West Bengal Swasthya Sathi Scheme 2024: Apply Now

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On December 30, 2016, the West Bengal Chief Minister introduced the Swasthya Sathi Scheme. This system will embrace all families and citizens, regardless of age group, and cover them all. This provides a family with basic health coverage for tertiary and secondary healthcare up to Rs 5 lakh annually. The scheme is entirely cashless, paperless, and smart card-based, and the state government fully sponsors it.

The Chief Minister of West Bengal State has established several new projects to assist locals in improving their livelihoods and avoiding the fatal consequences of the coronavirus. According to the Chief Minister’s statement, this scheme will begin on December 1, 2020. She added that the West Bengal State government was responsible for funding the entire Cashless Health Scheme.

We will explain to you all the details of the new Swasthyasathi Health Insurance Scheme in this article. So, you may apply and take advantage of the health benefits. We will also tell you the qualifying requirements that you must meet to apply for the Swasthya Sathi Card initiative.

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West Bengal Swasthyasathi Health Insurance Scheme

The West Bengal government’s premier scheme for promoting public welfare is the Swasthya Sathi Scheme. Offering free medical care to West Bengal residents is the primary goal of this initiative. The West Bengal government would cover the premium for the Swasthya Sathi.

The Nodal Department of the scheme is the West Bengal Government Department of Health and Family Welfare. Families that register for this initiative will receive basic health coverage for secondary and tertiary treatment up to Rs. 5 Lakh annually each. The Swasthya Sathi Scheme is available to all permanent residents of West Bengal.

For the beneficiary to take advantage of the Swasthyasathi Health Insurance Scheme, a Smart Swasthya Sathi Card will be given. Currently, the West Bengal government has appointed the three insurance companies listed below.

• National Insurance Company. (In 6 Districts)
• Oriental Insurance Company. (In 9 Districts)
• United India Insurance Company. (In 8 Districts)

Under the Swasthya Sathi Scheme, all treatments are cashless, paperless, and based on smart card technology. The Swasthya Sathi initiative will cover all pre-existing ailments. The beneficiary must apply for a Swasthya Sathi Card using an offline application form or the Swasthya Sathi Portal to get the benefits of this scheme.

Swasthya Sathi Card

The senior-most female of the eligible family will receive a Swasthya Sathi Card under this plan. People can use the Smart Card to access health benefits at any of the available private or public government hospitals. There are no special eligibility criteria to fulfil because the scheme is now available to all West Bengal families. The state government has spent roughly Rs. 2000 crore each year on this Health Scheme. Smart cards will enable patients to receive various treatments without paying a single cent to hospital authorities.

Purpose of the Swasthya Sathi Prakalpa

The primary goal of the Swasthyasathi Health Scheme is to assist the people of West Bengal in receiving cashless medical care. The scheme was first introduced by the West Bengal state chief minister in 2016 and covered all secondary and tertiary care up to rupees 5 lakh annually per family in the state.

However, the scheme has since been expanded to cover all West Bengal estate residents, regardless of their socioeconomic status or position in the backward society. Starting on December 1, 2020, the ladies in the families will receive their health cards.

Benefits of Swasthya Sathi

At least 7.5 crore individuals are expected to participate in West Bengal’s Health Scheme. According to the Chief Minister of West Bengal, the Swasthya Sathi initiative will cover every family in the state. The Chief Minister further stated that the Central Government only funds 60% of the Ayushman Bharat Yojana.

However, the State Government will fund the entire Swasthya Sathi Cashless Health Scheme. The smart card will provide the most significant benefit under this plan. Each family will be given a smart card that will be valid at all government and private hospitals in West Bengal.

• The Swasthya Sathi Scheme will provide basic health coverage for annual secondary and tertiary care of Rs 5 lakh per household.
• All of the treatments will be paperless, cashless, and smart card-based.
• The scheme covers all pre-existing disorders.
• There are no limitations on family size.
• The Swasthya Sathi Scheme includes parents from both spouses, as well as all dependant physically challenged members of the family.
• The West Bengal government will bear the entire premium sum for the Swasthya Sathi plan.
• Beneficiaries do not have to pay any premium.
• Each enrolled family will receive an online Swasthya Sathi Card with the details of family members, photographs, biometrics, addresses, mobile numbers, etc.
• The Swasthya Sathi scheme provides 24-hour call support.

Statistics

Eligibility Criteria to be Eligible for the Scheme

There are no such eligibility criteria, but the following things you should meet to apply to this health scheme.

• Applicants must be permanent residents of West Bengal state.
• The smart card will be issued to the female candidates of the household.

Reasons to be Ineligible

Families covered under the below-mentioned health assurance schemes are not eligible for the West Bengal Swasthya Sathi Prakalpa.

