Understanding Internet Options for Rural Areas
Access to reliable high-speed Internet is missing from too many rural communities. And that limits access to essential healthcare services, which impacts patient care. It also plays a key role in connecting underserved communities to essential other resources and opportunities. But major Internet service providers (ISPs) are expanding to bring internet options to rural Americans. Options include mobile and fixed broadband, satellite, DSL, cable, and fiber.
This article looks at Internet options for rural areas, the types of connections available, top providers to consider, and how you can start (or improve) connectivity for your rural healthcare practice or facility.
The Challenge of Getting High-Speed Internet in Rural Areas
Rural America faces unique challenges with internet connectivity, including slower speeds, limited options, and higher costs. In March of 2025, the Federal Communications Commission reported that 45 million Americans still didn’t have access to a quality rural internet option. And most of those Americans were in rural areas. Infrastructure gaps, low population density, and economics create barriers to providing service.
Infrastructure Gaps
According to the Pew Research Center’s Americans’ Use of Mobile Technology and Home Broadband, rural residents are less likely than urban ones to have access to home broadband. The availability and cost of internet options in rural areas are often dependent on existing infrastructure. Deploying fiber, that offers the most reliable Internet connection needed by healthcare organizations, is especially costly in remote places. Large distances between locations and uneven terrain increase the cost of laying and maintaining equipment.
The demand for high upfront investment makes it hard for providers to justify expanding into sparsely-populated regions.
For more information on broadband availability, see https://broadbandmap.fcc.gov/home.
Economic and Market Constraints
The National Telecommunications and Information Administration (NTIA) notes that deploying affordable broadband to unserved and underserved locations is often challenging due to the economics. Because homes are spread out and demand is lower, providers face higher costs per connection for trenching, cabling, and “middle‑mile” linkages in rural areas.
One industry commentary estimates that the total cost to connect all rural Americans could reach $150 billion or more. And for many providers, there’s often not enough demand in rural areas to cover the cost of building the network.
Availability, Cost, and Choice
As a result of the challenges faced by ISPs, many rural areas have only one or two broadband options, reducing competition and slowing innovation. And even when infrastructure exists, performance often lags.
Cost is also a major barrier. Pew Research Center’s data shows that offline rural households are willing to pay around $10 per month. While the average U.S. broadband bill is usually between $50 and $70 with taxes and fees included.
Why Patient Care Requires Internet Options for Rural Areas
For healthcare providers, connectivity powers the system tools that define modern medicine, such as an EHR, especially cloud-based systems, HIEs, telehealth, remote patient monitoring (RPM), clinically integrated networks (CINs), and virtual consults. In rural settings, not having a reliable Internet connection limits access to key services and tools from record‑keeping to patient communication. See The Definitive Guide to Rural Healthcare for insights on rural healthcare challenges and opportunities.
Cloud‑Based EHRs
Leading electronic health record (EHR) systems, such as the Hospital EHR and Ambulatory EHR from Azalea Health, operate entirely in the cloud. This requires dependable Internet service to consistently access patient data, imaging, and laboratory results in real time. Without adequate connectivity, clinical workflows can take longer, which jeopardizes both efficiency and patient outcomes.
Health Information Exchanges (HIEs)
Sharing patient records, imaging, and referrals across multiple providers depends on broadband infrastructure. With sufficient Internet bandwidth, rural healthcare workers have timely access to vital patient information needed for coordinated care.
Telehealth and Virtual Consultations
Telehealth has become a lifeline for rural healthcare. Data from OCHIN on video versus audio telehealth showed that rural patients continue to use telehealth services as much as 5 times more than urban patients. Providers use it to connect with patients, connect patients with distant specialists, reduce unnecessary transfers, and expand access to care across distances that once made it impractical.
Remote Patient Monitoring (RPM) and Clinically Integrated Networks (CINs)
RPM systems and clinically integrated networks rely on stable Internet to transmit patient data. CINs create a network of doctors, clinics, and hospitals that provide integrated care and negotiate for better reimbursements.
Without reliable connectivity, data sharing and remote collaboration needed for continuity of care also falters. Devices may fail to report, alerts may be delayed, and clinicians lose real‑time visibility into patient status.
Patient Portals and Engagement Tools
Digital engagement tools empower patients to take ownership of their health by checking results, messaging providers, and managing appointments online. But without consistent broadband performance, patient portals become frustrating or unusable. Connectivity affects patient participation and can shape how rural populations interact — or don’t interact — with their care providers.
