This study of 1,482 farm families assesses the extent and cost of health insurance coverage among Minnesota farm families and finds that these families are buying less insurance coverage than urban families, while paying a higher proportion of their income for these premiums. More than three-fourths of the farm families surveyed buy their health insurance plan themselves and pay for it out of pocket. Their plans, on average, are slightly less expensive than employer-provided plans in urban areas, but they provide much less coverage and have more copayments and deductibles. Unlike their urban counterparts, who often choose health plans for convenience of location or freedom to choose physicians, farmers generally choose plans on the basis of costs and services provided. About 7 percent of farm families are without insurance, and many others are underinsured because they cannot afford to purchase an adequate plan.