The National Health Insurance Scheme (NHIS) in Ghana has been in operation since 2005 as a nationwide health financing option in the form of District Mutual Health Insurance Schemes. With the Kwabre District Mutual Health Insurance Scheme as a case study the study sought to assess; households level of satisfaction, challenges affecting the scheme, the scheme’s sustainability prospects and make recommendations to inform policy. Primary data were obtained through a household sample of 203, which was distributed through a proportionate stratified sampling technique. Interview guides were used to obtain information from 12 accredited health service providers and the scheme management. Secondary data were also acquired from the Kwabre East District Health Directorate (DHD) and the scheme’s management office. Data analysis indicated that, the scheme is substantially dependent on tax funding (93.5%). Everybody pays for the scheme through taxation (NHIL) but unfortunately the scheme excludes over 72.1% of the population it covers. There is a low internal fund generation as a factor of excessive disenrollment resulting from membership non-renewal. Based on this premise, the scheme may not be sustainable in the long run as a Mutual Health Insurance Scheme since the schemes are dependent on the collective pool of resources. It is recommended that Government should boldly implement the one-time premium on a progressive and reasonable premium affordable to all. Conscious efforts should thus be geared towards improving revenue collection from premiums through education, enforcement of subscription renewal and introduction of copayment.