Rural-Urban Differences in Barriers to Care and Utilization of Preventive Care Among Traditional Medicare and Medicare Advantage Beneficiaries

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11/2025

This policy brief examined rural and urban differences in barriers to care and use of preventive care services among enrollees in traditional Medicare and Medicare Advantage. Medicare Current Beneficiary Survey data was used to examine barriers to care, such as out of pocket costs, and utilization measures, such as flu shots and cholesterol tests, comparing rural and urban Medicare Advantage enrollees, rural and urban traditional Medicare enrollees, and rural traditional and Medicare Advantage enrollees.

Key Findings:

• Rural Medicare Advantage enrollees faced more barriers in accessing health services due to cost, compared to their urban counterparts and to all traditional Medicare enrollees, urban and rural.
• A lower proportion of rural enrollees in both traditional Medicare and Medicare Advantage received a flu shot compared to their urban counterparts.
• Female traditional Medicare enrollees living in rural areas were the least likely to utilize health care services compared to both their urban counterparts and Medicare Advantage enrollees.

RUPRI Center for Rural Health Policy Analysis

Gawain Williams, Dan Shane, Whitney Zahnd, Keith Mueller

Health services, Healthcare access, Medicare, Medicare Advantage (MA)