Megan from marketing got two televisions, a DVD player, an Xbox 360 and two iPods. Vicki from training got a digital camera, a GPS navigation system and a Bose speaker dock with her iPod. Ben and So Youn, the couple from the lab, got a 42-inch flat-screen TV.

And the list goes on for workers at Ottawa Dental Laboratory outside Chicago. Their health plan gives them "bucks" for getting in shape, quitting smoking, lowering their cholesterol or managing chronic conditions such as diabetes and asthma. They use the bucks to get merchandise on the health plan's Web site — items including luxury watches, barbecue grills and mountain bikes.

"The shopping is great," said Vicki Stacey, 53, who earns her bucks by, among other things, exercising at least four times a week. And "I feel real good," she said. "I have more energy."

Exasperated by ever-rising healthcare costs and frustrated that conventional health plans fail to promote good health, a growing number of U.S. employers and their insurers are enticing workers to stay healthy with prizes, discounted insurance and even cash.

What began a few years back with a gift card here and a coupon there is evolving into a much more comprehensive effort by companies, health benefits experts said.

At IBM Corp., employees get as much as $300 a year for exercising regularly, quitting smoking or logging on to the company's preventive-care Web site.

Blue Shield of California, which insures 300,000 of the state's public workers, began offering them as much as $200 this year for, among other things, filling out a health-risk assessment form and exercising.

Banking giant Wells Fargo & Co. deposits as much as $500 a year into medical savings accounts for workers with chronic conditions such as diabetes who follow recommended diet, exercise and drug regimens. Wells Fargo's health plan provider, UnitedHealth Group Inc., one of the nation's largest, said it was rolling out similar incentives to more than 2 million members this year.

Workers say these approaches give them the motivation they need to drop a few pounds or quit smoking. Employers say these methods should pay off on the bottom line, too, because healthier workers have less absenteeism and are more productive.

Whether these tactics will decrease healthcare costs in the long run remains to be seen, experts said. If the benefits are too rich, they might end up costing more than they save; too little or unsustained and workers eventually will lose interest. But the rewards are getting workers' attention, at least.

With the country's medical bill expected to reach $4 trillion and consume a fifth of economic output in a decade, prevention is more urgent than ever, nearly everyone in the debate agrees. Gov. Arnold Schwarzenegger recently proposed making prevention programs mandatory for health plans sold in California.

Health maintenance organizations have done little to boost disease prevention because most are about controlling costs rather than managing care, some experts say.

Conventional health insurance isn't doing the trick either, experts said. Co-payments and deductibles have gone up, but not enough to affect behavior, experts said. Most consumers do not equate their bad habits with higher health-care costs, because bad behavior takes years to take a toll while out-of-pocket costs are felt immediately and perceived as something arbitrarily imposed by insurance companies.

Moreover, raising out-of-pocket costs too much can cause already sick patients to skip needed care, which only worsens their condition and the ultimate cost of their medical care.