- Objectives. Older people use more health services due to health problems, but various reasons impede their ability to use health services. The purpose of this study is to examine difficulties in accessing and affording specialist services and to explore the factors that explain these difficulties among elderly people. Methods. The sample included 1,255 respondents in three age-groups: 65-75, 76-89, and 90+ years who were interviewed face-to-face in their homes. Results. The findings showed that between 21% and 41% of the respondents encountered difficulties in visiting specialists. Those aged 90+ encountered more accessibility problems and fewer affordability problems compared to their younger counterparts, and those aged 76-89 encountered more availability problems compared to the other two age-groups. Enabling and need factors were the most significant factors in explaining problems in accessing and affording specialist services. Discussion. Recommendations for policy and practice are discussed.