West Bengal rolls out Ayushman Bharat: Eligibility, steps to apply

Eligible residents can now access cashless hospital treatment worth up to Rs 5 lakh under PM-JAY

West Bengal’s decision to implement Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) means eligible residents of the state can now access the Centre’s flagship health insurance scheme, which provides cashless hospitalisation cover of up to Rs 5 lakh per family every year.

 

The move is expected to expand access to affordable healthcare for millions of beneficiaries and bring West Bengal under the national health protection framework.

 

West Bengal joins Ayushman Bharat

 

The National Health Authority (NHA) and the West Bengal government have signed a memorandum of understanding (MoU) to roll out AB PM-JAY in the state. With the agreement in place, eligible residents can avail cashless treatment at empanelled hospitals under the scheme.

 

 

The programme is designed to provide financial protection against major medical expenses, particularly for families that may struggle to bear the cost of hospitalisation. Coverage is available for secondary and tertiary care treatment, and beneficiaries can access services at both public and empanelled private hospitals.

 

The inclusion of West Bengal is significant because it extends the reach of one of India’s largest publicly funded health insurance programmes to another major state, potentially benefiting millions of households.

 

What is the Ayushman Bharat scheme?

 

Ayushman Bharat PM-JAY is the Centre’s flagship health insurance programme aimed at reducing out-of-pocket healthcare expenses for eligible families.

 

Under the scheme:

 

•       Beneficiaries receive health cover of up to Rs 5 lakh per family per year.

 

•       The cover is available for hospitalisation expenses related to secondary and tertiary care.

 

•       Treatment is cashless at empanelled hospitals.

 

•       The cost of treatment is borne by the government.

 

•       Beneficiaries can access services across India at participating hospitals.

 

The scheme seeks to ensure that a serious illness does not push families into financial distress or debt.

 

What is an Ayushman card and why is it important?

 

An Ayushman card serves as the beneficiary’s identification document under PM-JAY. It allows eligible individuals to access treatment and verify their entitlement at hospitals covered under the scheme.

 

The card can now be generated digitally, reducing the need for physical visits to government offices. Once issued, beneficiaries can download and store it electronically for future use.

 

Having the card is important because hospitals typically use it to verify eligibility and process cashless treatment under the scheme.

 

How to apply for an Ayushman card online

 

Eligible beneficiaries can apply digitally through the official PM-JAY beneficiary portal.

 

Steps to apply:

 

1.      Visit the PM-JAY beneficiary portal.

 

2.      Log in as a beneficiary using a registered mobile number and OTP.

 

3.      Select PM-JAY and choose the relevant state and district.

 

4.      Search for eligibility using a name or Aadhaar number.

 

5.      Complete the verification process.

 

6.      Upload a photograph and provide the required details.

 

7.      Submit the application.

 

8.      Download the Ayushman card once approved.

 

Applicants should ensure that personal details and identity information match official records to avoid delays during verification.

 

Who is eligible?

 

One of the notable features of the current framework is that all Indian citizens aged 70 years and above are eligible for coverage, irrespective of income levels.

 

This means:

 

•       There is no income-based eligibility criterion for senior citizens aged 70 years and above.

 

•       Existing private health insurance policies do not affect eligibility.

 

•       Eligible individuals can obtain an Ayushman card and access benefits under the scheme.

 

The expansion of eligibility for senior citizens reflects growing concerns over rising healthcare costs in old age, when medical needs typically increase.

 

What if you already have CGHS or ECHS coverage?

 

Many retirees and former government employees already receive healthcare benefits through public schemes such as:

 

•       Central Government Health Scheme (CGHS)

 

•       Ex-Servicemen Contributory Health Scheme (ECHS)

 

•       Ayushman CAPF and other government-backed health programmes

 

For citizens aged 70 years and above who are already covered under these schemes, the rules provide flexibility. They may continue with their existing healthcare arrangement or choose to opt for AB PM-JAY instead.

 

The choice allows beneficiaries to evaluate which scheme offers better access, convenience and hospital networks based on their personal healthcare requirements.