• Massachusetts requires health insurance coverage for most 18-year-olds.massachusetts map image by Vladislav Gajic from Fotolia.com
  
  Massachusetts required health insurance for college students long before it passed a health care reform law in 2006. State health care reform also requires coverage for most adult residents, aged 18 and older. Young adults are less likely to buy insurance than older adults. Based on state public health surveys, the number of uninsured young adults aged 18 to 34 dropped by 8.3 percent in the first 18 months after the law took full effect in July 2007.
  
  

Students

• In 1989, Massachusetts passed a law requiring health insurance coverage for all full-time, and some part-time, students at higher education institutions in the state. Thus, 18-year-old students must pay for student health plans to enroll in a college, university or other postsecondary school, unless the school exempts them. If students already have health insurance, their plans must meet the Massachusetts standard for a student health plan and full services must be available to them while they are at school to qualify for exemptions. This rule includes students who are residents of other states and countries. Schools bill non-exempt students for coverage in student health plans.
  
  

Residents

• By law, 18-year-old Massachusetts residents must have health insurance that meets specific state standards unless they demonstrates they can't afford it or obtain an exemption for religious reasons. This rule applies to all 18-year-old residents, not just to students. Massachusetts offers lower cost options for buying health insurance to young adults aged 18 to 26, in addition to other options for residents who can't afford to buy private insurance. The state's health care reform law also extends opportunities for young adults to stay on a parent's family health plan until they turn 26.
  
  

Proof

• Massachusetts residents 18 and older must file information about their health insurance coverage with their annual state tax returns, showing they had coverage during the tax year, or face income tax penalties if they don't have health insurance and their income is at or above 150 percent of the federal poverty level. The state allows a grace period for some gaps in coverage during the year, but the potential tax penalty for an 18-year-old who doesn't comply with the law was up to $792 for the 2010 tax year. The penalty is half the annual cost for a health insurance plan.