OBJECTIVES: To evaluate the impact of the National Health Insurance Scheme’s Free Maternal Care Program (FMCP) on maternal health care utilization and mortality rates. METHODS: Review and participant observation methods were employed to review maternal care utilization data from the NHIS and Ghana Health Service over the 2005- 2012 period. Maternal and child mortality data from UN Inter-agency Group for Child Mortality Estimation (WHO, UNICEF, UN DESA, UNPD, World Bank) were also reviewed.  RESULTS: The amount of money paid for maternal health services increased from GHS21.9 million (USD6.88m) in July 2008 to GHS52.4 million (USD16.39m) in December, 2009. As of June 2010, an amount of GHS26.3 million (USD8.24m) had been paid. Antennal care coverage (at least four visits) increased from 61% to 72% between 2008 and 2012; postnatal care coverage increased from 54% to 58% between 2006 and 2008 and went up to 65% in 2011; skilled delivery saw no improvement between 2006 and 2008 (44%) but went up to 59% in 2012. The institutional maternal mortality ratio (IMMR) recorded a reduction of 7% over the 2005-2008 period and went down considerably by 23% to 155 deaths per 1000 live births over the post 2008 period. Under-five mortality rate declined from 88.4 to 83 deaths per 1000 live births (5.4%) between 2005 and 2008; it went down to 72 deaths per 1000 live births (11%) over the post 2008 period.  CONCLUSIONS: There have been substantial improvement in maternal care utilization and reduction in mortality rates five years after full implementation of the FMCP. However, big gaps exist between the current mortality rates and MDG 4 and 5 targets, with barely a year to the 2015 deadline. Therefore, much effort is needed from government, development partners, and maternal care advocates to accelerate progress towards achieving MDG 4 and 5.