Blitz Bureau
NEW DELHI: West Bengal joined Ayushman Bharat PM-JAY on 16 August. The number that decides whether the scheme actually works is not the coverage target — it is the gap between the people who have registered and the people holding a card they can present at a hospital counter.
The Pradhan Mantri Jan Arogya Yojana was formally launched in West Bengal on 16 August 2026, extending up to ₹5 lakh of annual cashless hospital cover per family to a state that had until then run its own Swasthya Sathi programme. The state expects roughly 1.5 crore families — about six crore people — to come within its ambit. About 3.4 crore people had already enrolled by the launch date, and Ayushman cards were handed to 1.23 crore of them who had completed verification.
[ PHOTOGRAPH ] A government hospital building in India, of the kind empanelled under Ayushman Bharat PM-JAY
Where the card is used: PM-JAY pays empanelled public and private hospitals directly for treatment; the beneficiary presents a verified Ayushman card and pays nothing at the counter for a covered procedure.
Enrolment is a database entry. A verified card is a hospital admission. The distance between 3.4 crore and 1.23 crore is the distance between a scheme announced and a scheme working.
At a Glance
• Launched in West Bengal: 16 August 2026
• Cover: up to ₹5 lakh per family a year, cashless, at empanelled hospitals
• Target coverage: about 1.5 crore families, roughly 6 crore people
• Enrolled by launch: about 3.4 crore people
• Cards issued after verification: 1.23 crore — 36.2% of those enrolled
• Senior citizens: all those aged 70 and above are covered irrespective of income
• Pre-existing conditions: covered from day one of enrolment
• No cap on family size or age
• Transition: Swasthya Sathi to run alongside for two to three months, with a phased withdrawal after a 60-day review
Two features of PM-JAY are worth stating precisely, because they are the ones most often misunderstood. First, there is no upper limit on family size or age: a household of nine is covered on the same terms as a household of three, which matters most in exactly the districts where households are largest. Second, pre-existing conditions are covered from the first day of enrolment — there is no waiting period of the kind commercial health insurance applies. A person diagnosed with a chronic condition before enrolling is not excluded from treatment for it.
The third feature is the one that changes household finance rather than household health. The ₹5 lakh cover is per family per year, not per person, and it is cashless at the point of treatment: the hospital bills the scheme, not the patient. Separately, every citizen aged 70 and above is eligible regardless of what the household earns — the only demographic in the scheme where income is not a test at all.
The transition arrangement is the part a Bengal reader should note now. Swasthya Sathi will continue to run alongside PM-JAY for two to three months, with a phased withdrawal to follow a 60-day review of operations and hospital empanelment. In practice that means a family holding a Swasthya Sathi card is not stranded while the new system beds in, and has a window in which to complete PM-JAY verification without losing cover.
The way forward is administrative rather than financial, and it is measurable. Converting the remaining 2.17 crore enrolments into verified cards is a verification-camp problem — biometric authentication, address proof, family linkage — of the sort that Bihar and Uttar Pradesh worked through in earlier rounds of the scheme. It is the least glamorous stage of a health programme and the one that decides whether a family at a hospital counter is turned away or admitted.
