The new Rural Cooperative Medical Scheme (RCMS) was introduced in China to address the longstanding difficulties that rural Chinese experience in accessing appropriate health care. Little is known, however, about the responses to the Scheme by the residents of rural areas, particularly older people. This absence of knowledge and understanding is especially acute in relation to China’s sizeable ethnic minorities who tend to live in the poorest and more remote parts of rural China. Accordingly, this exploratory study investigated the experiences of the new RCMS by elderly Miao people in a rural township where there is a significant concentration of older Miao people. It focused on the barriers and opportunities that older Miao people face in accessing health care since the introduction of the new RCMS. The study has contributed to current knowledge and understanding of the kinds of social relations and practices involved in the implementation of the RCMS in rural China. It has potential to inform ongoing development of health policy and service processes in ways that will enhance the health outcomes of marginalised ethnic minorities, particularly older people, in such communities.