Ayushman Bharat to launch in West Bengal: Eligibility, coverage, and how to apply

With the BJP government taking office in West Bengal under Chief Minister Suvendu Adhikari, the Centre’s biggest welfare programmes are now set to become part of the state’s public healthcare framework.

The rollout of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) brings West Bengal back into the national health insurance network after years of political disagreement over the scheme’s implementation. For families dealing with rising hospital costs, the decision could have immediate, practical consequences.

What the scheme offers

At its core, Ayushman Bharat is a government-funded health protection scheme designed to reduce the financial pressure of serious illness. Under the programme, eligible beneficiaries receive up to Rs 5 lakh a year in cashless hospital coverage for secondary and tertiary care.

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Treatment can be accessed at empanelled government hospitals as well as approved private hospitals across the country.

Expanded eligibility for senior citizens

One of the biggest changes under the updated rules concerns senior citizens. Every Indian aged 70 years and above is now eligible for coverage, regardless of income, social category, or whether they already hold private health insurance.

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The expansion reflects a simple reality: medical emergencies in old age often create financial pressure even in families that are otherwise financially secure.

Who else qualifies

Beyond senior citizens, the scheme continues to cover economically vulnerable households identified under government socio-economic criteria.

In urban areas, this may include street vendors, labourers, sanitation workers, and other informal sector workers.

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In rural regions, eligibility often extends to landless families, households living in kutcha homes, female-headed families, or homes without able-bodied adult earners. Final beneficiary lists in West Bengal are expected to follow central eligibility norms once implementation formally begins, reported the Indian Express.

What expenses are covered

The coverage itself goes well beyond admission costs. It includes doctor consultations linked to treatment, diagnostic tests, medicines, ICU and non-ICU care, surgical procedures, implants where medically required, room charges, food during hospital stay, and treatment-related complications.

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The scheme also pays for medical expenses incurred up to three days before hospitalisation and follow-up care for 15 days after discharge.

However, routine OPD visits, cosmetic procedures, fertility treatment, and certain elective services remain outside standard coverage.

How to apply

For those who qualify, accessing the scheme is largely Aadhaar-based. Applicants can verify eligibility online through the PM-JAY portal or the Ayushman mobile app by completing e-KYC using a registered mobile number.

After verification, a digital Ayushman card is generated, which can be used for cashless treatment. Those unfamiliar with online registration can also complete the process through Common Service Centres or authorised enrolment facilities.