Kolkata: West Bengal will formally join the Centre’s flagship health insurance scheme, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY), with Chief Minister Suvendu Adhikari set to launch the programme at Netaji Indoor Stadium on Sunday, the state health department said.
Scale and coverage
According to health department sources, about 3.39 crore beneficiaries in the state have already been enrolled under Ayushman Bharat and the number is expected to rise as more eligible households are brought under the scheme. Simultaneously, the state will roll out the Mukhyamantri Swasthya Bima Yojana, under which around 80 lakh people have been enrolled so far.
Both Ayushman Bharat and the Mukhyamantri scheme will provide a health cover of ₹5 lakh per family. State Health Minister Sharadwat Mukherjee said the Ayushman Bharat policy would cover hospitalisation costs as well as certain expenses incurred before and after admission.
"Ayushman Bharat will cover not only expenses incurred during hospitalisation but also those incurred during the three days preceding admission and for 15 days after discharge," Mukherjee said.
Transition arrangements and legacy scheme
The government said the Bengal-specific scheme and Ayushman Bharat will run alongside the existing Swasthya Sathi scheme — launched by the previous administration — for a transition period. A senior health department official told reporters that Swasthya Sathi would remain active for those who have not yet migrated to either Ayushman Bharat or the Mukhyamantri scheme.
"The schemes will run simultaneously for at least the next two or three months. Swasthya Sathi will be phased out gradually after that," Mukherjee was quoted as saying. The official emphasised that beneficiaries not migrated immediately will continue to be covered by Swasthya Sathi until enrolment under the new schemes is completed.
Key features at a glance
- Ayushman Bharat (PM-JAY): Central scheme; comprehensive in-hospital cover plus expenses three days prior and 15 days after discharge; covers pre-existing diseases.
- Mukhyamantri Swasthya Bima Yojana: State scheme mirroring coverage of Ayushman Bharat; around 80 lakh beneficiaries enrolled.
- Swasthya Sathi: Existing state scheme to remain operational during migration; will be phased out gradually over two to three months.
| Scheme | Coverage per family | Current enrolled (approx.) | Notes |
|---|---|---|---|
| Ayushman Bharat (PM-JAY) | ₹5 lakh | 3.39 crore | Includes pre- and post-hospitalisation expenses; covers pre-existing diseases |
| Mukhyamantri Swasthya Bima Yojana | ₹5 lakh | 80 lakh | State-run parallel scheme |
| Swasthya Sathi | Varies | Beneficiaries not yet migrated | To be phased out after transition period |
Practical implications for families
Officials noted that Ayushman Bharat’s inclusion of the three-day pre-admission and 15-day post-discharge windows aims to reduce out-of-pocket spending on medicines, diagnostics and physiotherapy — costs that patients and families commonly bear around hospital stays. The Centre’s scheme also covers pre-existing conditions, removing waiting periods that often delay claims.
Health department sources said the state would continue to manage enrolment and migration of beneficiaries, with administrative arrangements likely to be announced at the launch event. No timeline beyond the two-to-three-month overlap window has been specified for the complete integration or winding down of Swasthya Sathi.
What to watch
Stakeholders in Kolkata and across districts will monitor how swiftly eligible households are migrated, the robustness of grievance redressal and hospital empanelment under the joint rollout. Given West Bengal’s population and the scale of existing state schemes, the phased approach is aimed at ensuring continuity of cover while aligning state and central benefits.
The launch represents a significant administrative shift in the state’s health-insurance architecture and will be closely watched by civic groups, hospitals and political actors in the run-up to implementation.
