Not Eligible for Ayushman Bharat Card? West Bengal Announces New Health Insurance Scheme: Check if you can apply

West Bengal has announced a new state health insurance scheme. It is meant for people who are not eligible for the central scheme ‘Ayushman Bharat Yojana’. The scheme is called ‘Mukhyamantri Swasthya Bima Yojana’ which means Chief Minister’s Health Insurance. Eligible residents must already have coverage under ‘Swasthya Sathi’, Anandabazar Patrika reported.

In early July, Chief Minister Suvendu Adhikari announced the scheme at a public meeting in Rejinagar. CM Adhikari said, “Those who do not get Ayushman Bharat will get Mukhyamantri Swasthya Bima Yojana. ₹5 million will be available.”

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“The state government will ensure that the benefits of this card are available not only in this state but across India,” he added.

Who is eligible?

Only residents of a permanent state excluded from Ayushman Bharat can enroll here. The goal of this program is to protect people from catastrophic medical expenses. The coverage focuses specifically on the complex and expensive treatment of the disease.

However, certain conditions determine eligibility under this new regime. Families earn more ₹8 crore per annum will not be eligible for benefits. Anyone covered by the West Bengal Health Scheme 2008 is automatically excluded.

Similarly, beneficiaries of Central Government Health Scheme (CGHS) 1954 cannot enroll in this new scheme. ESI Scheme members are also completely excluded from this insurance.

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Employees or pensioners who are insured in the public sector also remain ineligible. This includes coverage by statutory bodies or municipal authorities.

People receiving regular health benefits will not be eligible for registration either. According to the publication, seniors over 70 are specifically excluded here.

Individuals excluded through the SIR process do not have access to this system. However, there are exceptions for some pending legal cases. Persons with outstanding CAA applications remain eligible despite exclusion elsewhere. Similarly, pending SIR Tribunal cases do not disqualify applicants from registration.

Cashless cover in value ₹5 lakhs

Eligible families will receive cashless coverage worth ₹5 million annually. Each family member will receive a separate insurance card.

This system applies to pre-existing diseases and conditions. There is no reimbursement option; the treatment remains completely cashless at all times.

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The system has relied heavily on digital monitoring systems since launch. The IT platform will immediately oversee the implementation of the entire scheme. Aadhaar-based biometric verification is mandatory for all registrations. Use of an ABHA ID is mandatory on admission and discharge from hospital.

The types of treatment and medical guidelines will reflect the existing Ayushman Bharat rules. This ensures consistency between state and central systems.

Interest in ‘Ayushman Bharat’ was on Google India during 27-28 july high:

Interest in ‘Ayushman Bharat’ was on Google India during 27-28 July high(Google India)

Swasthya Sathi

Mamata Banerjee launched Swasthya Sathi as the flagship health insurance scheme of West Bengal. It offered up to ₹5 lakhs of annual coverage per family. Treatment remained completely cashless through a paperless IT network.

The TMC government funded the entire premium with zero required contribution. Eligible households will receive chip cards issued to the eldest female. There was no limit on family size or number of members.

Pre-existing diseases were covered immediately after registration. Coverage also extended to pre- and post-hospitalization expenses. Originally intended for low-income workers, it then expanded to cover wider populations. Permanent government employees already in receipt of allowances remained generally excluded.

After the regime change, the Swasthya Sathi was scrapped. It will now be replaced by the new Mukhyamantri Swasthya Bima Yojana.