Check Details of Swasthya Sathi Scheme Yojana
Updated On Oct 18, 2023
On December 30, 2016, the Chief Minister of West Bengal announced the Swasthya Sathi Scheme, making it accessible to all people, regardless of age. This healthcare scheme covers primary, secondary, and tertiary care expenses up to Rs 5 lakh per family each year. The fact that it is completely cashless and paperless makes it even better. you just need the Smart Card to make the payment and the best thing is that it's fully funded by the state government.
Table of Contents
- Swasthya Sathi Yojana Highlights
- Critical Features of the Swasthya Sathi Scheme
- Advantages of Swasthya Sathi Yojana
- Eligibility Criteria of Swasthya Sathi Scheme
- Process to Apply for the Swasthya Sathi Scheme
- List of Documents Required for Swasthya Sathi Scheme Application Process
- Swasthya Sathi Smart Card
- Frequently Asked Questions
Swasthya Sathi Yojana Highlights
The Swasthya Sathi Scheme intends to lessen the high cost of healthcare for the residents of West Bengal. This program guarantees that you can receive treatment without being concerned about the expense in today's world of increasing healthcare costs.
The State Government is putting a lot of effort into enhancing healthcare by locating specialist hospitals, reasonably priced diagnostic facilities, pharmacies, and critical care facilities within a 50 km radius of you. This implies that you can receive top-notch care without breaking the bank.
West Bengal Government
Rs. 5 lakh
30th December 2016
Citizens of West Bengal
Critical Features of the Swasthya Sathi Scheme
The Swasthya Sathi Scheme, initiated by the West Bengal Government, offers an array of remarkable features that are listed below:
- Transparent Hospital Gradation: Hospitals participating in this scheme undergo a rigorous evaluation process by the Empanelment Committee to ensure transparency and quality of care.
- Compulsory Pre-Authorization for Treatment: Beneficiaries of the Swasthya Sathi scheme enjoy the peace of mind of 100% pre-authorization for all medical treatments and procedures, processed within a swift 24-hour timeframe.
- Real-time Updation: Upon discharge from the hospital, beneficiaries' e-health records are promptly and automatically updated in real-time. This facilitates seamless record-keeping and future healthcare decisions.
- Swasthya Sathi Mobile App: A user-friendly Android-based mobile app is available to provide valuable assistance and information to beneficiaries. This in turn simplifies the healthcare journey of beneficiaries.
- SMS Alerts: Beneficiaries can stay informed with SMS alerts that notify them in case of health card blockage. This ensures uninterrupted access to healthcare services.
- Toll-Free Call Centre: Access round-the-clock support and assistance through the toll-free helpline at 1800-345-5384, complete with a feedback option for an enhanced experience.
- Online Grievance Monitoring Mechanism: Share your feedback and concerns effortlessly through the Swastha Sathi online portal, contributing to the continuous improvement of the scheme.
- Quick Claim Reimbursement: Hospital claims are processed and settled with remarkable speed, guaranteeing claim reimbursement within 30 days.
Advantages of Swasthya Sathi Yojana
Are you wondering about what benefits you will receive after enrolling for the Swasthya Sathi Scheme? If yes, then we have covered some of the many advantages below:
- Universal Healthcare Coverage: Swasthya Sathi Yojana aims to offer healthcare insurance to all West Bengal inhabitants, especially those from low-income families.
- Cashless Treatment: The scheme offers cashless treatment for various medical procedures and hospitalizations at empaneled hospitals and healthcare facilities. This means that beneficiaries could receive medical care without the need for upfront payments.
- Convenience through Swasthya Sathi Card: The Online Swathya Sathi Smart card offers the invaluable benefit of providing each enrolled family with immediate access to a comprehensive health and welfare system.
- No Family Size Limit: Unlike some other healthcare programs, the Swasthya Sathi Scheme does not place a cap on the total number of family members eligible for coverage.
- No Income Requirements: Swasthya Sathi had no income requirements, making it open to families of all economic levels.
