The RUPRI Center's annual analysis of Medicare Advantage (MA) enrollment shows that there are 2.6 million nonmetropolitan beneficiaries (24.6% of eligible nonmetropolitan beneficiaries) enrolled in an MA plan. The number of nonmetropolitan beneficiaries enrolled in an MA plan increased by 9.5% from 2017 to 2018. Nonmetropolitan MA enrollment remains significantly lower than metropolitan enrollment (24.6% v. 36.4%), but in 2017 the nonmetropolitan rate of growth in MA plan enrollment was higher than the rate of growth in metropolitan areas (4.7% v. 2.0%). Among MA plans, nonmetropolitan enrollment in private fee-for-service MA plans declined sharply between 2009 and 2018, while nonmetropolitan enrollment in health maintenance organizations and local preferred provider organizations saw significant increases.