Mukhya Mantri Swasthya Bima Yojana (MMSBY), West Bengal
Fact-checked against official sources, reviewed by Aapt Dubey
4 min read · 3 official sources
Introduced in 2026 for residents outside PM-JAY; the department's FAQ of 17 August 2026 describes it, but the full eligibility notification is not posted online.
Source: swasthyasathi.gov.in
West Bengal state government scheme
Mukhya Mantri Swasthya Bima Yojana (MMSBY) is West Bengal's state health cover of up to Rs 5 lakh per family per year for residents left outside Ayushman Bharat PM-JAY, mainly former Swasthya Sathi families. Treatment is cashless at empanelled hospitals, with national portability. Eligibility follows conditions notified by the state, so check your status before a planned admission.
What is Mukhya Mantri Swasthya Bima Yojana?
Mukhya Mantri Swasthya Bima Yojana (MMSBY) is a West Bengal state government health scheme for hospital treatment. The Health and Family Welfare Department introduced it in 2026, when the state began moving families from its older Swasthya Sathi scheme to Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). Not every Swasthya Sathi family qualifies for PM-JAY, and MMSBY is meant to make sure families outside PM-JAY do not lose cover for hospitalisation.
According to the department's FAQ booklet on AB PM-JAY and MMSBY, published on the Swasthya Sathi website on 17 August 2026, MMSBY gives cashless health coverage of up to Rs 5 lakh per family per year. It is a separate scheme from PM-JAY, with its own eligibility criteria set by the Government of West Bengal, though the benefits are described as similar.
The state also listed MMSBY among the services offered at its single-window camps held across West Bengal from 2 to 4 October 2026, according to the scheme list on jks.wb.gov.in.
What is not yet public. The department's FAQ refers several times to "eligibility conditions notified by the Government of West Bengal", but the notification itself was not posted on the health department's portals we checked as of 26 October 2026. This guide gives only what the department has published. Ask at your hospital helpdesk or block health office for the current criteria.
Who is eligible for MMSBY?
The department's FAQ says MMSBY is for eligible West Bengal residents who remain outside AB PM-JAY coverage, as per the criteria defined by the state. In practice the department describes three situations:
| Your situation | What the FAQ says |
|---|---|
| Swasthya Sathi family found eligible for PM-JAY | You move to PM-JAY and are treated under PM-JAY rules |
| Swasthya Sathi family not eligible for PM-JAY | Check whether you fall in the MMSBY category and complete any verification or renewal |
| Not in Swasthya Sathi and not in PM-JAY | Not eligible, unless you independently meet the conditions notified for MMSBY |
You are not eligible for MMSBY if:
- You are already eligible under AB PM-JAY. MMSBY is meant for people outside PM-JAY, and the FAQ says not to assume a separate MMSBY entitlement.
- You do not meet the eligibility and enrolment conditions notified by the state. An old Swasthya Sathi card by itself does not guarantee cover.
Senior citizens aged 70 and above are eligible for AB PM-JAY irrespective of income under Ayushman Vay Vandana, with up to Rs 5 lakh a year, so they should check PM-JAY first.
What does MMSBY cover?
- Up to Rs 5 lakh per family per year of cashless hospital treatment.
- Empanelled hospitals, both government and private, for treatments in the approved package list.
- National portability, subject to PM-JAY rules, so treatment can be taken at participating hospitals outside West Bengal.
MMSBY does not make every treatment free. The FAQ says cover is as per the approved package list, and services or items outside the package may still need payment. A family should not expect to use PM-JAY and MMSBY together for the same hospital stay.
What happens to my Swasthya Sathi balance?
The department says the unused Swasthya Sathi wallet balance should not be presumed to move automatically to the new scheme, and hospitals should not deduct earlier Swasthya Sathi use from a new entitlement unless the system or official instructions require it. A physical Swasthya Sathi card should not be assumed to authorise treatment once it has been deactivated.
