Kolkata: West Bengal formally launched the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) on 16 August. The scheme opens free cashless hospitalisation cover of up to ₹5 lakh per family a year across the state. Chief Minister Suvendu Adhikari launched the scheme at Netaji Indoor Stadium in Kolkata with Union Minister of State for Health and Family Welfare Anupriya Patel. The state has marked the date as Ayushman Diwas.
The 1.43 crore figure, broken up
The Union Health Ministry puts the approved beneficiary base at roughly 1.43 crore families. The number splits three ways: about 1.24 crore eligible families, nearly 15.95 lakh families of senior citizens aged 70 and above, and around 3.06 lakh families of ASHAs, Anganwadi Workers and Helpers. The Centre’s contribution works out to close to ₹1,000 crore a year.
What the cover includes
The ₹5 lakh limit applies to the family as a whole and resets each financial year. There is no cap on family size and no age or gender bar. Pre-existing diseases are covered from day one of enrolment. The scheme also covers pre- and post-hospitalisation expenses, typically three days before and 15 days after admission. Medicines, diagnostics and a transport allowance are free during hospitalisation.
Senior citizens aged 70 and above receive an additional cover under Ayushman Vay Vandana, irrespective of socio-economic status. Treatment is cashless and portable, so beneficiaries can be treated at any empanelled hospital in the country. The Health Ministry flagged that last point as significant for migrant workers from the state.
Eligibility rests on SECC 2011
Eligibility is decided by the Socio-Economic Caste Census database rather than by current income, as set out by the state government.
Rural households: They qualify on deprivation criteria such as:
- Single-room kutcha house
- No adult member aged 16 to 59
- SC or ST status
- Income from landless manual labour
Urban households: They are eligible based on occupation. The following families are within the listed categories:
- Ragpickers
- Domestic workers
- Sanitation workers
- Street vendors
- Cobblers
- Construction workers
- Plumbers
- Electricians
- Mechanics
- Drivers
No income ceiling applies.
Senior citizens aged 70 and above are automatically eligible. They need only Aadhaar, with no income proof or SECC listing. For everyone else, documents at verification include Aadhaar, a ration card or another government identity document, and a mobile number linked to Aadhaar for OTP authentication.
A state scheme for those left out
The government launched the Mukhyamantri Swasthya Bima Yojana on the same day for households outside the central scheme. Around 80 lakh families are expected to be covered, with benefits available at the same hospitals empanelled under Ayushman Bharat. Between the two schemes, treatment for 1,950 diseases is covered, including knee replacement and hip surgery. The state also announced 100 Amrit pharmacies and 458 Jan Aushadhi centres.
A Swasthya Sathi card does not convert into PM-JAY entitlement on its own. The two schemes run on separate databases, so status has to be checked independently.
Checking status and getting the card
Verification runs through the beneficiary portal at beneficiary.nha.gov.in. The steps are:
- Log in with an Aadhaar-linked mobile number and OTP
- Select West Bengal as the state and PMJAY as the sub-scheme
- Choose the district
- Search by Aadhaar number, ration card number or name
Family members appear on screen with individual card status.
Where the status reads “Not Generated”, complete e-KYC using Aadhaar OTP and download the card as a PDF once verification clears.
Offline, the same process runs at a Common Service Centre, an Ayushman kiosk, or the Arogya Mitra help desk at an empanelled hospital. No agent may charge a fee beyond the ₹30 printing charge, and complaints go to the toll-free helpline 14555.
Locating an empanelled hospital
The hospital list is searchable at hospitals.pmjay.gov.in under Find Hospital, filtered by state, district and speciality. Empanelment status changes during audits, so a call to the hospital before admission is advisable.
How MyRupia Helps You Decide
PM-JAY pays for hospitalisation, not outpatient treatment. The ₹5 lakh limit is shared across the whole family. And households that do not appear in the SECC database fall to the state scheme or to nothing at all.
That leaves most families weighing what private cover to keep, drop or add alongside the government one. MyRupia works on that question. It is an independent guidance platform rather than an insurer, agent or broker, holds no insurer partnerships, and charges for expert consultation instead of earning commission on a sale.
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Disclaimer: This MyRupia article is for informational purposes only and is based on publicly available government, regulatory and industry sources. It should not be treated as investment, financial, tax, insurance, or legal advice. Information, examples, market data, and expert views mentioned in the article may change over time and should not be considered a recommendation to buy, sell, invest in, or surrender any financial product. Readers should evaluate their individual circumstances and consult a qualified financial professional before making decisions.