Put simply: the ability of a rural healthcare organization to adopt and sustain modern care models relies on the quality and availability of Internet options for rural areas.
How Rural Healthcare Providers Can Access Internet Options
Several programs exist that help rural providers bridge the digital divide. These initiatives reduce costs, fund infrastructure, and promote sustainable connectivity across underserved communities.
The Healthcare Connect Fund (HCF) Program
The Healthcare Connect Fund is managed by the Universal Service Administrative Company for the Federal Communications Commission. The fund offers a 65% discount on eligible broadband expenses for rural healthcare providers. It covers both recurring and non‑recurring costs for broadband services, dark fiber leases, and network equipment essential to care delivery.
Eligibility: The site must be a public or non‑profit healthcare facility, such as a rural health clinic (RHC), community health center, or not‑for‑profit hospital. Facilities must also be located in an FCC‑defined rural area. Non‑rural sites can participate if the majority of locations served are rural.
Purpose: To support the essential connectivity services that drive modern healthcare. Everything from EHR access to telehealth consults and remote diagnostics.
The Distance Learning & Telemedicine (DLT) Grant Program
The USDA’s Distance Learning & Telemedicine (DLT) Grant Program helps rural communities use telecommunications technology to enhance healthcare and education. Typical awards range from $50,000 to $1 million, depending on project scope. Matching funds of at least 15% are required and must come from non‑federal sources.
Eligible uses: Broadband facilities, interactive video systems, software, and networking equipment that enable distance learning or telemedicine in communities with populations of less than 20,000. The program’s goal is to connect rural providers and patients to the same digital tools available elsewhere.
State, Local, and Private Initiatives
Beyond federal funding, many states and private foundations offer additional assistance. State teleconnect funds (like California’s Teleconnect Fund) help subsidize broadband services for eligible rural health organizations. Foundations also play an active role, investing in projects that improve digital access and healthcare infrastructure across underserved regions.
How to find opportunities:
- Contact your State Office of Rural Health (SORH): They often maintain updated lists of grants, state teleconnect programs, and local broadband initiatives.
- Visit state and local government websites: Many states have broadband offices or telehealth programs that publicize funding and partnership opportunities.
- Reach out to foundations and nonprofits: Those focused on healthcare, digital equity, or rural development may provide grants, technical assistance, or pilot programs.
- Check out the How to Navigate Rural Healthcare Grants in 2026 webinar.
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Available Internet Options for Rural Areas
There’s no one‑size‑fits‑all solution for rural connectivity. Each option has its strengths, limitations, and ideal use cases depending on location, population, and existing infrastructure. Here are the most common options for connectivity in rural areas.
Mobile Broadband (4G/5G Home Internet)
Mobile broadband uses cellular networks to deliver home Internet via a modem or gateway. It’s easy to install and increasingly available in smaller towns. Some popular examples include Straight Talk and T‑Mobile, which have expanded coverage, offering download speeds between 20 and 200 Mbps on 5G and 4G LTE networks.
For small clinics or home-based providers, this can be a quick and affordable option. The setup is easy and offers moderately faster speeds for cloud EMR access, basic telehealth, and routine administrative work. Ideal as a backup solution when your main ISP becomes unavailable.
Fixed Broadband Internet (Fixed Wireless Internet)
Fixed wireless connects homes via a small antenna that communicates with a nearby tower. It’s often faster than DSL and doesn’t require running cables to each address. It’s a viable alternative in many rural areas. Does require a clear line of sight (between the antenna and the tower) and can be affected by distance, weather, or terrain.
Consider a fixed wireless set up if your clinic needs more speed than DSL for telehealth video calls and EMR systems. Ask your ISP to confirm that your location has a clear line of sight to ensure consistent performance.
DSL (Digital Subscriber Line)
DSL uses existing copper telephone lines to deliver Internet service. It remains one of the most widely available rural options because the connection runs through existing landline equipment. Still, speeds are generally lower, and performance decreases with distance from network hubs.
A DSL set up can work for rural solo practices or small care offices where reliability matters more than speed and where only lightweight EMR use or simple telehealth is needed. Providers, such as Windstream, offer DSL in many rural areas.
