While there are fewer rural residents enrolled in Medicare Advantage plans than micropolitan or metropolitan residents, MA enrollment in rural areas is growing much more rapidly, new research shows.
The KFF report, published Thursday, defines rural areas as having less than 10,000 people, micropolitan areas as having 10,000 to 50,000 people and metropolitan areas as having at least 50,000 people. The findings come when Medicare Advantage growth overall is on the rise, accounting for more than half of eligible Medicare beneficiaries in 2023.
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According to the report:
- In rural areas, the share of eligible beneficiaries enrolled in MA plans nearly quadrupled from 11% in 2010 to 40% in 2023. This represents 400,000 rural MA beneficiaries in 2010 and 1.8 million in 2023.
- In micropolitan areas, the share of eligible beneficiaries enrolled in MA plans nearly tripled from 15% in 2010 to 44% in 2023. This represents 700,000 micropolitan MA beneficiaries in 2010 and 2.6 million in 2023.
- In metropolitan areas, the share of eligible beneficiaries enrolled in MA plans nearly doubled from 27% in 2010 to 53% in 2023. This represents 9.7 million metropolitan MA beneficiaries in 2010 and 26.3 million in 2023.
“Despite recent growth, Medicare Advantage enrollment in rural areas remains lower than enrollment in more populated areas,” KFF said. “This could be the result of fewer investments in marketing and outreach in these areas by Medicare Advantage insurers, because financial returns are lower given the smaller population of potential enrollees.”
KFF also discovered that the average Medicare beneficiary living in a rural community has a selection of 27 MA plans to choose from, up from 19 in 2010. Micropolitan residents have 31 plans to choose from in 2023, versus 21 in 2010. Metropolitan residents have 46 plans to choose from in 2023, compared to 32 in 2010.
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In 2023, rural residents can choose from MA plans across six firms, the same as micropolitan residents. Metropolitan residents have 10 firms to choose from. This is not much of a difference from 2010, when rural residents and micropolitan residents also had a selection from six firms and metropolitan residents had a selection from eight firms. However, from 2011 to 2018, rural residents and micropolitan residents could choose from plans across three firms and metropolitan residents could choose from plans across six firms.
About 69% of rural MA beneficiaries are in a plan that requires no premium other than the Part B premium, versus 66% of micropolitan enrollees and 75% of metropolitan enrollees, KFF also found.
The researchers added that with MA enrollment increasing, “understanding how plans differ across metropolitan, micropolitan and rural areas will be increasingly relevant to assessing how well private plans meet the needs of their enrollees.”
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