Rural-Urban Differences in Medicare Supplemental Insurance Coverage

Medicare beneficiaries often seek supplemental coverage to reduce out-of-pocket costs and improve access to care. Coverage options include employer-sponsored plans, Medigap, Medicaid for dual eligibles, or Medicare Advantage (MA). Historically, rural beneficiaries have been less likely to enroll in MA or have employer-sponsored coverage, relying more on Medigap, Medicaid, or Fee-for-Service (FFS) alone. Using the Medicare Beneficiary Survey, this project examines current rural-urban differences and trends in supplemental coverage from 2015-2024. Specific research objectives include:

1. Compare rural and urban Medicare beneficiaries' sources of supplemental coverage (MA, employer, Medigap, Medicaid/dual, other, or FFS only).
2. Assess how rural-urban differences in coverage types have evolved over time.
3. Identify demographic and health-related factors explaining these differences across coverage groups and between MA vs. FFS.

Findings will inform policymakers and stakeholders about geographic differences in Medicare coverage, supporting efforts to improve access for rural populations.