Introduction. Wellness of people with mental illness is increasingly a public health priority. This study examined factors associated with difficulties receiving medical care in adults with mental illness. Methods. In a sample of 1,670 adults with mental illness, we assessed difficulties in accessing medical care and stigma. Results. A total of 465 (28%) participants reported difficulties in accessing medical care; 211 (13%) attributed difficulties in access to stigma. Lack of comprehensive medical care coverage and mental health symptoms were associated with increased odds of perceived difficulties in accessing medical care; personal empowerment was negatively associated with perceived difficulties attributed to stigma; education was positively associated. Discussion. The findings highlight unmet need for medical care in this population and the need to recognize stigma as a barrier medical care. Interventions to empower patients and educate medical providers about wellness for people with serious mental illness could help to reduce barriers.