Swasthya Sathi at a Glance

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