Abstract: The difficulties often encountered in out-of-pocket financing of health has compelled introduction of pre-paid health insurance in many developing countries. This study assessed rural households access to health facilities and their willingness to pay for the National Health Insurance Scheme (NHIS) that was implemented by the Nigerian government. Data were collected from 102 rural households from some villages using the multi-stage stratified random sampling. The descriptive and Probit regression methods were used. Results show that general ratings of the conditions of health facilities were very poor and awareness about NHIS is very low. Willingness to participate in the scheme is explained by amount able to pay, frequency of illness, workability and coverage of the scheme (p<0.10). The study concluded that NHIS will improve access of rural households to quality health services, but issues of awareness and proper design to ensure workability and higher coverage should be considered.