The West Bengal government has launched the Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) along with the Mukhyamantri Swasthya Bima Yojana (MMSBY) to significantly expand healthcare coverage across the state. With this dual launch, West Bengal became the 36th state and final state to implement the central government’s flagship health assurance programme, completing its nationwide rollout. The twin initiative ensures that eligible families across the state receive cashless health cover of up to ₹5 lakh per annum for secondary and tertiary care hospitalisation.
What Is Ayushman Bharat PM-JAY?
Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is the world’s largest government-funded health assurance scheme, launched by Prime Minister Narendra Modi on 23 September 2018 in Ranchi, Jharkhand. The scheme was announced in the Union Budget 2018-19 and is administered by the National Health Authority (NHA) under the Union Ministry of Health and Family Welfare.
AB-PMJAY provides a health cover of ₹5 lakh per family per year on a family floater basis for secondary and tertiary care hospitalisation. It is an entitlement-based scheme that offers cashless and paperless treatment at empanelled public and private hospitals across the country. The scheme subsumed the earlier Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
The beneficiary families are identified from the Socio Economic Caste Census (SECC) 2011 on the basis of select deprivation and occupational criteria across rural and urban areas. Over 10.74 crore families (approximately 50 crore individuals) are eligible under the scheme. There is no cap on family size, age, or gender, and pre-existing diseases are covered from the first day.
Since its launch, AB-PMJAY has provided over 12 crore treatments worth more than ₹1.82 lakh crore to beneficiaries across India. Out-of-pocket healthcare expenditure, which was around 64.6 per cent before 2018, has declined to approximately 43.4 per cent, reflecting the impact of the scheme. AB-PMJAY operates on the principle of cooperative federalism, allowing states flexibility in scheme design and implementation while ensuring portability and fraud detection at the national level.
West Bengal’s Two-Pronged Healthcare Launch
The West Bengal government’s decision to launch AB-PMJAY and MMSBY together is a carefully designed dual strategy. The National Health Authority (NHA) signed a Memorandum of Understanding (MoU) with the West Bengal Department of Health and Family Welfare for implementing AB-PMJAY in the state. The MoU signing ceremony was attended by Union Health Minister JP Nadda and West Bengal Chief Minister Suvendu Adhikari.
Under AB-PMJAY, approximately 1.43 crore families in West Bengal are now eligible for benefits. This includes about 1.24 crore eligible beneficiary families, nearly 3.06 lakh families of ASHA workers, anganwadi workers and helpers, and about 15.95 lakh families of senior citizens aged 70 years and above. Senior citizens in this age group receive coverage under the Ayushman Vay Vandana component, which provides an additional ₹5 lakh health cover with no income limit.
Simultaneously, the state government introduced the Mukhyamantri Swasthya Bima Yojana (MMSBY), a state-funded health insurance scheme announced by Chief Minister Suvendu Adhikari on 11 July 2026. MMSBY provides cashless health coverage of up to ₹5 lakh per family per year to eligible residents who are enrolled under the existing Swasthya Sathi scheme but do not qualify for AB-PMJAY. This ensures that no family in the state is left without healthcare protection.
Swasthya Sathi: The Existing State Scheme
To understand the significance of the new dual launch, it is important to know about the Swasthya Sathi scheme, which has been West Bengal’s flagship healthcare programme since 30 December 2016. Launched by then Chief Minister Mamata Banerjee, Swasthya Sathi provides cashless and paperless health coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalisation.
The scheme issues a smart card in the name of the eldest female member of the family and covers all pre-existing diseases from the first day. It operates through empanelled insurance companies and offers treatment at government and private hospitals within West Bengal. The entire premium is borne by the state government. Over the years, Swasthya Sathi expanded to cover nearly 6 crore beneficiaries in the state.
However, Swasthya Sathi had a key limitation. While it offered near-universal coverage within West Bengal, treatment was largely restricted to hospitals empanelled within the state. West Bengal was the only major state that had not joined the central AB-PMJAY scheme for seven years. The previous Trinamool Congress government under Mamata Banerjee had chosen to run its own Swasthya Sathi scheme instead of participating in the central programme.
With the change of government after the May 2026 Assembly elections, the new BJP government under CM Suvendu Adhikari decided to integrate with AB-PMJAY. This brought two major advantages. First, eligible families now get access to pan-India portability, meaning they can receive cashless treatment at any of the 36,000+ empanelled hospitals across the country, including AIIMS and other premier institutions. Second, the central government approved a healthcare package of ₹3,505 crore for West Bengal to support the implementation.
