This paper report findings from analysis of the Centers for Medicare and Medicaid Services data to examine the trends and geographic variations in Medicare Advantage (MA) plan enrollment, premiums and market concentration by firm. MA enrollment in rural areas remains strong and continues to grow in 2011, despite the recent shift in enrollment from private fee-for-service plans to preferred provider organization plans. The data presented in this policy brief provide an overview of the Medicare Advantage program in rural America and highlight key rural/urban differences within the program.