A Group Health Protection scheme named “Swasthya Sathi” is announced by the Government of West Bengal vide notification no – 1104-F (P) dated 25th February 2016, which is implemented in the state for certain categories of employees/beneficiaries.

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Swasthaya Sathi at a Glance

 

Swasthya Sathi” was announced in Cabinet No – 2625 dated 17th February, 2016, and Finance Department notification no – 1104-F (P) dated 25th February, 2016.

A State level Implementation Committee (SLIC) under the chairmanship of the Chief Secretary formed to oversee the scheme and there is a registered society named “Swasthyasathi Samiti” ( Registration no S/M/4377 OF 2016-2017 Dated 15.11.2016) for monitoring the scheme.

 

The scheme was officially launched by Hon’ble CM on 30th December 2016

Main Features of the Scheme:

•       Basic health cover for secondary and tertiary care  up to Rs 1.5 Lakh per annum through Insurance mode and Critical illness like Cancer, Neuro surgeries, cardiothoracic surgeries, liver diseases, blood  disorders etc. up to Rs 5 Lakh through Assurance mode.

•        NIC was insurance partner in 9 District and UIIC in 11 Districts in the FY up to 28.02.2018. From 01.04.2018 Bajaj Allianz    selected as Insurance Partner in 18 Districts and IFFCO TOKYO in 5 Districts 

•       Paperless, Cashless, Smart Card based.

•       There is no cap on the family size and Parents from both the Spouse are included. Unmarried daughter upto 21 Years and all dependent physically challenged persons in the family also covered.

•       All pre-existing diseases are covered.

•       The entire premium is borne by the State Government and no contribution from the beneficiary.

•       Online Swathyasathi Smart card is provided to each family on the day of Enrolment. Smart Card captures the details of the family members , Photographs, biometric, address, Mobile Number, SECC ID, ADHAAR No ( if available)

•       Management of the scheme is in paperless IT platform from day one.

•       Online empanelment & gradation of Hospitals based on the services and infrastructure available

•       100% online Pre-authorisation with turn around time of 24 Hrs.

•       SMS triggers and instant alerts to the beneficiaries on blocking of card.

•       Real-time uploading of E-health record of the beneficiaries on discharge

•       Claim reimbursement to the hospital with TAT of 30 days else interest are being charged for delayed payment.

•       24X7 toll free Call Centre (18003455384)  with feedback option

•       Online grievance monitoring Mechanism

•       Android based Swasthya Sathi Mobile app for assistance to the beneficiaries




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Website Last Update Date: Monday, August 20, 2018 1:51:13 PM



Any Hospital having bed capacity between 10 to 29 may also apply for empanellement under Swasthyasathi. Pl click Hospital registration and fill up the details. In case any query pl contact District Swasthyasathi Cell.