As new graduates revel in their academic accomplishments - and start planning for their first jobs - a major financial and health decision is brewing.

What will the former students do about health insurance?

Many students may no longer be eligible for coverage under their parents' health insurance plan upon graduation.

Graduates who don't get a job immediately won't have access to employer-sponsored health insurance.

Or they'll get a job that does offer health insurance but might opt not to take it.

Whatever the situation, students and their parents should make moves to address this important decision.

Young adults are the largest and fastest growing group of uninsured people, risking significant financial hardship should they get seriously sick or hurt.

In upstate New York, 44 percent of unemployed young adults (age 18 to 24) are uninsured. Even young adults who work full-time face an uninsured rate of 36 percent, according to “Health Coverage Among Upstate New Yorkers, 2000-2005,” a recent report by Excellus BlueCross BlueShield.

Here are some health insurance tips for new graduates and their parents:

€ Parents should check their health insurance contract to see how much longer their son/daughter will be covered by their policy.

Recent college graduates may no longer be eligible for coverage as dependents (eligibility varies by plan type and contract).

€ Young adults picking a health plan for the first time shouldn't make a decision based solely on the plan's premium. Consider other health plan features, such as deductibles, coinsurance, copayments, etc.

€ Government-sponsored programs such as Family Health Plus and Healthy New York might be an option for young adults who can't afford or don't have access to employer-sponsored health coverage.

€ Young adults offered health insurance by an employer should seriously weigh their decision.

“Young invincible” is an often-used term for young adults who opt out of health insurance because they are young, healthy and don't think they need coverage.

Nationally, almost 14 million 19- to 29-year-olds lack health insurance and are uninsured at twice the rate of adults age 30 to 64, according to a Commonwealth Fund report, “Rite of Passage? Why Young Adults Become Uninsured.”

According to the report, 57 percent of the young and uninsured said they have gone without needed care (prescriptions, doctor visits, etc.) because of cost, and 46 percent said they were having trouble paying medical bills.

New graduates who tackle the health insurance question now will hopefully avoid such problems in the future.

James R. Smith is the regional president of Excellus BlueCross BlueShield.