Context: Evidence exists for differences in health insurance coverage among states, but less is known about variations across different kinds of communities within states. Purpose: This article assesses the role of residential setting (metropolitan county, rural adjacent, and rural nonadjacent) in health insurance coverage for adult residents, under age 65, using data from large-scale surveys collected in 3 diverse states (Florida, Indiana, and Kansas). Methods: Descriptive statistics are provided, and logistic regression models are used to examine the relationship between uninsurance status and residential settings while controlling for personal characteristics. Adjusted uninsurance rates by residential settings are presented for each state. Findings: Residential settings are significantly associated with uninsurance status in 2 of the 3 states we examined. We find that adult Floridians of rural adjacent counties are more likely to be uninsured than those in urban counties, but, for Indiana residents, uninsurance status is comparable between urban and rural adjacent residents. Rural nonadjacent Indiana residents are more likely to be uninsured compared to those in urban counties. The insurance status of adult Kansans does not vary across residential settings. Conclusion: Residential settings are significantly associated with being uninsured, but the significance of this link between residential locations and uninsurance status varies from state to state. © 2006 National Rural Health Association.