Enrollment of rural beneficiaries into Medicare Advantage (MA) plans has more than quadrupled since the inception of the MA program at the beginning of 2006 and increased 35% in the last year. However, as a percent of all beneficiaries, the enrollment rate in rural areas remains well below the national enrollment rate. The tremendous growth in rural MA plans over the past two and a half years is mostly attributed to the spread of private fee-for-service plans across the country, which now account for 58% of rural Medicare eligibles. This policy brief provides findings about enrollment in the MA program in rural areas and across the United States and updates findings from analysis of the MA program presented in previous RUPRI Center policy briefs. Funded by the Office of Rural Health Policy: Cooperative Agreement for Rapid Response to Issue-Specific Rural Research.