West Bengal's New Health Shield: Who Gets Rs 5 Lakh Cover After Ayushman Bharat Shift?

West Bengal has rolled out the Mukhya Mantri Swasthya Bima Yojana (MMSBY), a new health insurance scheme offering Rs 5 lakh in cashless annual coverage per family. Announced by Chief Minister Suvendu Adhikari on Monday, this initiative specifically targets permanent state residents who are covered under the existing Swasthya Sathi scheme but do not qualify for the central government's Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). The move aims to close a critical healthcare gap following the state's recent re-entry into the national Ayushman Bharat framework. This new scheme marks a significant policy adjustment after years of a distinct state-led healthcare approach under the previous administration, which had opted out of Ayushman Bharat citing differing funding models. While Swasthya Sathi provided broad coverage, MMSBY offers crucial pan-India portability for cashless treatment at any AB-PMJAY empanelled hospital, a benefit previously unavailable to many state beneficiaries. Eligibility for MMSBY includes an annual family income cap of Rs 8 lakh and excludes those already covered by other government health schemes like the West Bengal Health Scheme, CGHS, or ESI, as well as senior citizens over 70 who are now directly covered under Ayushman Bharat. A recent report by the Comptroller and Auditor General (CAG) had also flagged issues with the Swasthya Sathi scheme, noting potential ineligible beneficiaries and deprivation of national portability benefits. With notification for implementation already sent to various state agencies, the application process for MMSBY is expected to be managed through the State Health Agency or District Magistrate offices. Beneficiaries will need documents like Aadhaar and Swasthya Sathi cards for verification, with Aadhaar-based authentication being mandatory for enrolment and hospital admissions. This new scheme is anticipated to provide comprehensive health coverage to a large section of the population, ensuring access to quality medical care across India.