The intensity of the national debate over health care reflects the importance of the subject. Opinions may not be universal, but there’s no disputing the need for health insurance.

In looking for health insurance, you have to be a smart shopper. That requires gathering some facts and learning some terminology.

It’s important to understand the difference between a co-payment and co-insurance. A co-payment is the set dollar amount that the insured must pay toward their health care costs per visit, such as to a physician or emergency room. Most health plans that offer prescription drug benefits will also assign a co-payment for each prescription, but the amount may vary depending on the class of medication.

Co-insurance refers to the percentage of cost that the insured must pay. In some cases, you pay 100 percent of the cost upfront, then are reimbursed by the insurance company for the portion it covers once you have met your deductible (the next key term).

A deductible is the out-of-pocket expense you must shoulder before your insurance coverage kicks in; at that point you are responsible only for co-pays and or/co-insurance, if they apply in your policy. Deductibles generally are computed on an annual basis, with separate amounts for each family member and a joint one (usually double the amount for individuals) for the whole family. Insurers also set an out-of-pocket maximum, above which they pay all health-related costs.

If you’re in good health, consider going with a higher deductible, which will lower your premium. But make sure you can afford the cost should you or a family member have a major medical need.

When getting started, it’s smart to do a little research on your state's insurance website. A concept that is gaining popularity is consumer-directed health care (CDHC) , which increases the role of consumers in purchasing health care services. Supporters of CDHC believe that direct consumer involvement in health care purchasing decisions will help keep down health care costs. These health plans encourage individuals to manage their health insurance as an asset that should be properly managed.

With CDHC, consumers can choose from several types of spending accounts: medical savings accounts, flexible spending accounts, health reimbursement accounts or health savings accounts (usually coupled with high-deductible health plans).

Do you have any pre-existing conditions? These are illnesses or health problems that existed before buying your health plan or the time your health insurance coverage takes effect. In general, insurance companies exclude pre-existing conditions for a minimum of six months to a year after you have bought your coverage, but that period varies from state to state.