Purpose: This study examined patient satisfaction under Ghana’s National Health Insurance Scheme (NHIS) by exploring service quality, perceived value, and access barriers in selected healthcare facilities in Accra.

Methodology/Design: A qualitative approach was used, adopting a descriptive phenomenological design. Data were collected through semi structured interviews with 30 NHIS beneficiaries selected using purposive sampling. The data were analysed using thematic analysis to identify key patterns and experiences.

Findings: The results showed that patient satisfaction was influenced by waiting time, staff attitude, and availability of medicines. Long delays and overcrowding reduced perceived service quality, while inconsistent provider behavior affected patient experience. Although NHIS reduced financial burden, perceived value declined when patients made additional payments for drugs and services. Access barriers such as staff shortages, medicine unavailability, and indirect costs like time and transport further limited effective use of services and reduced satisfaction.

Implications: The study highlights the need for improved healthcare delivery, better resource availability, and stronger patient centered practices to enhance satisfaction under NHIS. Policymakers and healthcare managers must address both service quality and access challenges.