Complete MMSBY eligibility rules for 2026 - the Rs 8 lakh income limit, exclusions (WBHS/CGHS/ESI, 70+, SIR), required documents and the verification process.
Tick off the required papers as you gather them for your application:
In July 2026 the West Bengal government launched Mukhyamantri Swasthya Bima Yojana (MMSBY) — a state-level scheme providing Rs 5 lakh of cashless treatment per year for those who are enrolled in Swasthya Sathi but are not eligible for the central Ayushman Bharat (PM-JAY). This article details every eligibility and exclusion rule of MMSBY.
If you don’t know the application process yet, first read: Apply Online for the MMSBY Scheme 2026.
To enrol in MMSBY, two basic conditions must be met:
If the conditions are met, the benefits: up to ₹5,00,000 of secondary and tertiary cashless treatment per year for all family members combined, pre-existing diseases covered from day one, no limit on the number of members, and treatment at Ayushman empanelled hospitals across India.
MMSBY is not “universal” like Swasthya Sathi. You cannot apply if any of the following conditions applies:
| # | Exclusion criterion |
|---|---|
| 1 | Family annual income above Rs 8 lakh |
| 2 | Covered under WBHS 2008 (West Bengal Health Scheme) or CGHS 1954 |
| 3 | Covered under the ESI Act 1948 |
| 4 | Covered by group medical insurance of a PSU / municipality / statutory body |
| 5 | Government or parastatal employees/pensioners receiving a regular medical allowance |
| 6 | Above 70 years of age (for them: Ayushman Vaya Vandana scheme) |
| 7 | Name removed from the voter list in SIR (absence/death/relocation/duplicate) |
Exception: In SIR cases, eligibility is retained if the other conditions are met and a case is pending before the CAA or the SIR tribunal.
Helpline: 1800 345 5384 (toll-free).
| Aspect | Swasthya Sathi | MMSBY |
|---|---|---|
| Coverage | ₹5 lakh/year/family | ₹5 lakh/year/family |
| Income limit | None (nearly universal) | Income ≤ Rs 8 lakh |
| Portability | Mainly within the state | Nationwide (AB empanelled hospitals) |
| Target group | All families of the state | Families not eligible for PM-JAY |
If you need the core benefits of the Swasthya Sathi card and the hospital list, read: Swasthya Sathi Card 2026: Benefits and Application.
See where the card works in your district: Swasthya Sathi / MMSBY / Ayushman Bharat Hospital List
You cannot apply for MMSBY if the family's annual income exceeds Rs 8 lakh. This income limit is verified on the basis of self-declaration — you do not need to pay for a separate income certificate.
No. Employees and pensioners covered under WBHS 2008, CGHS or ESI, covered by PSU/municipality group medical insurance, or receiving a regular medical allowance are outside MMSBY.
People above 70 years of age do not come under MMSBY — for them the central Ayushman Vaya Vandana scheme is available. Enrol in that scheme instead.
If a name was removed from the voter list in SIR due to absence, death, relocation or duplication, the person is generally not eligible for MMSBY. However, where a case is pending before the CAA or SIR tribunal, eligibility is retained if the other conditions are met.
Contact the official West Bengal Government helpline for immediate resolution.