- Financial Support: Swasthya Sathi offers financial assistance for a variety of medical costs, including hospitalization fees, operations, diagnostic exams, and medication.
- Coverage for All Family Members: The best part about this scheme is that it provides coverage for all members of the family. The program includes coverage for the primary cardholder, spouse, and any dependent children as well as other family members.
- Portability: Last but not least, the Swasthya Sathi Scheme offers the advantage of portability as well. This means that Beneficiaries could use the advantages of the system not only in West Bengal but also in other Indian states. This makes it portable and practical for anyone who might require medical care outside of their home state.
Eligibility Criteria of Swasthya Sathi Scheme
The eligibility criteria for the Swasthya Sathi Scheme may include the following:
- Residency: To be eligible for the Swasthya Sathi Scheme, you must be a resident of West Bengal. This scheme is typically available to all residents of the state, irrespective of their income level.
- Not Receiving Medical Benefits as Part of Wage: If you are receiving medical benefits as part of your employment package or wage, you may not be eligible for coverage under the Swasthya Sathi Scheme. This is to avoid double coverage for the same individual.
- Not Covered by Other Government Schemes: Individuals who are already covered by another government-sponsored health insurance scheme may not be eligible for Swasthya Sathi benefits. This is to prevent duplication of benefits and ensure efficient use of government resources.
- Income Criteria (Optional): While the Swasthya Sathi Scheme is generally open to all residents, there may be optional income criteria in certain cases. For example, there might be specific income limits for certain categories of beneficiaries, such as economically weaker sections (EWS) or individuals below the poverty line (BPL).
NOTE: These income criteria can vary, so it's always essential to check the latest guidelines issued by the government.
Process to Apply for the Swasthya Sathi Scheme
Here's a step-by-step guide for the Swasthya Sathi Scheme application process:
Step 1: Download or Collect Form-B from the official Swasthya Sathi website or obtain a physical copy from the nearest government hospital.
Step 2: Complete Form-B with accurate and required information. Ensure all details are correctly filled.
Step 3: Submit the Application Form to the nearest government hospital.
NOTE: Applicants can also register for the Swasthya Sathi Scheme through authorized agents located at nearby ward offices, Grama Panchayats, or village medical centers.
Step 5: After the submission of the application form, you will receive an SMS with a unique ID, district code, or serial number.
Step 6: Now, a smart card will be delivered to you within approximately one week from the date of application submission.
Step 7: Lastly, you will also receive a Unique Registration Number (URN) associated with your Swasthya Sathi membership.
Please note that it's highly important to keep the smart card and URN safe, as both of them will be required for availing healthcare benefits under the Swasthya Sathi Scheme.
List of Documents Required for Swasthya Sathi Scheme Application Process
- Aadhaar card as proof of identity
- If an Aadhaar card is not available, you can use any photo ID card issued by the government
- Legal domicile documents
Swasthya Sathi Smart Card
Upon enrollment, a Swasthya Sathi Smart card is given to each recipient. The Swasthya Sathi card contains information on each insured family member, including their name, address, phone number, biometric information, and SECC ID.
Using this smart card, the covered family can take advantage of the medical care offered by this program at both private and public hospitals. It’s important to note that, for cashless payments, individuals must deposit the smart card within 24 hours after being admitted; otherwise, they would be responsible for hospitalization costs.
Swasthya Sathi Yojana aims to make healthcare accessible to all the residents of West Bengal. With its coverage and cashless benefits, it's a big step towards a healthier India. So, if you're eligible, don't miss out on this opportunity to secure your health and well-being. Stay healthy, stay informed!
Frequently Asked Questions
Ques 1. When was the Swasthya Sathi scheme launched?
Ans. The scheme was launched on 30th December 2016.
Ques 2. Is Swasthya Sathi applicable for pregnancy?
Ans. Yes, maternity benefits and newborn care are included in Swasthya Sathi Yojana.
Ques 3. Is the Swasthya Sathi Scheme free?
Ans. Yes, the scheme is free because the entire premium is borne by the State Government and no contribution is required from the beneficiary.