• West Bengal Health Scheme, 2008.
• Central Government Health Scheme, 1954.
• Employee’s Insurance Scheme (ESI), 1954.
• Group Medical Insurance Scheme of Public Sector Undertaking.
• State/Central Government employee drawing Medical Allowance.

Required Documents for the Scheme

The following documents are necessary when applying for a Swasthya Sathi Card under the West Bengal Swasthya Sathi Health Insurance.

• Aadhar Card
• Khadyasathi Card
• Mobile Number

Apply for Swasthya Sathi Scheme to get Swasthya Sathi Card

There are both offline and online methods by which eligible beneficiaries can apply for a Swasthya Sathi Card under the West Bengal Swasthyasathi Health Insurance Scheme.

Offline Enrolment to the Swasthyasathi Health Insurance

• The application form is given below. Download it now.

• Take a printout of it, and enter the required details in the application form.
  • District Name.
  • Block/Municipality Name.
  • Category.
  • Name of the Applicant.
  • Name of Head of the Family.
  • Address.
  • Name of All the Members of the Family.
• The government-appointed insurance company will register the beneficiaries.
• Camps for registration will be held in each village, town, and block, and people will be notified ahead of time.
• Applicants’ information will be submitted to the Swasthya Sathi Portal once they have completed the Application Form.
• The applicant will be given a slip that includes the URN (Unique Registration Number).
• Eligible candidates will receive activated Swasthya Sathi cards within seven days.

Swasthya Sathi Card Online Apply

• Visit the West Bengal Swasthya Sathi Official Website.
• Click on “Apply Online for Swasthya Sathi Card.”

• After entering your mobile number, you must provide an OTP for verification.

• After that, Online Form B will appear on the portal.

• Enter the required details asked in the application form.
  • District Name.
  • Block/Municipality Name.
  • Category.
  • Name of the Applicant.
  • Name of Head of the Family.
  • Address.
  • Name of All the Members of the Family.
• Now, click the “Submit” option.
• The portal will generate the registration number.
• Officials will properly review the application.
• The Applicant will get an online Swasthya Sathi Card to benefit from free medical services.

Swasthya Sathi Portal Login

• Go to the official website, and click on “Login” on the homepage.
• A new page will appear, enter your username and password.
• After that, click on the “login” option to log in to the portal.

West Bengal Swasthya Sathi Scheme Details

The West Bengal government provides all beneficiaries with health insurance up to Rs 5 lakh through the West Bengal Swasthya Sathi Prakalpa. On December 27, 2020, health officials and private hospitals met. Representatives from private hospitals met to discuss treatment charges. They believe that the scheme offers extremely inexpensive rates.

• The private hospital had some worries. The initial concern was over the cost of therapy under the Swasthya Sathi scheme.
• The private hospitals have urged that the government modify the prices under this plan, as they are extremely low. Patient reimbursement and treatment categorization were discussed during the conference.
• Private hospitals have also asked the government that no payments be pending for months.
• At this meeting, it was also determined to modernize the infrastructure and equipment. The rates for surgeries under the scheme are as follows.

Key Functionalities

The government and private healthcare service providers have discussed the significance of health insurance programs.

Large Network Of Hospitals

Under this scheme, there are almost 1500 hospitals that are empanelled. The beneficiaries are free to choose any hospital. The public has access to information about these hospitals, and as time goes on, the number of hospitals grows on its own.

Claim Settlement

Under this approach, disputes are resolved in 30 days or less. If not, interest would be paid according to the terms of the contract.

Health Records of Patients

The patient’s electronic health records will be kept and accessible using their login credentials.

Monthly Analytical Report

Proactively disclosing monthly analytical support will be made public.

Grievance

This initiative provides access to the online grievance monitoring tool. Posting complaints is an option for stakeholders.

Website

Additionally, the department has established an interactive website where the general public can verify their eligibility, enrollment information, etc.

Compulsory Pre-Authorization

Under this scheme, every medical operation and treatment is pre-authorized within 24 hours.

Hospital Gradation

Under this method, the hospitals are transparently ranked according to the grades they receive for the facilities and services they offer, which are confirmed by the insurance company and an independent administrator.

Complete Cashless Hospitalization

Under this scheme, all tertiary treatment-related costs will be reimbursed.

Transport Allowance

The patient is entitled to a transport stipend of Rs 200 after they are discharged. If the patient receives treatment at a state government hospital, they would receive further compensation over Rs 200.

Toll-free Call Centre and Social Media

A toll-free number appears on the back of smart cards. If beneficiaries need any kind of help, they can call this number. There are social media sites like Facebook, WhatsApp, and Twitter.

Mobile App

The Google Play Store offers the Swasthya Sathi mobile app as well. Users who download this app can file complaints, request information, and more.

