The slumping economy has forced many to ration their health care as they stretch dollars. But what’s OK to skip and what’s a must-do, when you have arthritis?

What’s OK to let slip:

• Routine screenings: As long as they were normal on the last go-round, experts say it is fine to miss some kinds of routine tests, like Pap smears, bone density tests and mammograms, until you can work them back into your budget.

• Vitamins: Recent studies have shown that many vitamins offer little or no health payoff. The exception to this advice would be any vitamins or minerals that a doctor has prescribed, such as calcium, vitamin D, folic acid or iron.

What not to skip:

• Medication: Edward H. Yelin, PhD, professor of medicine and health policy at the University of California, San Francisco, says he believes that people who have arthritis are more likely than those with other kinds of chronic diseases to skip medications.

What many don’t realize, Yelin says, are the repercussions of failing to control the inflammation in their joints and other organs. “If they don’t take their drugs and have to stop working and get sicker, and have more joint damage, then there’s a good chance they will become permanently disabled and unable to work again.”

• Doctor visits: It’s also not a good idea to skip visits with your primary care doctor or your rheumatologist. If you don’t have insurance, you may be able to negotiate with your doctor for a lower fee.

• Vaccinations: According to the Centers for Disease Control and Prevention, vaccines are among most cost-effective health interventions available, saving between $2 and $27 in direct medical costs for every dollar invested in them.