially, “We’re just checking,” McClanahan says, ask your doctor whether you can safely skip that test because you’re trying to control costs.

Compare medication costs

Your prescription medication might cost significantly less at another pharmacy. For example, a recent search for sumatriptan, a common migraine medication, showed prices ranging from about $7 to $36 at various pharmacies in Austin, Texas.

“People should always shop their prescription costs,” McClanahan says.

She suggests checking sites like goodrx.com, which offers coupons on prescriptions and shows nearby prices, or costplusdrugs.com, which sells drugs at a low cost. And ask your insurer if there are preferred pharmacies on your plan.

If a medication is expensive, check with the manufacturer for discount programs or coupons. The manufacturer of diabetes medication Jardiance, for instance, offers a savings card that reduces prescription costs to $10 per month for a limited time for eligible people. A month’s supply of the drug lists for more than $500 on GoodRx.

And if your insurer declines to cover a medication you need, appeal the decision. “Appeals are a pain and time-consuming, but they do work,” says Leslie Beck, a certified financial planner in Rutherford, New Jersey.

Use tax-advantaged benefits

If your employer offers an FSA, you can set aside pretax money toward medical expenses. In 2023, employees can contribute as much as $3,050, and employers can allow a carry-over from year to year of as much as $610.

If you’re using a high-deductible health plan for your health benefits, you can save to an HSA. Savings to an HSA are pretax, the money can be invested and grow over time, and anything spent on eligible medical expenses is tax-free.

“HSAs are very flexible, and for people dealing with chronic conditions, it may be quite attractive to have this type of account set aside just for their health care costs,” says Jacqueline Koski, a certified financial planner in Dayton, Ohio.

(You generally can’t save to an HSA and a health care FSA at the same time – or if your employer allows it, the FSA is limited to dental and vision expenses only, per the IRS.)

Use a case manager

Many insurance companies offer a patient advocate program that can help you manage a condition of yours or a dependent’s. Molly David, whose daughter has a disability, found her insurer’s medical case management program to be a game-changer.

“I now had a go-to person for questions and concerns I had,” says David, who also created sempergrata.com, a website for parents of children with disabilities. “This alone was a huge relief. But they could also help with prior authorizations, explaining my options and getting me in touch with other programs that could help.”

David’s case manager also pointed out a variety of benefits that were available to her. “We had probably about $80,000 worth of home modifications done by insurance that we never would have thought they would have covered,” David says.

Find your community

There’s strength in numbers, and social media makes it easier to find a group of people in the same situation you’re in. Facebook groups and blogs are helpful places to start.

“I found a community of Type 1 diabetics, and the guidance that I got from them was life-changing,” says Beck, who also has the condition. “Once you find your community, they’re so helpful in terms of managing (the condition), what works, what doesn’t work, where you can go to get resources — you’d be shocked.”

Kate Ashford is a writer at NerdWallet. Email: [email protected]. Twitter: @kateashford.