SMS Alert

Additionally, during their hospital stay and following their release, recipients have access to an SMS facility.

Package Rates

This scheme offers around 2092 Swasthya Sathi packages. These bundles’ prices fluctuate. Additionally, a package selection committee exists that justifies the package’s pricing as needed.

Coverage of pre-existing Diseases

Every pre-existing illness and condition is covered by this plan starting on the first day.

No Cap on Family Size

The oldest female family member is listed as the head of the family on the Swasthya Sathi card. Additionally, there is no limit on the size of the family under this plan. Apart from that, this program covers parents from both covered.

No Contribution

To receive the benefits of this system, recipients are not obliged to contribute in any way. West Bengal’s government will cover all of the program’s expenses.

IT Platform

A simple cloud-based IT platform serves as the foundation for the entire system.

How to Register for Hospital?

• Go to the official website.
• On the homepage, click on the “Apply Online” tab.

• Now, click on “Hospital Registration”
• A form will appear, enter all the required information
  • State Name
  • District Name
  • NABH Accredited
  • Hospital Type
  • Category of the Hospital
  • Specialty Name
  • Hospital Name
• After entering all the details, click the “Submit” option to do hospital registration.

Check the Status of the Hospital Registration

• Visit the official website and click on the “Apply Online” tab on the homepage.
• Now, click on “Check Hospital Registration Status”
• A new page will open, enter your registered mobile number and click the “Search” option.
• The result will appear on your screen.

View the Hospital Information

• Visit the Swasthya Sathi official website.
• Select the “Hospital Information” option on the homepage.
• Now, you will get the four options containing hospital information.
  • Active hospital list
  • Hospital HR details
  • The Hospital facility details
  • Hospital service details
• Select any one, and a new form will appear on your screen.
• Enter the required details and click on “Submit” to get the details.

How to Register for Treatment Outside of West Bengal?

• Go to the official website.
• On the homepage, click on the “Apply Online” tab.
• Next, click on “Registration for Treatment outside of West Bengal”
• A new page will open where you need to enter your Swasthya Sathi URN and mobile number.
• Then, click “Get OTP” and enter the received OTP in the box.
• After that, click the “Submit” option to register in the hospital located outside of West Bengal for treatment.

Registration Procedure for Vellore (CMC)

• Go to the Swasthya Sathi official website.
• Click on the “registration for Vellore (CMC)” option on the homepage.
• A new page will open where you need to enter your Swasthya Sathi URN and mobile number.
• Then, click “Get OTP” and enter the received OTP in the box.
• After that, click the “Submit” option to register in Vellore (CMC) for treatment.

How to Check Your Name in the Swasthya Sathi Beneficiary List?

• Visit the official website.
• On the homepage, click on the “Find Your Name” tab.
• Then, enter your registered mobile number, and click the “Get OTP”
• Enter the received OTP in the box, and click on “Submit” to get the required details.

Swasthya Sathi App Download

• Go to “Google Play Store” on your device.
• Type “Swasthya Sathi” in the search box, and click “enter” to continue.

• A list will appear, click on the topmost option.
• Now, click “Install” to download the app to your device.

Benefits & Features of Swasthya Sathi App

• Active Hospital List: By choosing your district, hospital type, and hospital grade on the app, you may see a list of all the open hospitals.
• Nearby Hospital: Using the app, you can view information about a nearby hospital by entering the distance in kilometres.
• Doctor Details: Additionally, this app offers Doctor’s details. You can find out details about any doctor by selecting the kind, hospital, name, specialization, and district.
• Hospital Facility Details: The Swasthya Saathi app allows users to examine hospital facility details by selecting the district, hospital type, and hospital facility.
• Hospital Services: It is possible to retrieve the hospital’s list of services by choosing the District, kind of hospital, and service
• About the Schemes: Key information regarding the Swasthya Sathi scheme is provided in the “About the Scheme” section.
• Our Packages: To see details about packages, the user must first pick the group and then click the show data button.
• URN Verification: The Swasthya Sathi app allows you to view URN verification details. To view URN verification details, first choose your district and enter your URN.
• Hospital Registration Status: The app allows you to track hospital registration status. To verify the status of hospital registration, the user must enter the hospital’s mobile number.
• Admin & Team Set Up: The app also provides access to administrative and team setup information. To view administrative and team setup details, the user must first select a department.
• IC TPA SCSP: Selecting the insurance type allows the user to access the details of the insurance company, TPA, and SCSP.
• How Can I Help You: In this section, you can file complaints and track their status. You can even provide feedback through this section.

Contact Details

All the relevant details about the Swasthya Sathi scheme are available to you through this article. Contact the helpdesk number to get your issue resolved if you’re still having issues.

Frequently Asked Questions

Important Links

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