The West Bengal government has introduced the Mukhya Mantri Swasthya Bima Yojana (MMSBY) to improve access to public healthcare and reduce the financial burden of medical treatment. The scheme provides health insurance coverage of up to ₹5 lakh to eligible residents covered under the state's Swasthya Sathi scheme but not under the Centre's Ayushman Bharat Yojana.
To ensure the benefits reach the intended beneficiaries, the state government has laid down eligibility as well as exclusion criteria. Here's who can avail of the scheme and who cannot.
To be eligible for the scheme, applicants must meet all of the following conditions:
Be a resident of West Bengal.
Enroll under the Swasthya Sathi scheme.
Not covered under the Ayushman Bharat Yojana.
Have an annual family income of ₹8 lakh or less.
Satisfy the eligibility criteria prescribed by the West Bengal government.
Eligible beneficiaries can receive health insurance coverage of up to ₹5 lakh under the scheme.
The following categories are not eligible for the scheme:
Families with an annual income exceeding ₹8 lakh.
Employees or pensioners covered under the West Bengal Health Scheme, 2008.
Employees or pensioners covered under the Central Government Health Scheme (CGHS), 1954.
Employees or pensioners covered under the Employees' State Insurance (ESI) Act, 1948.
Employees or pensioners enrolled in group medical insurance schemes offered by Central or State public sector undertakings (PSUs), urban local bodies, statutory corporations, trusts, societies or boards.
These exclusions are intended to avoid duplication of health insurance benefits and ensure the scheme reaches households that are not already covered under similar government or employer-sponsored health insurance programmes.
The Mukhya Mantri Swasthya Bima Yojana provides ₹5 lakh health insurance coverage to eligible Swasthya Sathi beneficiaries in West Bengal who are not covered under Ayushman Bharat. Residents should check both the eligibility and exclusion criteria before applying to determine whether they qualify for the scheme.
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Published on: Aug 1, 2026, 9:00 AM IST
Rakesh Deshmukh
Rakesh Deshmukh is a financial content specialist with around 3 years of experience writing impactful content across equities, mutual funds, IPOs, and personal finance. At Angel One, he decodes real-time market trends and breaking news, helping investors and traders stay updated. He also helps investors make informed decisions by simplifying market fundamentals and technical analysis. He holds a bachelor’s degree in commerce.
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