Examines Medicare Part D enrollment rates in rural and urban areas and the resulting impact on rural beneficiaries' overall prescription drug coverage rates.

Key Findings:

• Overall Medicare Part D enrollment rates increased from 55.5% in 2006, the first year of the program, to 61.4% in 2009. Annual increases were between 1 and 5 percentage points.
• Rural Part D enrollment rates consistently lagged behind urban rates by 2 to 4 percentage points, increasing from 53.7% in 2006 to 58.6% in 2009, compared to urban rates increasing from 56.0% to 62.3%, respectively.
• Geographic disparities in prescription coverage have greatly diminished over time: by 2009, prescription drug coverage rates topped 90% in both rural and urban areas. Rates of continuous uninsurance are approaching all-time lows of 7% in rural areas and 4% in urban areas.
• Independent of geographic location, there is strong evidence of less-healthy beneficiaries enrolling in the Part D program, and no evidence of the Part D program crowding out private prescription drug coverage.