2.4 Crores +Families Covered
2200 +Hospital Empanelled
46 Lakhs + Hospitalization
Data updated Upto : 31/01/2023
Settled 96.32% of Claim Preferred Upto 20/12/2022
Swasthya 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.
The scheme was officially launched by Hon’ble Chief Minister of West Bengal on 30th December 2016.
Main Features of the Scheme:
- Basic health cover for secondary and tertiary care up to Rs. 5 lakh per annum per family.
- Paperless, Cashless, Smart Card based.
- All pre-existing diseases are covered.
- There is no cap on the family size and Parents from both the Spouse are included. All dependent physically challenged persons in the family are also covered.
- The entire premium is borne by the State Government and no contribution from the beneficiary.
- Online Swathya Sathi 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.
- 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
- Online triggers and alerts to detect probable frauds with escalation matrix..
- Android based Swasthya Sathi Mobile app for assistance to the beneficiaries