What documents are required?
| Document | Needed | Notes |
|---|---|---|
| Aadhaar | Yes | For identity and e-KYC |
| Mobile number | Yes | For OTPs during verification |
| Family and household details | Yes | Cover is per family |
| Identity and address proof | Yes | As prescribed by the competent authority |
| Swasthya Sathi card | If you have one | Do not surrender it unless instructed |
| PM-JAY card or details | If any member has one | Helps the hospital pick the right scheme |
How to get MMSBY cover
- Check PM-JAY first. Verify through an authorised AB PM-JAY channel, a Common Service Centre, an Ayushman Arogya Mandir or the Ayushman Mitra at an empanelled hospital whether your family is under PM-JAY.
- If you are not under PM-JAY, ask whether you fall within the MMSBY category. Keep your Swasthya Sathi details and identity documents ready.
- Complete verification or renewal as instructed by the Health and Family Welfare Department, including e-KYC with your Aadhaar-linked mobile.
- Before a planned admission, confirm that the hospital is empanelled, that the procedure is covered and whether pre-authorisation is needed.
- At the hospital, carry Aadhaar and your scheme card or e-card. The hospital verifies your active record, checks eligibility under PM-JAY and then MMSBY, and processes the claim under the correct scheme.
What if the hospital asks for money?
Ask the hospital helpdesk or Ayushman Mitra to check your beneficiary record, e-KYC status, the hospital's empanelment for the speciality and whether the procedure is covered. If a covered service is being charged, report it through the official grievance mechanism. The department also warns against paying any agent to generate a card.
Where to get help
The department's FAQ and orders are on swasthyasathi.gov.in, under Govt. Order. For individual cases, ask the helpdesk at an empanelled hospital or your block or district health office. Beneficiary records for PM-JAY are checked through the official PM-JAY beneficiary portal or an authorised enrolment centre.
Documents required
Frequently asked questions
What does Mukhya Mantri Swasthya Bima Yojana give?
Cashless health cover of up to Rs 5 lakh per family per year. The Health and Family Welfare Department's FAQ says MMSBY gives coverage of up to Rs 5 lakh per family per year, for treatment covered in the approved package list at empanelled hospitals.
Is MMSBY the same as Swasthya Sathi?
No. The department's FAQ says plainly that MMSBY is not the same as Swasthya Sathi. Swasthya Sathi families found eligible for Ayushman Bharat PM-JAY move to PM-JAY, and MMSBY is meant for eligible residents who remain outside PM-JAY.
Will my old Swasthya Sathi card automatically give me MMSBY?
Not necessarily. Eligibility depends on the conditions notified by the Government of West Bengal, so an old card alone does not guarantee MMSBY cover. Check your status before a planned admission.
I have an Ayushman Bharat PM-JAY card. Should I also apply for MMSBY?
Generally no. MMSBY is meant for people outside PM-JAY. If you are eligible under PM-JAY, use that entitlement first and do not assume a separate MMSBY entitlement is available.
Can I use MMSBY outside West Bengal?
Yes, MMSBY has national portability, subject to PM-JAY rules and treatment at participating or empanelled hospitals.
Do I have to pay a premium for MMSBY?
The department describes MMSBY as a government-sponsored scheme and asks beneficiaries to follow the latest official notification on enrolment and any contribution. It has not published a premium for families.
Someone is asking for money to make an MMSBY card. What should I do?
Do not pay. The department warns against paying unauthorised agents for scheme cards. Use only government channels, empanelled hospitals or designated service centres.