Satellite Internet
Satellite service delivers Internet via a dish that connects to orbiting satellites, offering coverage across almost all of the U.S., including remote locations. Performance for this type of connection varies. Advanced satellites. like Starlink, may be good for healthcare providers in highly remote areas that need a stable connection to support telehealth and EMR use.
Satellite Internet has higher latency due to long signal distance. It’s ideal for non-real-time tasks or if you have no other options.
Cable and Fiber
Cable Internet operates through coaxial cables, where fiber Internet uses optical fibers that offer gigabit speeds. Both provide fast, dependable connections. Typically, they’re the fastest options if available. In rural areas though, their availability is often limited due to expensive infrastructure needs.
Hospitals, urgent care centers, and technologically integrated clinics in rural areas will do best with cable or fiber connectivity. IThey offer high-bandwidth and low-latency connectivity, which is ideal for telehealth, large EHR workloads, digital imaging, and multiple users at once.
Providers That Offer Internet Access in Rural Areas
Here are some of the major ISPs serving rural markets, along with their primary connection types and key considerations. Availability and performance vary by ZIP code, so check with the ISP to make sure that your location is covered by their service.
Viasat
Viasat offers satellite Internet with coverage across nearly 100% of the U.S. Plans range from 25 to 150 Mbps depending on location. As with all satellite services, latency and potential data caps (usage limit) are considerations, but Viasat’s reach makes it accessible even in remote regions.
HughesNet
Another leading satellite provider, HughesNet, markets itself as “available where you live,” including areas far beyond cable or fiber reach. Speeds average around 100 Mbps, though latency and pricing vary with location and weather.
Providers like Viasat and HughesNet offer plans up to 150 Mbps in some areas and cover almost all rural areas. However, latency is higher due to the long signal distance, and plans often come with data caps or higher costs compared to wired alternatives
Starlink
Operated by SpaceX, Starlink uses low‑Earth‑orbit satellites to deliver high-speed Internet with lower latency than traditional satellite systems. Availability now spans most of the U.S., providing unlimited data in many regions. While promising, performance can vary and may not meet federal speed benchmarks in extremely remote areas.
Performance depends on tower proximity and signal strength, and some plans may include data caps or deprioritization during congestion.
EarthLink
EarthLink combines wireless and satellite technologies to serve roughly 96% of U.S. homes. Exact connection types depend on local infrastructure and tower proximity, so checking coverage for your specific address is important.
CenturyLink
CenturyLink provides DSL and fixed wireless in rural areas and focuses on underserved communities. Fixed wireless requires a clear path to a nearby tower, while DSL speeds are limited by distance. Still, these options offer a bridge for clinics and hospitals not yet covered by fiber or cable.
T‑Mobile and Verizon (5G/4G Home Internet)
Both carriers are expanding mobile broadband options into rural markets. Their home‑Internet offerings use 4G LTE and 5G networks to deliver wireless connectivity. Availability depends on infrastructure. So while coverage continues to grow and ISPs may list your address among their covered locations, tower distance and heavy network traffic can affect speeds and latency in less populated areas.
Steps Toward Better Connectivity
With reliable Internet essential to modern healthcare, taking a proactive role in improving access matters more than ever. Here are 5 steps to help you begin improving Internet connectivity in your area.
- Evaluate and determine your current internet speeds, bandwidth usage, and number of connected devices.
- Research local availability using tools like the FCC Broadband Map to identify providers and technologies, such as fiber, fixed wireless, satellite, or mobile broadband.
- Explore eligibility for programs. such as HCF or DLT, noting deadlines and matching‑fund requirements.
- Compare providers carefully by reviewing their speed tiers, latency (the delay when you click something online), reliability, and service agreements.
Plan for growth and anticipate future bandwidth needs as telehealth and remote monitoring expand.
The Path Forward
For rural healthcare organizations, reliable Internet connectivity is essential in adopting modern care delivery models (telehealth, cloud‑based EHRs, remote patient monitoring, and patient engagement). And while challenges remain, Internet options for rural areas have expanded. Mobile broadband, fixed wireless, satellite, DSL, and fiber connectivity are all helping close the gap.
The way ahead is clear: evaluate your existing internet connectivity, verify local service providers, investigate funding options, and choose a solution that fits your current and future needs. Also assess rural Internet service providers by important performance indicators, such as download and upload speeds, latency, data usage caps, service agreements, and long-term growth potential.
By establishing the right partnerships and planning, rural healthcare organizations can provide excellent, connected care to all your providers and patients.
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