Swasthya Sathi Scheme
08
Nov 2024

About the Swasthya Sathi Scheme

Swasthya Sathi is one of the most popular beneficiary schemes launched by the West Bengal Chief Minister. Whether you are an individual, have dependents in your family, or are earning or not, you can register for the Swasthya Sathi scheme with all of your family members, irrespective of the age group.

The group healthcare scheme ensures basic coverage for tertiary and secondary healthcare expenses of up to Rs. 5 Lakhs annually per family. There is no need to stand in long queues for Swasthya Sathi registration or worry about hectic paperwork.

Apply for the Swasthya Sathi scheme online by providing essential information. After enrolment, you will get a Swasthya Sathi card that you can use to gain cashless healthcare benefits at any registered hospital.

Also Read: Pradhan Mantri Jan Arogya Yojana

Key Highlights of Swasthya Sathi

The table below will help you discover the key specifications of the Swasthy Sathi scheme: 

Official Launch Date

December 30th, 2016

Official Website

https://swasthyasathi.gov.in/ 

Cashless Healthcare Benefit

Up to Rs. 5 Lakhs

Family Size

No capping

Total Families Covered 

2.4 Crore+

Hospitals Empanelled 

2400+

Total Hospitalisations

76 Lakhs+ (Dated: 30/06/2024)

Claims Settled

97.98% (Dated: 20/07/2024)

Treatment Type

Paperless, smartcard-based

Pre-Existing Diseases Covered

All

Beneficiary Contribution

Zero

Objectives of Swasthya Sathi

The primary objective of launching Swasthya Sathi is to provide basic health coverage to all state residents, mainly targeting economically vulnerable groups. Here are the main objectives behind the launch of the scheme:

  1. Universal Health Coverage: Ensure universal health coverage for all residents of West Bengal, regardless of their socio-economic status.
  2. Financial Protection: Fund the significant healthcare expenses, reducing out-of-pocket expenditures for families.
  3. Cashless Treatment: Streamline cashless treatment across empanelled hospitals, both public and private, and ensure that beneficiaries do not face financial barriers in accessing healthcare services.
  4. Family-Focused Benefits: Provide coverage for all family members, including dependent parents, but it focuses on female family members as the head of the family.
  5. Comprehensive Health Services: Avail of comprehensive health services that include hospitalisations, surgeries, and treatments across various specialities.

Also Read: Bangla Shasya Bima

Features of Swasthya Sathi

Here are the coverage features of the Swasthya Sathi that promise hassle-free healthcare facilities for you: 

  • Completely Cashless and Paperless: Everything is kept paperless, from the Swasthya Sathi online application to healthcare benefits at the registered hospital. It is no hassle to maintain papers or keep records. You get access to smart card-based transactions with lifetime validity. 
  • Hospital Gradation: The empanelment committee approves the hospital’s grade and empanels them under Swasthya Sathi based on the available services and infrastructure. You can check the Swasthya Sathi hospital list on the official website and reach per your requirements. 
  • 100% Pre-Authorisation: Within the first 24 hours of every medical treatment, a pre-authorisation process is carried out to help you determine whether the hospital covers the procedure, service, or medication required. 
  • Online Grievance Monitoring: You can file your grievances anytime by calling the 24/7 toll-free number 1800-345-5384 or through the Swasthya Sathi online portal. An online grievance monitoring system makes the process easier for you.
  • Quick Claim Settlement: The claims registered under the Swasthya Sathi scheme are settled within 30 days from the date of claim raise. The scheme has recorded a claim settlement ratio of 97.98%.

Also Read: Chief Minister’s Comprehensive Health Insurance Scheme

What are the Benefits of Swasthya Sathi?

