Now more than ever, it’s important you know how to advocate for your own health care. Our medical system is complex and costly — and soon to be changing. No one knows entirely what’s in store. Because of that, and to ensure your needs as a patient don’t get lost in the shuffle, you should know how to be an active, informed health care consumer.

Fair warning — it’s not easy. But it’s worth it.

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While our health care system is top-of-the-line here in the U.S., there are systemic issues that often leave patients out of the center of their own care. Among some of the more concerning issues — there are not enough primary care physicians to address the needs of a growing and aging population.

A lack of these “gatekeepers” accounts for longer wait times to get in for a first appointment and then to see other specialists for follow-up care. Many physicians on the job are burned out and overburdened with mandated paperwork and data entry for electronic health records. Baby boomers are additionally flooding the market with a whole new set of health care needs, while Medicare funds continue to dry up. And all of this is happening as insurance deductibles and premiums soar.

Related: Pushy Patients, Pushover Doctors

These factors and more are creating the perfect storm for patient errors and other health care issues. Knowing how to be your own best advocate is critical.

1.) Ask about your medical bills — and question everything.
Here is why it’s important: According to Medical Billing Advocates of America, nine out of 10 medical bills contain errors. But question more than just your bills. Question your physician, your clinic, your insurance company.

Question your medical bills — nine out of 10 contain errors.

What services are they recommending? Why you are getting them? Where you are getting them? Is it in your network? Do you need that test? Why — and what will anyone do with the results? Should you have a certain procedure in the hospital as an inpatient — or as an outpatient at a clinic? Do a gut check. Make sure everything aligns financially and aligns in the way you want to be cared for as a patient.

2.) Don’t take no for an answer.
If you find you are getting the runaround or are not being heard, ask for a supervisor, or ask to speak to another representative. Most things in life and in your health care are negotiable or can be approached in different ways.

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3.) Get a second opinion.
This one is big. But it is important — especially for major medical decisions. Any good physician should welcome this. You almost always have the time to do this — often, another person’s perspective and expertise on complex matters make a big difference or simply offer peace of mind.

Related: Patients and Their Doctors Can Talk Again

4.) Do your homework.
What are your goals as a patient? Define this — and make sure your family and your providers know. Also, research your concerns and write down any questions you want your team to answer. It also helps to bring along someone you trust to big appointments. That extra set of eyes and ears is vital.

5.) Get help.
Does the above sound like a lot of work? It can be. Reach out to family and friends to help and know there are countless resources available to you. There are many independent health care advocates, liaisons provided by health care systems, navigators, and programs to access.

Health care is shifting — but it will not happen overnight, and illness doesn’t wait or discriminate. Be your own best advocate, or find ways to have someone you can count on be an advocate for you.

Bridget Raisbeck Krueger is founder of KaleidoCare, a Madison, Wisconsin-based patient advocacy firm.