Improved means of transportation play a vital role in accessing medical services, particularly in remote and ageing municipalities. In this study, we identify crucial attributes for improving access to medical services in the Shinhidaka and Urakawa municipalities in Japan. Using a randomised conjoint field experiment, we identify individuals’ preferences regarding the time and means of transportation to hospitals that can provide high-level medical services, along with additional tax payments to support these services. We find, inter alia, that respondents have the highest preference for reducing emergency ambulance transportation time to high-function hospitals. We also estimate the minimum average willingness to pay for these services; respondents are willing to pay at least JPY 60,000 (approximately USD 500) additional tax per year to the municipal government if the emergency transportation time to high-function hospitals is reduced. The findings of this study provide valuable insights into addressing the challenges of improving access to medical services in remote areas with an ageing population.