This chapter provides a conceptual framework for understanding access to medical care and discusses many of the barriers faced by residents of rural communities. The sociodemographic characteristics of rural residents differ from those of urban populations in ways that may affect their need for medical care. A substantial body of research indicates that individuals without health insurance coverage are at substantially greater risk for poor medical care access and health outcomes. One of the more intractable access problems facing rural Americans is the relatively lower supply of medical care professionals practicing in rural versus urban settings. To address the shortage of health care professionals, the more limited financial resources of rural residents, and the geographic dispersion of rural populations, the federal government has implemented a number of programs aimed at improving access to rural medical care.