When you enrol at Swasthya Sathi, you, including your family, can access the following healthcare advantages:

  • Health Cover: You can get a basic health cover of up to Rs. 5 Lakhs per annum for secondary and tertiary care per family registered. 
  • Pre-Existing Disease Coverage: The Swasthya Sathi scheme covers all pre-existing diseases from day one. There is no need to wait for the lock-in period to get over. 
  • Trusted Insurance Partners: To provide seamless healthcare coverage, Swasthya Sathi has partnered with prominent insurance companies, such as Bajaj Allianz, IFFCO Tokyo, New India Insurance, National Insurance, Oriental Insurance, and United India Insurance Company. 
  • Full Family Coverage: Whether you have a two, three, or four-member family, the Swasthya Sathi scheme covers all family sizes. The government scheme also covers all dependent physically challenged persons. To encourage women empowerment, the Swasthya Sathi card is issued in the name of the eldest female family member. 
  • Zero Contribution: The entire premium amount is borne by the State Government. Hence you do not need to contribute anything to the scheme reducing your financial burden. 
  • Cashless Hospitalisation: All the expenses incurred under Swasthya Sathi, including consultation, diagnostic test, and medicines, are covered 1 day before the admission and up to 5 days after the discharge from the hospital. 
  • Transportation Allowances: You receive Rs. 200 in transportation costs at the time of discharge. If admitted to a state government-run hospital, additional transportation costs are provided.

Also Read: NREGA

Who is Eligible to Apply for Swasthya Sathi?

The West Bengal government has made it easy for state residents to apply for the Swasthya Sathi scheme and receive benefits. Here’s a simple representation to help you understand whether you can begin with the Swasthya Sathi application: 

Specification

Description

Residential Status

Permanent resident of West Bengal

Age

No bar

Number of Insured in a Family

No capping

Documentation

No documentation, only digital enrollment

However, you cannot apply for the Swasthya Sathi scheme, if the following cases: 

  • Already insured under any of the Government health insurance scheme
  • Receiving medical allowance in your salary

Also Read: Ladli Behna Yojana

Swasthya Sathi Card

When you enrol in the Swasthya Sathi scheme, an online Swasthya Sathi smart card will be assigned immediately. You need to hold the smart card when reaching a hospital to seek healthcare facilities. All the transactions are done via the card and are auto-renewed yearly with lifetime validity. The smart card contains important details, such as:

  • Insured family members name
  • Biometric
  • Photographs
  • Contact details
  • Address
  • SECC ID
  • Issue date
  • Unique card number

Also Read: Ladli Behna Yojana Status

How can I Apply for Swasthya Sathi?

You can complete the Swasthya Sathi application online and offline per your suitability and convenience by following the given easy steps: 

Swasthya Sathi Apply Online

  • Visit the official website at www.swasthyasathi.gov.in.
  • Navigate to the ‘Apply Online’ option on the top menu bar and select ‘Online Application for Swasthya Sathi Card’ from the drop-down menu. 
  • Enter your mobile number and verify with OTP. Click ‘Submit’. 
  • Select the district, panchayat, and municipality name from the list provided. 
  • Provide other importation details, such as residential address, PIN code, etc. Employed applicants can provide employer details. 
  • Enter the name of the applicant and the name of the head of the family. 
  • Mention if any family members are enrolled under any government or private healthcare scheme.
  • Click ‘Submit’ to complete the Swasthya Sathi application. 

Swasthya Sathi Apply Offline

For offline application, you can begin with any of the following methods: 

  • Download and fill out Form B (application for enrolment). Submit it to the nearest government hospital. 
  • Obtain Form B from the nearest government hospital, ward office, Gram Panchayat, or village medical centres. 

Upon submission of the application with the supported documents, you will receive an SMS alert with the district code and serial number on your registered mobile. In addition, a unique registration number is generated, and the smart card is delivered to your residential address.

Also Read: Ladli Behna Yojana Payment Status

Documents Required for Swasthya Sathi Application

While submitting the Swasthya Sathi application online, prepare the following documents: 

  • Aadhar card number 
  • Khadyasathi Ration card 
  • Employment status
  • Registered mobile number
  • Legal domicile certificate

How Can You Find a Name in Swasthya Sathi Application?

