The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 created the Medicare Part D outpatient prescription drug program allowing Medicare beneficiaries to add prescription drugs to their Medicare coverage. Within Medicare, beneficiaries can select either a stand-alone Part D Plan (PDP) or Medicare Advantage plan that provides prescription drug coverage (MA-PD plan). Those plans offer an array of payment options and provided benefits. PDPs must offer the same design throughout the region in which they operate so minimal differences across types of counties were found. MA-PD plans were offered in lower numbers in noncore counties (compared to metropolitan and micropolitan counties), were found to have higher monthly premiums, and were less likely to offer enhanced benefits. Of most concern, the brief shows that 10.6% of noncore counties have no MA-PD plans available, and 8.7% have only one plan offered.