Skip to Main Content

Survey Among Rural and Urban Medicare Beneficiaries Shows Similarities and Shared Potential

Differences between Medicare populations overshadowed by glaring parallels that point to possible improvements

Most people are quick to conclude that rural and urban communities are naturally different. Both environments embody different cultures that reinforce the dichotomy of rural versus urban healthcare. Yet, a recent survey of these populations found commonalities that suggest the old paradigm may be shifting among Medicare beneficiaries.

We commissioned an online survey of U.S. residents, age 65+ and enrolled in Medicare. Participation totaled 4,992 individuals between March 18 to April 5, 2021. The data was segmented by rural and urban beneficiaries. We defined rural and urban populations by zip code, according to the Federal Office of Rural Health Policy. The study examined access to health care, Medicare satisfaction and healthcare utilization.

Here’s what we found:

Original Medicare (Parts A and B) and Medicare Advantage (Part C) beneficiaries:

Different Settings, but Equally Engaged in their Health

Rural vs. Urban Medicare Enrollment

Rural landscape

67% vs. 33%

Original Medicare (Parts A & B) vs. Medicare Advantage

city landscape

58% vs. 42%

Original Medicare (Parts A & B) vs. Medicare Advantage


Regardless of where they live, or whether they had Original Medicare or Medicare Advantage:

flexing arm


Consider themselves to be in “good health” or better



Have a primary care physician



See their doctor at least once a year

hearbeat icon


Have taken the initiative to use at least one at-home health monitoring device

The data show that older adults aren’t just willing participants in their health; they’re actively working to maintain their “good health.”

Even though so many beneficiaries feel they’re in good health (or better), a few small changes could spark some significant improvements.

Somewhat lost in the broadly similar results were themes that, when examined further, seemed to show potential for improvement in several areas.

pie chart


say their doctor considers them overweight.


1/4th pie chart


of those said their doctor doesn’t discuss how their weight can impact their overall health.

3/4th pie chart


of all Medicare beneficiaries have access to video communication.


about half pie chart


had a telehealth visit in the past year.


telehealth icon


of those visits were first-time telehealth patients.

No matter where they live or what type of Medicare they have, plan confusion is still quite common.


Medicare Advantage beneficiaries said they were “very satisfied” with the plans available to them.


Original Medicare beneficiaries said they were “very satisfied” with the plans available to them.

half of people

Excluding those who said “I don’t know,” half of those on Original Medicare believe that Medicare Advantage “limits access to healthcare.”

6 in 7 people

Excluding those who said “I don’t know,” a majority of those on Medicare Advantage believe it “does not limit access to healthcare.”

pie chart

When asked why they chose their plan, the leading response among those on Original Medicare (26%) was,

“I paid Medicare/Social Security tax, so I chose the plan I paid for with my tax dollars.”

It shows a misunderstanding of how tax dollars fund Medicare, including the insurance companies that administer Medicare Advantage plans, not only Original Medicare.

These disparities highlight that these populations’ health can improve, and many Medicare beneficiaries can take active steps to make the most of local healthcare.

Medicare Advantage beneficiaries aren’t just aware of their benefits — they base their decisions on them.

Medicare Advantage enrollment has doubled over the past decade and remains a popular Medicare choice for millions of Americans. When asked why they chose Medicare Advantage over Original Medicare (Parts A and B), Part C beneficiaries pointed to features they felt were advantages over Original Medicare.


Said Medicare Advantage offered better overall costs than Original Medicare.


“I was able to get a Medicare Advantage plan with a $0 monthly premium.”


“I found a Medicare Advantage plan that included the best coverage/cost for specific prescriptions I need to take.”


“I wanted prescription drug coverage bundled under one plan.”


“I wanted vision, dental and/or hearing coverage included under one plan.”

United States of Medicare, GoHealth Report

Click here to read the full report, "United States of Medicare: Similarities and Shared Potential Among Rural and Urban Medicare Beneficiaries"

Download Report

Read the full report

Media Resources

Media Inquiries

Email our media relations team.

News Releases

The latest from GoHealth.
Read all news releases >