Washington's health-care reform debate could go on for a while, but who can afford to wait?

In the next few months, most employees will have to choose a health insurance plan for 2010. Others may face job loss and the loss of employer-provided benefits, or are newly emancipated -- graduated and unemployed -- young adults who need to find their own coverage.

They all have this in common: The likelihood of higher premiums, more confusing choices, and more policy "gotchas" that can limit, or even kill, their coverage after they've paid those costly premiums. And, the need to nail down coverage before Washington acts. Here's how to make smart health insurance decisions while hoping that Congress does the same.

-- Don't wait. "All the health insurance proposals have one thing in common," notes Sam Gibbs of eHealthInsurance.com, an online health insurance brokerage and shopping site. "They don't start until 2013." That means finding your own coverage from now until then, without benefit of any of the potential reforms, such as the elimination of screening for pre-existing conditions. But unlike the credit card companies, which met forthcoming legislation by jacking up rates and fees and changing their policies, most health insurance firms are continuing business as usual in the interim. As a matter of fact, between 2008 and 2009, the median premium for family coverage, bought privately, increased less than 3 percent to $329, according to ehealthinsurance's latest survey.

-- Don't assume your group plan is best. Group coverage can actually cost more than individual coverage. That's especially true if you are young and healthy, or if your company has a relatively small pool of workers with complicated health problems, or if your boss isn't actually kicking in much to cover the premiums. If you shop privately for a plan, you may discover a competitive plan that costs you less. That's what happened to Alex Rivlin of InsureMonkey.com, another health insurance brokerage and shopping site. His last group health plan was costing him $1,027 per month to cover his family of four; he now buys his own similar policy for $396 a month.

-- Define your terms. "Even the brightest rocket scientists don't know about health insurance," says Rivlin. Maybe that's an exaggeration, or maybe it's because they're just too busy, but it could also be that the legalese in most insurance policies exceeds the complexity involved in running the space station. Break it down by learning as much as you can about the fine print that's important to you and your family. One place to check, is the website of the consumerist group FamiliesUSA. Planforyourhealth.com, an educational website co-sponsored by the Financial Planning Association and Aetna, offers calculators and articles about insurance.

Beginning September 14, the site will post a new booklet, "Navigating Your Health Benefits for Dummies" that explains basic health insurance terms and offers money-saving tips. Both eHealthInsurance and InsureMonkey offer background info and calculators on their websites as well.

-- Shop locally, too. Every state has its own insurance regulations and its own insurance companies. You can find two different state-by-state consumer guides at the website of the Georgetown University Health Policy Institute and at the site of the American Diabetes Association.

-- Don't cover your first dollar, cover your last. Consumers are catching on to the fact that they pay a lot in premiums to keep their deductibles low. That's not worth it. You can save money every month by raising your deductibles. Raise them high enough, and you could qualify for a health savings account. These accounts let you take a tax deduction for the money you contribute, and you can withdraw the funds tax free to pay for out-of-pocket expenses. You can also save and invest them for retirement, when you'll really have high healthcare expenses. Learn more from the Treasury Department or from HSABank, the leading financial firm creating these accounts, at http://www.hsabank.com. Just remember to feed your account, cautions Tracey Baker of the Financial Planning Association. It's not good to "save" money by raising your deductible without putting away enough to cover it.

-- Get a custom plan. Health insurance plans are increasing in number and diversity because many companies are creating plans that differ in small ways from each other. One might include prescription drugs or maternity benefits, or generous mental health coverage, and another might not. You can save money by choosing a plan that has exactly the combination of coverage you expect to use, without a lot of extras.

-- Consider these money savers. If you're married and both working, compare the two plans and choose the best one. Paying for double coverage is rarely worth it. It can be worth splitting the coverage, however, especially if one spouse has health problems. The healthier spouse can buy a less-expensive plan for herself (if it's the wife) and the kids, and the husband can buy his own individual plan. And ask about domestic partner coverage. Companies in many states offer this, for both same-sex and male-female couples. It can't hurt to ask.

