Iran’s rapidly ageing population has created an urgent need to improve older adults’ access to primary healthcare services. In Saveh, many older adults face barriers including limited availability of specialized services, inadequate physical infrastructure, financial constraints, transportation difficulties, insufficient awareness of available services, and low trust in public health centers. These challenges reduce service utilization, increase reliance on more expensive healthcare, and threaten equity in access. This policy brief synthesizes evidence from a qualitative study involving policymakers, health managers, healthcare providers, and older adults to identify key barriers and propose practical policy options. The findings indicate that improving access requires coordinated action across the health system, insurance organizations, and community sectors. Recommended policy options include expanding the package of geriatric services, strengthening and incentivizing the healthcare workforce, developing age-friendly health centers, enhancing public awareness through targeted communication, implementing proactive follow-up through home visits and telephone contacts, improving insurance support, and strengthening intersectoral collaboration. Successful implementation will require sustainable financing, investment in human resources and infrastructure, stronger coordination among health, insurance, welfare, and municipal sectors, and continuous monitoring and evaluation. Adopting an integrated, multisectoral approach can improve equitable access to primary healthcare, enhance healthy ageing, and reduce the long-term health and economic burden associated with population ageing.