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US Counties With the Lowest Medicare Spending per Enrollee

3,143 US counties ranked by Medicare spending per enrollee, from lowest to highest. First are Copper River Census Area, AK (5,333), Judith Basin County, MT (5,754) and Denali Borough, AK (5,917). The middle one of the 3,143 has 11,477.

What this measures

What Medicare spent per person in a year, for people in traditional Medicare, where Medicare pays each doctor and hospital bill itself. Medicare pays more for the same care where wages and rents are high. This figure takes those price gaps out, so it shows how much care people used, not what it cost locally. It is not adjusted for how sick people are. It leaves out people in private Medicare Advantage plans. Source: CMS Medicare Geographic Variation Public Use File.

For most measures, a national ranking mostly sorts places by income and by how urban they are. Each county’s own page compares it with the 50 counties most like it instead, which is often the fairer view.

The 100 lowest counties

RankCountyUS$ per enrollee
1Copper River Census Area, AK5,333
2Judith Basin County, MT5,754
3Denali Borough, AK5,917
4Yakutat City and Borough, AK6,205
5Arthur County, NE6,331
6Southeast Fairbanks Census Area, AK6,465
7Boundary County, ID6,576
8Hanson County, SD6,656
9Powder River County, MT6,712
10Billings County, ND6,729
11San Miguel County, CO6,774
12Saguache County, CO6,875
13Fairbanks North Star Borough, AK7,065
14Rich County, UT7,086
15Harding County, SD7,125
16Torrance County, NM7,324
17Catron County, NM7,369
18Hawaii County, HI7,474
19Kauai County, HI7,492
20Sheridan County, WY7,495
21King County, TX7,540
22Sanders County, MT7,718
23Fergus County, MT7,747
24Hayes County, NE7,786
25Adams County, ID7,801
26Archuleta County, CO7,810
27Jackson County, CO7,847
28Clark County, SD7,868
29Emmons County, ND7,870
30Maui County, HI7,870
31Stevens County, WA7,870
32Aleutians East Borough, AK7,913
33Bonner County, ID7,915
34Lyman County, SD7,921
35Kusilvak Census Area, AK7,960
36Ontonagon County, MI7,965
37Idaho County, ID7,977
38Skagway Municipality, AK8,021
39Hood River County, OR8,048
40Garfield County, MT8,054
41Gilliam County, OR8,073
42Benton County, OR8,116
43Bethel Census Area, AK8,116
44Aleutians West Census Area, AK8,126
45Jones County, SD8,127
46Routt County, CO8,133
47Ouray County, CO8,140
48Custer County, ID8,142
49Johnson County, WY8,158
50Wasco County, OR8,170
51Baker County, OR8,175
52Presidio County, TX8,197
53Rio Arriba County, NM8,198
54Tillamook County, OR8,208
55Pend Oreille County, WA8,214
56Douglas County, OR8,215
57Jefferson County, MT8,234
58Sherman County, OR8,241
59Humboldt County, CA8,256
60Brewster County, TX8,265
61Klamath County, OR8,265
62Grand Isle County, VT8,271
63Highland County, VA8,278
64Huerfano County, CO8,284
65Park County, CO8,284
66Essex County, VT8,314
67Island County, WA8,370
68Klickitat County, WA8,377
69Greenlee County, AZ8,378
70Summit County, CO8,381
71Flathead County, MT8,384
72Santa Fe County, NM8,385
73Bayfield County, WI8,388
74Siskiyou County, CA8,402
75Sanborn County, SD8,402
76Colfax County, NM8,403
77Clallam County, WA8,406
78Mora County, NM8,406
79Teton County, WY8,407
80Taos County, NM8,416
81Carbon County, MT8,438
82Santa Cruz County, AZ8,441
83Grand County, UT8,448
84Del Norte County, CA8,451
85Las Animas County, CO8,463
86Lewis and Clark County, MT8,474
87Sweetwater County, WY8,482
88Montrose County, CO8,484
89Norton city, VA8,496
90Green County, WI8,501
91Lincoln County, OR8,505
92McHenry County, ND8,509
93San Juan County, CO8,511
94Columbia County, OR8,513
95Owyhee County, ID8,516
96Lincoln County, MT8,521
97Los Alamos County, NM8,527
98Toole County, MT8,528
99Houghton County, MI8,541
100Campbell County, SD8,556

Every state, lowest first

Each state’s own published figure, not an average of its counties.

RankStateUS$ per enrollee
1Puerto Rico6,359
2Hawaii8,203
3Oregon9,019
4Alaska9,082
5Montana9,198
6Vermont9,315
7Washington9,433
8Wyoming9,761
9New Mexico9,793
10Maine9,841
11Idaho9,990
12New Hampshire10,026
13Wisconsin10,415
14North Dakota10,602
15Colorado10,671
16South Dakota10,700
17Iowa10,707
18Virginia10,774
19North Carolina10,891
20Minnesota11,172
21Rhode Island11,224
22West Virginia11,334
23Utah11,400
24Ohio11,456
25South Carolina11,478
26Nebraska11,556
27District of Columbia11,652
28Pennsylvania11,693
29Massachusetts11,729
30Tennessee11,777
31Michigan11,780
32Georgia11,788
33Arizona11,790
34Delaware11,811
35Maryland11,852
36Kentucky11,853
37Missouri11,954
38Indiana12,043
39Arkansas12,120
40California12,125
41Nevada12,325
42Kansas12,390
43Illinois12,444
44Connecticut12,480
45New York12,606
46Alabama12,787
47New Jersey12,837
48Texas13,288
49Mississippi13,474
50Florida13,686
51Oklahoma13,690
52Louisiana13,805

More on Medicare spending per enrollee

A ranking describes places, not the people in them, and a high or low place does not by itself say why. All US rankings.