The West Bengal government on Monday introduced the Mukhya Mantri Swasthya Bima Yojana (MMSBY) to strengthen access to public healthcare and insulate households from high medical expenses. It offers a Rs 5-lakh health coverage to residents who are covered under the state’s Swasthya Sathi scheme but do not qualify for the central Ayushman Bharat Yojana.To ensure targeted financial assistance and avoid duplicating benefits, the government has outlined specific exclusion criteria. You are ineligible for the MMSBY if you fit into any of the following categories:State government health scheme: Employees or pensioners covered under the West Bengal Health Scheme 2008.Central government health scheme (CGHS): Employees or pensioners covered under the CGHS 1954.ESI coverage: Employees or pensioners covered under the Employees’ State Insurance Act 1948.PSU/statutory body insurance: Employees or pensioners enrolled in any group medical insurance scheme operated by central or state public sector undertakings, urban local bodies, statutory corporations, trusts, societies, or boards.Story continues below this adMedical allowance recipients: State or central government, parastatal employees and pensioners drawing a regular medical allowance.Senior citizens: Individuals over 70 years of age (as they qualify for coverage under the Ayushman Vaya Vandana Yojana).Electoral roll deletions: Individuals whose names were removed during the Special Intensive Revision (SIR) of the electoral roll under the absentee, deceased, shifted, or duplicate lists. Applicants with pending Citizenship Amendment Act or SIR tribunal adjudications remain eligible if they satisfy all other conditions.Also Read | With Ayushman Bharat roll-out in Bengal, what happens to Swasthya Sathi beneficiaries?MMSBY vs Swasthya SathiStory continues below this adWhile the MMSBY builds upon the foundations laid by Swasthya Sathi, it introduces key structural changes:Pan-India portability: Under Swasthya Sathi, cashless medical treatment was primarily limited to empanelled hospitals within the state. In contrast, the MMSBY offers nationwide portability, allowing beneficiaries to access cashless treatment at any Ayushman Bharat-empanelled hospital across India—a major relief for people travelling or working outside the state.Refined income and target criteria: Swasthya Sathi provided near-universal coverage by removing income barriers for all residents (except those on specific government health schemes). The MMSBY introduces a defined annual family income ceiling of Rs 8 lakh along with targeted exclusions to streamline resources for families without secondary coverage.What remains the sameDespite these logistical upgrades, the key benefits that protect families against medical debt remain intact:Story continues below this adCoverage amount: Families receive up to Rs 5 lakh per year for secondary and tertiary care hospitalisation on a floater basis.Pre-existing conditions: Covered from Day 1 with zero waiting period.No family cap: No limit on the number of dependent family members who can be covered under a single policy unit.How to applyBecause MMSBY targets residents covered under Swasthya Sathi who lack Ayushman Bharat coverage, the application and verification process is integrated directly into the state’s existing healthcare setup.Swasthya Sathi cardholders can check their eligibility status directly on the official portal (swasthyasathi.gov.in) by entering their registered mobile number or unique registration number.Story continues below this adIf your family is not yet registered under Swasthya Sathi, you can fill in the standard registration form on the official portal or submit a physical copy at local administrative camps (such as Duare Sarkar outreach drives or block development or municipal offices).Required documentsTo complete or verify your application, you will need:Aadhaar numbers of all family members.Khadya Sathi, Digital Ration Card.Self-declared income certificate confirming annual family income is Rs 8 lakh or less.