This quantitative, nationally representative study will use the Medical Expenditure Panel Survey (MEPS) to examine health plan characteristics and out-of-pocket healthcare spending by non-elderly, community dwelling, rural and urban residents. Using bivariate and multivariable analyses, the study will examine the:

• Characteristics of private health insurance plans held by rural versus urban residents.
• Out-of-pocket costs, total premium, and spending for privately insured rural versus urban residents.
• Percentage of healthcare spending paid out-of-pocket by rural versus urban residents and whether there are differences in out-of-pocket spending for individuals with chronic or acute health conditions, by events, or socioeconomic characteristics.
• Differences in out-of-pocket spending by plan characteristics.
• Percentage of rural versus urban household income represented by out-of-pocket healthcare spending and whether this varies by socioeconomic and health plan characteristics.