I live in Boston too, and I have to say the system does seem pretty good for American citizens and foreigners who are permanent residents; but it's not so hot f

I live in Boston too, and I have to say the system does seem pretty good for American citizens and foreigners who are permanent residents; but it's not so hot for foreign families on student visas who are poor by US standards. Schools give health insurance to the student and offer the option of buying very expensive health insurance for the rest of the family, other private health insurance companies won't take the rest of the family without the student signing up as well but the student's school doesn't usually let him or her opt-out of the school's insurance, the goverment run health insurance programs don't take the family because being here for 5 years on a student visa makes them "visitors" and thus ineligible. One affordable but risky option for a healthy family seems to be to not have health insurance and pay for all medical care directly, plus pay the fine for not having the mandatory health insurance --it is a small fraction of the cost of the health insurance.