Out of pocket expenditures always have devastating effects on families, more so those living beneath the poverty line. One way of mitigating this is by using health insurance. The Kitui County Government introduced a low-cost insurance scheme called the Kitui County Health Insurance Cover (KCHIC). Primary aim of this research work was to investigate the factors influencing uptake of Kitui County health Insurance Cover case of Kitui County, Kenya. A sample size of 357 households out of 96,653 registered households. Questionnaires were used to collect data. These instruments were piloted at Makueni County with a sample of 35 respondents which is a 10% representation of the sample of study which was 357. Data collection for this study was done in two months’ time in the 14 hospitals in Kitui County. Statistical Package for Social Science (SPSS) was used for data analysis. The study employed a probit model to answer the main research objective and found out that some factors were significant, whereas others were established to be statistically insignificant in explaining Kitui County Health Insurance uptake. The study noted that 50.98% of females had taken up health cover in comparison to 49.02% males. The married had a higher enrolment of 247 (69.19%) than unmarried 110 (30.81%), education level was important influencing factor in decision to register for the health cover (registration for those with higher income and the ones affiliated to social welfare groupings). Policy recommendations include; the County ought to consider letting workers from the informal sectors remit their premiums in small and manageable installments instead of insistence on remittance monthly, quarterly, semi-annually or annually. The government at both tiers needs to consider subsidizing or pay premiums for the family who are very poor, those elderly as well as disabled, who in most cases are never considered in the Social Security Programs. With this, the two levels of government can adopt it as a strategy to reduce poverty as they increase access to quality health care. Offering more health-related services improves or incentivizes individual to enroll for a health insurance package. Therefore, it requires the hospital management to introduce new services that were not previously done at their health facilities. This study recommended further research to investigate influence of religion and culture on registration or uptake decision, level of adversative selection in registration as well as the level of adversative registration selection and retention factors or insurance scheme drop out.

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