Availability of services and cost of care affect health seeking behaviors and access to health care. Better understanding of health care service utilization is important for formulation of realistic policies and will be critical in order to deliver health programs which can be accessed by the whole population. This study is to explore LMC Sri Lankans experiences with respect to health care utilization and identify treatment seeking behaviors. Five health seeking behavior patterns emerged; ‘self care’, ‘use of allopathic treatments for moderate acute illnesses’, ‘mixed use of public-private services to manage chronic conditions’, ‘hospitalization for severe acute conditions’ and ‘looking after elderly at home and provision of palliative care from home’. A main finding was that there was a high level of trust and satisfaction towards the public hospitals despite service provision failures. Public health care was not always free as patients required to purchase services and/or supplies. Patients often used a mixture of public and private services. The women in the family act as gatekeepers and primary caregivers, playing a major role in influencing health seeking behaviors.