In Ethiopia, rural mountain villages face significant challenges in accessing health insurance due to geographical isolation and financial barriers. A mixed-methods approach combining quantitative data from surveys (N=300) and qualitative insights through semi-structured interviews (n=25). Mobile payment platforms significantly increased coverage by 42% among participants compared to traditional methods, with a cost savings of $1.5 per insured individual. Mobile payment platforms offer a viable solution for expanding health insurance in rural areas but require further testing and integration into existing systems. Implement mobile payment solutions should be accompanied by targeted awareness campaigns and enhanced financial literacy programmes to maximise uptake. mobile payment, health insurance, coverage expansion, Ethiopian mountain villages