Kolkata: West Bengal has integrated the Centre’s Ayushman Bharat health insurance scheme with the state’s Mukhyamantri Swasthya Bima Yojana, bringing a combined network of more than 1,850 hospitals into the fold, Chief Minister Suvendu Adhikari said on Sunday.
Scope of coverage and benefits
Speaking at an ‘Ayushman Diwas’ event in Kolkata, Mr Adhikari said the merged packages will cover 1,240 private and 627 government medical facilities. Beneficiaries under the two schemes will be able to access healthcare services across India, he added, rather than being limited to West Bengal.
- Hospitals with access: about 38,600 hospitals nationwide where beneficiaries may seek treatment.
- Beneficiary reach: those not eligible for Ayushman Bharat are expected to be covered under the state scheme — estimated at roughly 80 lakh families.
- Coverage per family: cashless entitlements of up to ₹5 lakh, as stated by the state health minister in other briefings.
- Packages: around 1,950 treatment packages, up from more than 1,700 procedures under the earlier state scheme.
- Drug access: allocation of 100 'Amrit' pharmacies and about 480 Pradhan Mantri Jan Aushadhi centres at government hospitals across the state.
Implementation details and state assurances
Adhikari said the agreements underpinning the integration will enable beneficiaries to avail treatment at a nationwide network of hospitals. He also announced an eye-care programme under the integrated scheme and said he had himself undergone an eye check-up under that initiative.
“Earlier, the state government's scheme was limited to West Bengal. Now, you will get the benefits across India,”
The chief minister acknowledged concerns raised by some private hospitals, including those run by the Ramakrishna Mission, over reimbursement rates under the merged arrangement. He said some institutions had been placed in different rate categories and compared rates in West Bengal to those in cities such as Mumbai and Chennai and at premier institutions like CMC Vellore. Mr Adhikari said the government would look into these concerns.
Context and possible consequences
The move to integrate state and central insurance schemes follows a national trend towards portability and wider access for government-sponsored healthcare programmes. If effectively implemented, the integration could improve financial protection for families by offering cashless inpatient care across a larger hospital network and strengthening access to essential medicines via Amrit pharmacies and Jan Aushadhi centres.
However, integration also brings operational and financial challenges. Hospitals that treat a higher proportion of complex cases have previously raised issues about reimbursement adequacy. Differences in tariff categories between states and between institutions may lead to negotiation and revision of rates. The chief minister's pledge to examine these concerns will be central to maintaining private provider participation and ensuring timely claims settlement.
What beneficiaries should know
Beneficiaries eligible under Ayushman Bharat will continue to receive entitlements as per the national scheme, while those outside the Ayushman Bharat eligibility criteria will now be covered under the Mukhyamantri Swasthya Bima Yojana, which the state expects to extend to about 80 lakh families. The announcement indicates cashless hospitalisation benefits up to ₹5 lakh and expanded package listings to nearly 1,950 procedures.
Beneficiaries are advised to verify their eligibility and the list of empanelled hospitals through official state or Ayushman Bharat portals before seeking treatment, and to consult a qualified medical practitioner for care decisions.
The integration is likely to reshape the state’s public–private hospital relationships and will be watched closely for its effect on claims processing, provider reimbursements and actual access to tertiary care for low-income families.
