West Bengal Ayushman Bharat PM-JAY 2026: Benefits, Health Cover, Eligibility and How to Apply

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) has been officially rolled out in West Bengal. It allows citizens to use one of the largest publicly funded health insurance projects in India under this scheme. Eligible families are entitled to cashless treatment of up to ₹5 lakh in government and private hospitals in India. It aims to lower healthcare costs and improve the availability of quality healthcare services for the economically weaker sections of society. 

Highlights of Ayushman Bharat PM-JAY in West Bengal

Health Benefits and Coverage

• ₹5 lakh Annual Family Coverage: This policy covers secondary and tertiary hospitalisation up to ₹5 lakh for each family per year.

• Portability: Beneficiaries from West Bengal can obtain treatment at any network hospital in India, which is great for migrant workers and families going out of state.

• No restriction on Family Size or Age Limit: All family members are covered under a single family floater limit irrespective of gender and age.

• Pre-existing Disease Coverage: Existing medical conditions before issuance of the card will be covered from the first day.

• Comprehensive Pre and Post-Hospitalization Benefit: Here, pre- and post-hospitalization expenses are covered, which include expenses incurred before hospitalization, pre-operative consultations as well as up to 15 days of post-hospitalization expenses.

Eligibility Criteria for West Bengal Residents 2026

There are established criteria for qualifying to be a beneficiary under PM-JAY based on different economic factors of economy instead of being chosen through a lottery of any sort.

Income and Vulnerable Households

• For  Rural: Those who live in kutcha or temporary houses, landless agricultural laborers, families that do not include an adult man who earns, and SC/ST families.

• For Urban: People belonging to various professions such as street vendors, domestic helpers, construction workers, transport operators, sanitation workers, and mechanics.

Individuals Over 70 years of Age

In accordance with the provisions of the national government, all individuals over the age of 70 qualify for the Ayushman Vay Vandana Card which confers an annual sum insured of ₹5 lakh to the insured person.

Frontline Staff: In West Bengal, all ASHA workers, AWW’s and AWH’s are included directly as beneficiaries.

Integration with Swasthya Sathi and MMSBY

• For people who already hold the Swasthya Sathi Card. The Swasthya Sathi database is the basis.

• People qualifying from this database according to the central SECC list will be given PM-JAY coverage, with the others continuing to be covered under the MMSBY scheme.

Documents Required for Ayushman Card Registration 

Importance of Documents Required for Ayushman Card Registration to  have for getting quick e-KYC action:

• Aadhaar Card (to link to an active mobile number so that OTP can be verified).

• Ration Card (required for family composition verification: AAY, BPL or other priority household card).

• A valid mobile number.

• Age Proof Document (Voter ID/Aadhaar for elderly persons).

How to  Apply Online 

1. Go to the Portal: Visit the Official NHA Beneficiary Portal. Open https://beneficiary.nha.gov.in/ and select Beneficiary. Enter your mobile number with 10 digits and log in by entering the OTP received on your mobile device.

2. Find the Family Details: Search by ID/Aadhaar. Select the name of the State as West Bengal. Enter your Aadhaar number, Ration Card Number, or Family ID to search.

3. Perform e-KYC Confirmation: Digital Verification. If your name is listed as "Unverified," click on Action/e-KYC and select your choice of verification method (Aadhaar OTP, Iris Scan or Face Authentication) to complete the confirmation process.

4. Get your Ayushman Card: PDF Download. After approval from the system, click on Download Card to obtain the digital Ayushman Card PDF.

How to Apply Offline

Offline Card Issuance Options

Hospital Kiosks: Visit any empanelled government medical colleges, district hospitals, or private hospitals’ Ayushman Mitra helpdesks. You can go directly to the help desk with your Aadhaar and ration cards.

Duare Sarkar / Local Outreach Camps: Local administrative outreach camps throughout the districts of West Bengal are designated for the physical registration, e-KYC, and biometric updates.

How Cashless Hospital Admissions Operate

• Locate a Network Hospital: You can find a network hospital using pmjay.gov.in or a hospital helpdesk.

• Provide Ayushman Card: Visit the Ayushman Mitra desk.

• Get Biometric Approval: Identity authentication will allow for a digital pre-authorization request.

• Get Discharged Cashless: After assessment, the hospital will make a claim directly to the government body for reimbursement. Please note: Registration, e-KYC, and card download are completely free of charge.