Ecuador is one of the few countries in Latin America that still has a high maternal mortality rate (PAHO, 1999). Policy makers are committed to decreasing maternal mortality by increasing access to maternal health care services through the introduction of a national mother and child health insurance scheme. The purpose of this study is to generate empirical knowledge that will provide policy makers with an understanding of the influence of insurance coverage on demand for maternal health care. Simultaneous equations probit model is used to estimate the effect of insurance status, along with individual, -household-, and location-specific characteristics, on the use of prenatal care and birth delivery care, using data from the Survey of Living Conditions 1998. The results of the estimations are used to carry out policy simulations that assess the magnitude of the impact of health insurance status on service utilization. The results indicate that insurance status in general has a statistically significant effect on utilization of modern delivery services and utilization of adequate prenatal care visits. Policy simulations show that increase in insurance status and education would increase utilization of maternal health care services in urban and rural areas