The test (you know the one) together with the required day-before prep wasn’t exactly pleasant. The real pain came several weeks later when I opened the bill.

The total charge for the test Katie Couric suggests every adult should have routinely: $4,000. And that’s no typo.

Our semi-adequate health insurance covered most of the cost, leaving us to pay about $900. Still, that’s about ten times what I would have guessed given our astronomically high monthly premiums.

The statistics are alarming if not shocking: Premiums for family coverage in employer-sponsored health insurance plans have increased by 73 percent since 2000. Currently they are rising three times faster than the average paycheck and more than twice the rate of inflation.

Here are the two most important things you must believe and understand about health insurance going forward:

Health insurance is not optional. Don’t skip insurance altogether. Several studies have found that medical expenses on top of already maxed-out financial situations are the leading cause of personal bankruptcy. Everyone needs some kind of health plan.

Health insurance will not pay for everything. Even with the best plan out there you will have medical bills to pay in sickness and in health.

Help! I am uninsured

Don’t feel like the Lone Ranger. According to the U.S. Census Bureau, 48.5 million Americans are uninsured for one reason or another. 

Change in employment. Of course the biggies are getting fired, laid off or downsized. Some companies are simply dropping benefits, leaving employees stunned and uninsured.

Growing up. This month college graduates are going to get more than their degree. They’re going to get a rude wake-up call; they’ve just entered the world of the uninsured. Most health plans drop coverage for dependents once they are out of school.

Early retirement. Unless you are at least 65 (the age at which you qualify for Medicare, the government’s insurance program for the elderly and disabled) hanging it up early may leave you uninsured.

Divorce or death. All too often the non-working spouse gets left without health coverage.

Where to turn

COBRA. Most employers must offer coverage after any kind of displacement—even to the divorced or widowed spouse of the employee—under the Consolidated Omnibus Budget Reconciliation Act of 1986, or COBRA. This allows you to continue temporary coverage at group rates through the employer’s plan, generally for up to 18 months. But you have to pay for the entire premium yourself. I hope you are sitting down before I tell you how much.

On average that comes to $600 to $700 a month for an individual and $1,400 for a family. Yes, I know. Outrageous.

State health insurance. In most states you can now get covereage in a high-risk pool if you are sick or otherwise uninsurable. Eligibility requirements and costs vary greatly from one state to another. Call your state department of insurance or visit its website to learn the details.

Medicaid. If you are in serious trouble you can turn to your state’s program. Generally Medicaid is for low- or no-income individuals. However, if you are found to be "medically needy" your state may waive the income guidelines and offer you coverage. To enroll in Medicaid you must apply to your state department of social services. Check your state’s website for details.