Perhaps you’ve looked into alternative products or service and they won’t meet your needs. Perhaps you’ve already cut back to the minimum use on that product or service. Perhaps there are only a few providers in the first place for that item.

Brian J. O’Connor, who is writing The Grand Experiment cost-cutting series for the Detroit News, ran into that situation with speech therapy expenses for his son:

The other big budget item devoted to my boy is untouchable: speech therapy. Li’l Money could also be nick-named Li’l Talker, because of a severe language delay. He’s been diagnosed as a late talker, and his speech development will catch up — but only with a lot of help.

That includes private speech therapy, specialists and consultants, as well as a $190-an-hour special education attorney who has had to help us keep some specialists from making the common – but harmful — mistake of pushing a late talker into programs for autism.

None of it comes cheap, and none of it is covered by insurance.

But Brian did figure out how to save money through the method he uses to pay for that speech therapy. He can set up a Flexible Spending Account to pay for the eligible medical expenses, which results in savings on his tax bill.

I have used FSA myself for many years. Yes, there is paperwork and hassle involved. But if your employer offers it, do look at the list of the eligible expenses to see how it would work for you.

The bigger point is: be as resourceful as you can on a particular expense, and then look for savings in other directions in your family budget.

As Brian’s series shows, you will likely have to take multiple cost-saving steps throughout your family budget in order to noticeably improve cash flow.

It was hard for me to keep up with all the changes in the plans as more pharmacies signed on or made changes to their prescription lists – so I didn’t even try. I do suggest that you look up your favorite drugstore’s web site to bookmark or download the discount list for easy reference, or ask your pharmacist what the options are at his or her location.

My health insurance company also has a link to this site: Medtipster. You can look up your prescriptions and find out which pharmacies in your area have specific medications on a discount plan or low price.

Yes, there are Monroe, Mich., pharmacies in the database! I also saw Carleton and Rockwood drugstores pop up when I did a some test searches on common prescriptions. And the search page is really easy to use.

You may not be able to get all of your family’s medications on a generic drug savings plan. But even if you can get one of them on, that’s money saved.

I’ve had some posts during the past few months on dealing with flu expenses. Here are my H1N1 archives.

The Detroit Free Press had a big section in Sunday’s edition called Your Guide to Medicare.

One of the articles lists dates and agencies that are hosting counseling meetings to help senior citizens find the best Medicare drug coverage plan for them. The article includes information for Monroe, Livingston, Macomb, Oakland, St. Clair and Wayne counties. Check here for the details.

This is a real scenario for some families who are getting hit with the flu.

• Maybe you are at a job that doesn’t offer sick leave.
• Maybe you already ate up any sick leave you had available.
• Maybe your sick leave is for your purposes only, not when a family member is ill.

Solution: File any necessary paperwork for a vacation day or personal day on the affected dates.

Don’t fuss if you have that option available. At least you aren’t forced into an unpaid day off. Why do you think many parents who work outside the home hold off as long as possible into the year for scheduling their vacation days? Reason: sometimes they have to eat those vacation days for family situations that they don’t know about yet. Been there, done that!

The other possibility is to talk to your HR department about the procedures for requesting unpaid time off work.

What happens if you have to take unpaid time off of work? That’s the only option for those who are self-employed, for example.

You will need to rearrange your cash flow to handle that:

• Eat groceries out of your pantry or freezer for a week or so and get only the basics from the supermarket such as a gallon or two of milk.
• Pay only the minimum on your credit accounts or debts for that week or month.
• Cancel or reschedule any social gatherings for which you need to spend money (a dinner date, for example).

You’ll be making this effort on top of purchasing any needed medical and grocery supplies on sale, coupon or rebate.

Check through my H1N1 archives for more tricks and tips on how to deal with flu-related expenses.

The reality is that when someone gets sick in your home, your family has to take care of the ill person while trying not to infect anyone else.

The Centers for Disease Control has some good tips, including over-the-counter medication and household cleaning recommendations for those afflicted with H1N1, at Taking care of a sick person in your home.

Update: Schools in Monroe County, Mich., are reporting increased absences this week.

The Monroe County Health Department has been distributing fliers about the H1N1 influenza vaccination clinics that will start Nov. 2. Go to the health department’s site for the details.

If you haven’t noticed yet, the H1N1 vaccination will be free – as compared to the seasonal flu vaccine which usually costs about $25. But please follow the guidelines as to who should get in line first for the vaccination until the supplies can catch up with demand.

In  the meantime, if you will be in need of over-the-counter medicines and cleaning supplies to get through flu season, watch the drugstore fliers for the weekly specials. I’ve also seen a lot of coupons for cold and flu medications in the recent Sunday newspaper coupon packets.

If you have at least a couple of days’ supplies already on hand, you’ll save yourself some hassle should someone in your family become ill for a few days.

However, don’t waste your money on a panic buy situation. Look around your medicine chest, disaster supplies and school supplies before you go shopping – you may already have plenty for your family.

Those bottles do have expiration dates and even a little bottle will go a long way.

If you missed the AARP Walgreens Wellness Tour stop Monday Oct. 19 at Walgreens on Monroe St., there will also be a visit from noon to 6 p.m. Friday Oct. 23 , at the Walgreens at 484 S. Telegraph Rd., Monroe, Mich.

This program provides free health screenings for adults age 18 and older on blood glucose, body mass index, cholesterol and other tests.

For information, call the pharmacy at (734) 240-2594.

Dr. Joseph A. LaScala at Advantage Chiropractic, 7400 Lewis Ave., Suite J, Temperance, Mich., is offering free chiropractic health care for one full year for any U.S. military veteran who is returning from overseas deployment in Afghanistan or Iraq.

Those who wish to receive this benefit should bring their military ID or DD Form 214.

The services include a health history and consultation, orthopedic and neurological exam, initial X-rays if needed and chiropractic adjustments.

For information, call (734) 847-7640 or go to www.adchiropractic.com.