You can check your name under the Swasthya Sathi application and see if you are eligible to gain the benefits of the Swasthya Sathi scheme. You only require your Aadhar number or Khadyasathi Ration Card number to proceed. Follow these steps to find your name under the Swasthya Sathi scheme: 

  • Visit the official website of Swasthya Sathi. 
  • Select the ‘Find Your Name’ option from the top menu bar. 
  • Provide your mobile number and click ‘Submit’. 
  • In the next window, provide details such as state, district, municipality, and identity proof. Then, submit the information. 
  • You will see your Swasthya Sathi application status on the screen. 

Swasthya Sathi Login Process

If you have registered for the Swasthya Sathi scheme and want to check the details anytime during the year, you need to login to your account by following the given process: 

  • Visit the official website of the Swasthya Sathi scheme. 
  • Find the ‘Login’ option at the top right corner of the home page. Click on it. 
  • Enter your username and password to log in to the Swasthy Sathi portal. 
  • You will see all the details, such as covered members, available cover amount, validity, etc.

Swasthya Sathi Help Line Number

In case you face any difficulty in the Swasthya Sathi application or during your claim, or need any information about the scheme, connect with the 24/7 active support team at the following contact details: 

Helpline Number

18003455384 

Online Assistance

Swasthya Sathi Mobile App

Final Words

The state government recognised the challenges economically disadvantaged groups face in accessing healthcare and aimed to bridge the gap with the Swasthya Sathi scheme. The launch of the scheme has helped the state residents gain quality healthcare and become a helping hand in sharing financial burdens caused due to health issues. 

Since the launch of Swasthya Sathi, it has undergone various phases of expansion to cover a larger portion of the population. You can use 100% digitally enabled platform and Swasthya Sathi mobile application to gain all the information and solve your queries.

FAQs on Swasthya Sathi Scheme

  1. How can I check Swasthya Sathi card balance?

Ans. You can check the Swasthya Sathi card balance and other details by logging into your account through the official website or using the mobile application. Navigate to the ‘Fund Inquiry’ option to see the available balance and transaction history. You can also connect with the 24/7 available support team.

  1. Does Swasthya Sathi cover pregnancy?

Ans. Yes, the Swasthya Sathi scheme covers pregnancy-related expenses, including prenatal, delivery, and post-natal care. 

  1. Are OPD expenses covered under the Swasthya Sathi scheme?

Ans. The OPD expenses are not covered under Swasthya Sathi. However, if the OPD leads to IPD treatment, then the overall expenses are covered, which also includes the OPD. 

  1. What kind of hospitals are qualified under the Swasthya Sathi scheme?

Ans. Both government and private hospitals are eligible to register under the Swasthya Sathi scheme. They are graded based on their services and medical infrastructure. You can choose any listed hospitals to get the required treatment after checking the details available on the official or hospital website. 

  1. Is there any authentication required at the time of hospitalisation under the Swasthya Sathi scheme?

Ans. Under the Swasthya Sathi scheme, any enrolled family member can use their fingerprint at the time of hospital admission. 

  1. What is the registration process for Swasthya Sathi hospitals?

Ans. Here are the steps for the Swasthya Sathi hospital registration: 

  • Go to the official website of the Swasthya Sathi scheme. 
  • Navigate to the ‘Apply Online’ option on the top menu bar and select the ‘New Hospital Empanelment’ option from the dropdown menu. 
  • In the next window, provide all the hospital information and submit it after verifying the OTP. Attach the required documents. 
  • The further process for hospital registration will begin from the side of the officials. 
  1. How can I verify the Swasthya Sathi card?

Ans. You can verify the Swasthya Sathi card on the official website by following the given steps: 

  • Go to the official website. Select the ‘Card Verification’ option from the top menu bar. 
  • In the next window, provide the requested information, such as district and state. 
  • Provide your URN and click ‘Submit’. 
  • On the next screen, your card details will be visible.
Categories: Government Schemes

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