West Bengal Launches Mukhya Mantri Swasthya Bima Yojana: Check How To Apply To Get Rs 5 Lakh Health Cover

The West Bengal government has rolled out a fresh insurance scheme providing Rs. 5 Lac cover to the eligible citizens of the state.

The scheme is called Mukhya Mantri Swasthya Bima Yojana (MMSBY) and it is a new health insurance scheme offering Rs 5 lakh in coverage per family and will focus mainly on those residents who fall through the gap between the state's Swasthya Sathi scheme and the Centre's Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).

Chief Minister Suvendu Adhikari announced this scheme on Monday while addressing a rally in Jalpaiguri. The implementation notification was sent out to Kolkata Municipal Corporation, district magistrates, chief medical officers of health, the CEO of the state health agency, and the chief secretary of the health and family welfare department.

What Is MMSBY?

Mukhya Mantri Swasthya Bima Yojana or MMSBY has been curated to fix coverage gap left by Bengal's transition toward the central Ayushman Bharat framework. It provides Rs 5 lakh in cashless annual health coverage to residents who are enrolled under Swasthya Sathi but do not meet the eligibility criteria for AB PM-JAY.

Coverage for this insurance is available at all AB PM-JAY-empanelled hospitals, and the scheme comes with a free individual health card for each eligible member.

Who Cannot Apply for Mukhya Mantri Swasthya Bima Yojana

The state has put out a clear set of exclusions to prevent overlap with other health coverage and to keep the scheme targeted. Here is the list of all the exclusions criteria:

A family is not eligible for MMSBY if its annual income exceeds Rs 8 lakh.

Government employees and pensioners already covered under the West Bengal Health Scheme 2008, the Central Government Health Scheme (CGHS) 1954, or the Employees' State Insurance Act 1948 are excluded.

Those enrolled in group medical insurance run by central or state public sector undertakings, urban local bodies, statutory corporations, trusts, societies, or boards.
Employees and pensioners who already draw a regular medical allowance from state, central, or parastatal bodies also do not qualify.

Senior citizens above 70 years of age are excluded too, since they are meant to be covered separately under the Ayushman Vaya Vandana Yojana.

How To Apply For Mukhya Mantri Swasthya Bima Yojana

The application process for Mukhya Mantri Swasthya Bima Yojana scheme is expected to be processed through the State Health Agency or the concerned District Magistrate's office.

Applicants are expected to keep their Aadhaar card, Swasthya Sathi card, income certificate (where required), proof of West Bengal residence, and family documents ready. Once verified through Aadhaar authentication, an eligible applicant's individual MMSBY health card is issued, allowing cashless treatment at empanelled hospitals.