Enhanced access services are key components of the patient-centered medical home, but they are resource-intensive and may require significant trade-offs by practices and patients. Using qualitative research methods, we interviewed 20 parents about experiences accessing primary care for their children, priorities for enhanced access, and willingness to make trade-offs. Parents had strong preferences for certain services, such as same-day sick care appointments, and were willing to make trade-offs for high-priority services. Primary care practices and medical home programs should educate families about trade-offs needed to implement new services and engage families in setting priorities for medical home implementation.