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Potential beneficiaries of health insurance schemes are convinced to enrol based on varied expectations and justifications. This is so for persons leaving with HIV/AIDS. Considering the myriad of challenges confronting these insurance schemes, the current study explored the views and lived experiences of HIV/AIDS patients on the challenges and influence of the National Health Insurance Scheme (NHIS) on healthcare service usage in Ghana. Using in-depth semi-structured interviews with 17 HIV/AIDS patients, the study revealed proactiveness and shift to modern healthcare usage as major influences of the NHIS on healthcare usage. The capitation policy, frequent drug shortage and health workers posture were identified as major hindrances to the successful implementation of the NHIS in Ghana. Also, it emerged that HIV/AIDS patients’ expectations prior to enrolment were not met as claimed by friends and family members. The findings suggest that some measures should be put in place to educate potential beneficiaries on the NHIS to ensure that their intentions of enrolment are realised.