-- Consider your own pre-existing conditions, whatever they are. "Don't self-diagnose" by volunteering to exclude any of your body parts or disease propensities, says Rivlin. Wait for insurers to look at your health records and tell you what they won't cover. Increasingly, they'll offer insurance, but exclude one condition or require a much higher deductible for that particular condition. Not every insurer has the same policy on these specific health issues, so you may have better luck by working with an agent who knows how different insurers approach those conditions.

Most observers believe that whatever comes out of Washington will include a prohibition against excluding or overcharging people with pre-existing conditions, so you may not have too much more time to worry about getting coverage it.

(Editing by Gunna Dickson)

By now, most incoming college freshmen have met their new roommates, spruced up their dorm rooms, and run out of ready cash. Going to college is expensive, and it's not all about tuition bills. There are textbooks and highlighters and midnight snacks. And for most new college students, this is really the first time they've had to manage their own money and living expenses.

This year's freshmen are facing all of that, with less in their wallets than their predecessors. Skyrocketing tuition costs, coupled with parental job loss, debts or other money worries have constricted what's left for walking-around money.

Here's how to make it last.

-- Get a credit card and manage it yourself. This is the last incoming class that will have easy access to credit cards without a parent's co-signature. Get one that has no annual fee and caps your credit at $500 or so. (You can find a list of the best student credit cards at http://www.indexcreditcards.com). This is a great convenience, especially if you're buying bus, train or airline tickets. And learning how to manage that bill every month is probably at least as important as English 101. Don't have the bills sent to your parents; pay them yourself out of your spending allowance or job earnings.

-- Protect your debit card. Many banks are getting rich off young people going over limit on their debit cards. They'll accept the transaction and then charge as much as $30 in penalty fees. Go out in one day and buy a pack of gum in one store, a pack of pens in another and a cup of coffee in a third and you can incur $90 in over-limit charges before you even know you're overdrawn. So, go to the bank and ask them to flag your account and deny over-balance transactions. If it won't agree to do that for you, find a bank that will. Protect the physical card as well. Banks will make good on most losses due to debit card theft or fraud, but not before it makes a big mess of your checking account.

-- Reduce your car insurance. If your school is more than 100 miles from home and you have not taken a car with you, your auto insurer is likely to lower your rates. If you pay your own bills, that saves you money. If your parents become the beneficiaries of the price cut, they might be nice and share the savings with you.

-- Save on books. You can buy and sell used books on your own campus or at websites like http://www.textbookx.com, http://www.abebooks.com, and http://www.half.com. You can compare prices for every book at http://www.allbookstores.com. You can rent books at http://www.chegg.com. Some books can be downloaded for free at http://www.textbookrevolution.org, and freeloadpress.com (which puts ads in the books.) Lit majors can find many of the novels they have to read are no longer copyright protected and can be found online at www.gutenberg.org or the local library. Many professors put large numbers of their required textbooks on reserve at their school libraries. Buying the book together with your friend who is taking the same course is NOT a good way to save on books. You'll both want it on the same day.

-- Buy in bulk. If you know you'll want to walk around with a water bottle every day, the cheapest thing to do is refill your own bottle daily. Next up is buying a case at the grocery or superstore when they're on sale. Most expensive? Stopping in the convenience store every day for your drink. It's good to load up on those go-to snacks, too: popcorn, peanut butter, ramen, yogurt, cereal. That way you won't waste your money on boring mid-study snacks and have more left for outings with friends. And if you decorate your room with cases of water and soup, you won't have to spend too much on posters and other decorations.

-- Save on software. Don't buy any computer equipment or software until you've checked with your campus technology help center. Many offer free Microsoft and Apple software.

-- Squeeze that student ID for all it's worth. You may not even know you're eligible for discounts until you try. Ask for student discounts wherever and whenever you shop. Look for additional savings at http://www.studentsavingsclub.com.

-- Work. A part-time job brings in extra cash, but that's only one piece of it. It will give you another identity besides student, expose you to different people and environments and teach you something about real life. It will cut down on the time you have available to spend money, too. Think creatively: College students can make good money tutoring high school students, coaching pre-teen soccer players or helping older folks set up their televisions and iPhones.