Rural Medicare Advantage (MA) and other prepaid plan enrollment in March 2014 was nearly 1.95 million, or 20.3 percent of all rural Medicare beneficiaries, an increase of more than 216,000 from March 2013. Enrollment increased to 1.99 million (20.4 percent) in October 2014. MA enrollment increased in both rural and urban areas despite reductions in payment and the conclusion of the MA bonus payment demonstration at the end of 2014.

Some rural counties were reclassified, due to a change in population, and nearly 10 percent of the previously rural MA population is now considered urban; however, the percentage of the rural Medicare beneficiaries enrolled in MA did not change significantly. The majority of growth in rural MA enrollment was in Preferred Provider Organization plans, with over 56 percent of enrollment, while nearly a third of beneficiaries were enrolled in Health Maintenance Organization plans.