Rural-Urban Enrollment in Part D Prescription Drug Plans: June 2017 Update.

Area of Science:

• Health Services Research
• Public Health
• Health Policy

Background:

• Medicare Part D prescription drug coverage is crucial for beneficiaries.
• Historically, rural Medicare beneficiaries have shown lower enrollment rates in Part D compared to urban counterparts.
• Enrollment patterns differ significantly between rural and urban populations, particularly concerning standalone Prescription Drug Plans (PDPs) versus Medicare Advantage with Prescription Drug (MA-PD) plans.

Purpose of the Study:

• To update previous analyses on the rural-urban enrollment differential in Medicare Part D.
• To examine state-to-state variations in enrollment within PDP and MA-PD plans based on rural-urban residence.

Main Methods:

• Analysis of Medicare Part D enrollment data.
• Comparison of enrollment proportions between rural and urban beneficiaries.
• Examination of plan type preferences (PDP vs. MA-PD) in rural versus urban settings.

Main Results:

• As of June 2017, over 72% of eligible Medicare beneficiaries were enrolled in Part D plans, up from 55.6% in December 2008.
• Despite overall growth, rural Part D enrollment continues to lag behind urban enrollment.
• Rural enrollees disproportionately favor standalone PDPs, while urban enrollees are more likely to be in MA-PD plans. Rural participation in MA-PD plans has nearly doubled since 2008.

Conclusions:

• While Medicare Part D enrollment has grown substantially for both rural and urban beneficiaries, a persistent gap remains.
• The choice of plan type (PDP vs. MA-PD) shows a distinct rural-urban divide.
• Increased rural enrollment in MA-PD plans suggests a potential shift in preferences or increased availability of these plans in rural areas.