Eligibility and Exclusions Under Both Schemes
The eligibility criteria for AB-PMJAY and MMSBY are designed to complement each other, ensuring comprehensive coverage without overlap.
Who Qualifies for AB-PMJAY in West Bengal
Under AB-PMJAY, the following categories of families are eligible in West Bengal:
- Households living in kutcha or temporary houses
- Households of landless agricultural labourers
- Households without adult earning members
- Eligible Scheduled Caste (SC) and Scheduled Tribe (ST) households
- Street vendors, domestic workers, construction workers, sanitation workers, and transport workers
- ASHA workers, anganwadi workers, and helpers
- All citizens aged 70 years and above under the Ayushman Vay Vandana component
Beneficiary identification is based on the SECC 2011 database. Families that appear in this database with the relevant deprivation and occupational criteria are automatically eligible.
Who Qualifies for MMSBY
The Mukhyamantri Swasthya Bima Yojana is designed for families who are covered under the Swasthya Sathi scheme but do not meet the eligibility criteria for AB-PMJAY. To be eligible for MMSBY, the applicant must:
- Be a permanent resident of West Bengal
- Be enrolled under the Swasthya Sathi scheme
- Not be covered under AB-PMJAY
Who Is Excluded from MMSBY
The West Bengal government has notified specific exclusion criteria for MMSBY. Families are not eligible if:
- Their annual income exceeds ₹8 lakh
- They are covered under government health schemes such as WBHS (West Bengal Health Scheme), CGHS (Central Government Health Scheme), or ESI (Employees’ State Insurance)
- They are government or PSU employees or pensioners receiving medical benefits
- Family members above 70 years of age who are covered under the Ayushman Vay Vandana scheme
This dual structure ensures that Swasthya Sathi beneficiaries who fall outside the SECC 2011 criteria still receive ₹5 lakh coverage through the state-funded MMSBY, while those qualifying under the central parameters get access to the broader AB-PMJAY network with pan-India portability.
Why West Bengal’s Inclusion Matters
West Bengal’s integration into AB-PMJAY is significant on multiple fronts. It marks the completion of the nationwide rollout of the central government’s flagship health programme. Until now, West Bengal was the only state and union territory that had not joined the scheme, making it the 36th and final jurisdiction to implement AB-PMJAY.
The timing is especially relevant given the healthcare needs of the state’s population. West Bengal has nearly 1 crore migrant workers living in other states. Under the old Swasthya Sathi-only arrangement, these workers could not easily access cashless treatment outside West Bengal. With AB-PMJAY now active, they can receive treatment at any empanelled hospital anywhere in the country, a critical benefit for a state with one of the highest rates of labour migration.
For the central government, West Bengal’s inclusion reinforces the idea of universal health coverage as a shared national goal. Union Health Minister JP Nadda described the development as a historic milestone, noting that nearly 90 per cent of eligible cancer patients covered under PM-JAY have been able to start treatment within 30 days, according to findings published in The Lancet. The scheme’s cashless, paperless, and fully digital architecture has enabled timely and quality healthcare services for beneficiaries.
From an institutional perspective, the National Health Authority (NHA), established in 2018 as an autonomous entity under the Society Registration Act, 1860, now oversees the complete national implementation of AB-PMJAY. The scheme operates through State Health Agencies (SHAs) in each state, and West Bengal has set up its implementation infrastructure to manage the transition from Swasthya Sathi to the dual-model approach. Over 300 private hospitals in West Bengal have already completed onboarding workshops to participate in the AB-PMJAY network.
Key Takeaways
- West Bengal became the 36th and final state/UT to implement Ayushman Bharat PM-JAY, completing the nationwide rollout of the world’s largest government-funded health assurance scheme.
- AB-PMJAY was launched on 23 September 2018 by PM Narendra Modi in Ranchi, Jharkhand, and provides a health cover of ₹5 lakh per family per year for secondary and tertiary care hospitalisation.
- Over 12 crore treatments worth more than ₹1.82 lakh crore have been provided under AB-PMJAY across India since its launch.
- The Mukhyamantri Swasthya Bima Yojana (MMSBY) is a state-funded scheme offering ₹5 lakh coverage to Swasthya Sathi beneficiaries who do not qualify for AB-PMJAY.
- The Swasthya Sathi scheme, launched on 30 December 2016, has been West Bengal’s flagship healthcare programme covering nearly 6 crore beneficiaries.
- The National Health Authority (NHA), established in 2018, administers AB-PMJAY at the national level, while states implement it through State Health Agencies (SHAs).
