This study investigates the determinants of healthcare access and the effectiveness of government health schemes in a selected region of Belagavi district, with a focus on both financial protection and infrastructural availability. Using primary household survey data, we examine scheme awareness, enrolment, and utilization, as well as multidimensional health infrastructure, including proximity to facilities, availability of doctors and medicines, and transport access. Logistic regression analysis reveals that poverty status alone does not significantly predict receipt of government health benefits; enrolment emerges as the strongest determinant. A composite Health Infrastructure Index, analyzed through multinomial logistic regression, shows that distance to facilities, mode of transport, and rural residence significantly influence access, whereas income has a limited effect once infrastructural factors are considered. COVID-19-related disruptions further highlight vulnerabilities in service delivery and transport connectivity. Findings indicate that healthcare inequalities are primarily driven by spatial and administrative barriers rather than economic status alone. Policy recommendations emphasize simplifying enrolment procedures, enhancing awareness campaigns, and strengthening rural healthcare infrastructure to achieve equitable access and effective financial protection.