Introduction: The patient's perception of quality of care is fundamental to utilization of health services. Health utilization would partly depend on clients' perception of the quality of care. Methods: A cross-sectional study involving health clients (18 to 70 years) who accessed health services in the Bantama sub-metro in the Kumasi metropolis was conducted. A total of 400 clients were recruited from ten health facilities for the study. Data was collected through interviewing using semi-structured questionnaires using SPSS and analyzed into descriptive and inferential statistics with STATA 11. Results: Majority of subscribers assessed healthcare with their National Health Insurance (NHI) cards. Eight percent (8%) had never accessed healthcare with their NHIS cards. Respondents' reasons included not falling sick and low quality of healthcare under the NHIS. Respondents 216 (54%) indicated delays in seeing a doctor, getting laboratories done, and accessing health care as a whole. Seventy-four percent (74%) of the entire population attributed both NHIS and cash and carry systems as the payment methods associated with delays in health facilities. Clients who viewed the overall the quality of health provision as good or very good were more likely to access healthcare with NHIS card as compared to those who rated the overall health provision as poor or very poor (OR=2.1; p<0.01). Conclusion: Clients' perceptions and experiences with quality of health provision influence their utilization of healthcare under the NHIS scheme. Increased enrolment in the scheme should be supported with provision of quality services to enhance clients' satisfaction.