See all West Bengal Health and Family Welfare Department schemes →
Related West Bengal schemes
| Scheme | Who it's for | Benefit amount | Where to apply |
|---|---|---|---|
| Nabanna Scholarship (Chief Minister's Relief Fund Educational Assistance) | Permanent residents of West Bengal studying in the state after passing Secondary, Higher Secondary or an undergraduate examination, from families earning up to Rs 1,20,000 a year | Not published on the official portal. The grant is sanctioned case by case | Apply |
| Marriage Registration Certificate in West Bengal | Couples marrying in West Bengal, or already married couples where the marriage was solemnised in the state or either spouse resides there | - | Apply |
| Nijashree Housing Scheme | Lower Income Group and Middle Income Group families in West Bengal without a pucca house | A 2 BHK flat of 50.96 sq m (about 548 sq ft) at an average cost of Rs 9.28 lakh, with land and infrastructure provided free by the state | Apply |
| Manabik Pension Scheme | Residents of West Bengal with a certified disability of 40 percent or more | Not stated on an official page we could open; ask the BDO, SDO or Controller of Vagrancy office for the current monthly rate | Apply |
| Nijo Griha Nijo Bhumi | Landless rural families, agricultural labourers, artisans, fishermen and marginalised households | 5 decimals of homestead land (about 2,178 square feet) per family | Apply |
| Lokprasar Prakalpa | Folk and tribal performing artists resident in West Bengal | Rs 1,000 per month retainer and Rs 1,000 per programme | Apply |
| OBC Non-Creamy-Layer Certificate in West Bengal (State OBC NCL and Central OBC NCL) | West Bengal residents from a community listed as OBC-A or OBC-B whose family falls below the creamy-layer test | - | Apply |
| Legal Heir Certificate in West Bengal (Warish Certificate) and the Succession Certificate route | The surviving spouse, children, parents or other surviving family members of a person who died in West Bengal | - | Apply |
| Old Age Pension to Handloom Weavers under Cooperative Fold, West Bengal | Aged handloom weavers who are members of a registered handloom cooperative society in West Bengal | Rs 1,000 per month as listed on district handloom pages (Bankura, Howrah); confirm the rate in force at the district handloom office | Apply |
| Land Record / Record of Rights (Porcha, Khatian) in West Bengal | Any landholder, buyer, lender or legal heir who needs proof of who is recorded as raiyat of a plot in West Bengal | - | Apply |
| One Time Assistance to Small and Marginal Farmers for Purchase of Small Farm Implements (OTA-SFI), West Bengal | Small and marginal farmers registered under Krishak Bandhu (Natun), and recognised farmer groups such as PACS, FPO, FPC, FIG, SHG and LAMPS | Rs 10,000 | Apply |
| Lakshmir Bhandar Prakalpa | Women residents of West Bengal aged 25 to 60 from households without a salaried or pensioned government member | Rs 1,700 per month under the final Lakshmir Bhandar rates; Rs 3,000 per month under Annapurna Yojana | Apply |
| Paray Shikshalay (Neighbourhood School) | Children aged about 5 to 9 years, pre-primary to Class IV, enrolled in government and government-aided primary schools | No cash benefit, teaching, learning material and activities are provided free | Apply |
| Labour Card (BOCW) in West Bengal, BMSSY and the Samajik Mukti Card | Unorganised workers in West Bengal, including building and other construction workers registered under the BOCW scheme and transport workers under WBTWSSS | - | Apply |
Schemes in other states
Official forms & downloads
Links to official government PDFs and portals for this scheme.
Official government portal: click to visit
Didn't find what you needed?
Browse all West Bengal schemes, or the central government schemes open to every state.
Spotted something wrong or out of date? Report an error and we will check it against the official source and correct it.
Sources
This guide was checked against these official pages:
- swasthyasathi.gov.in (swasthyasathi.gov.in/Content/HomeTabItems/AB%20PMJAY%20MMSBY2026-19-8--13-34-31.)
- swasthyasathi.gov.in (swasthyasathi.gov.in/)
- jks.wb.gov.in (jks.wb.gov.in/Public/KnowYourScheme.aspx)
Fact-checked by Aapt Dubey
Last fact-checked: 26 October 2026