The present paper discusses universal access to health-care in the light of the barriers faced by some vulnerable individuals and groups due to caste based identities. Factors such as perception of self, availability of services, sensitivity of the providers determine access and consequently affect utilization among vulnerable populations. The paper examines the inter-linkages between these factors. Efforts, which create enabling environment have been discussed to highlight impeding and enhancing factors, Field based research has been used to reflect on some of these factors and possible best practices.