SWASTHYA SATHI SCHEME

What is the Swasthya Sathi Scheme?

 

 

The Swasthya Sathi Scheme is a landmark health insurance initiative launched by the Government of West Bengal. Designed to ensure healthcare access for all, this innovative scheme has transformed the healthcare landscape since its inception in 2016. With paperless and cashless health coverage of up to ₹5 lakh per family annually, the Swasthya Sathi Scheme is a boon for millions across the state.

This scheme has provided access to over 2,000 empanelled hospitals and facilitated more than 2.4 core treatments to date. Its universal health coverage model positions it among India's largest and most effective healthcare schemes.

What is a Swasthya Sathi Card?

The Swasthya Sathi Card is the cornerstone of this scheme. It’s more than just an ID; it’s a symbol of empowerment for West Bengal families. Issued in the name of the female head of the household, the card signifies gender equality while providing seamless access to medical care.

Each card includes a smart digital chip containing family health details, enabling cashless hospitalization at any network hospital under the scheme. Whether it’s for routine treatments, critical illnesses, or maternity care, the Swasthya Sathi Card bridges the gap between affordable healthcare and families in need.

Features of Swasthya Sathi Scheme

• Comprehensive Coverage: ₹5 lakh annual insurance for primary, secondary, and tertiary care for families.
• Cashless & Paperless: A fully digital process ensures no paperwork or upfront cash payments during hospital admissions.
• Zero Premiums: The scheme is entirely state-funded, so beneficiaries pay nothing for enrollment.
• Inclusive Eligibility: Open to all West Bengal residents who do not have other health insurance coverage.
• Women-Centric Approach: The card is issued in the name of the female head of the family, promoting gender equality.
• Pre-Authorization within 24 Hours: Medical treatments and procedures are authorized quickly to avoid delays in care.
• Dedicated Helpline & App Support: Beneficiaries can access a toll-free number (1800-345-5384) and a user-friendly mobile app for assistance.
• Network of Hospitals: Over 2,000 private and government hospitals offer treatments under the scheme.
• Fast Claims Processing: Claim reimbursements are processed within 30 days, ensuring timely assistance.
• SMS Alerts for Updates: Beneficiaries receive real-time updates about their card status and claims.

Benefits of Swasthya Sathi Scheme

The scheme delivers a lot of benefits to the people of West Bengal. Here are the key benefits-

• High Coverage: Families get access to significant medical coverage of ₹5 lakh per annum.
• Reduced Financial Burden: The cashless process eliminates out-of-pocket expenses for hospitalization and treatment.
• Pre- & Post-Hospitalization Support: Expenses incurred one day before hospitalization and post-treatment are covered under the scheme.
• Access to Quality Healthcare: Beneficiaries can avail of treatments at some of the best private and government hospitals.
• Support for Economically Weaker Sections: The scheme is a lifeline for low-income families in rural and urban areas of West Bengal.

Eligibility Criteria for Swasthya Sathi Card Application

To apply for the Swasthya Sathi Scheme, individuals must meet the following criteria:

• Must be a permanent resident of West Bengal.
• Should not already have any other health insurance.
• Domestic workers, street vendors, contract workers, and small farmers are eligible.
• Civic volunteers and certain categories of state employees are automatically included.

How to Apply for the Swasthya Sathi Scheme Online?

The procedure to apply for the Sathi Scheme is straightforward.

Step 1: Review the official website page of Swasthya Sathi Scheme.

Step 2: Select the ‘Apply Online’ option.

Step 3: Input your mobile number and press the ‘Get OTP’ button.

Step 4: Hit the ‘Submit’ button once the OTP gets verified.

Step 5: Fill the details in Form B as residence address, Aadhar card number, applicant’s name, etc.

Step 6: Submit the application for further process.

How to Apply for the Swasthya Sathi Scheme Offline?

To apply offline, follow these steps:

1. Visit your nearest Gram Panchayat office or government hospital.
2. Obtain and complete Form B.
3. Submit the form along with required documents for verification.
4. Once approved, the Swasthya Sathi Card will be issued to the female head of the family.

How to Use the Swasthya Sathi Card?

A step-by-step guide on Swasthya Sathi Card use

1. Explore the list of network hospitals: Check the nearby hospital under the scheme. The empaneled hospitals available on the official website of Swasthya Sathi.
2. Submit the card: For a cashless process, submit the card within 24 hours of being hospitalized. The hospital will perform a verification of your details. Smart card helps to assess your details through Swasthya Sathi portal.
3. Get the claim reimbursement: Hospitals will handle all your claim process directly. Within the time span of 1 month, hospitals receive the claim amount.  

Validity for the Swasthya Sathi smart card is sustained for whole life. It gets renewed every year automatically.

How to Check Status of Hospital Registration Under Swasthya Sathi?

Follow the below step to verify Hospital Registration Under Swasthya Sathi

Step 1: Go and navigate the Swasthya Sathi portal.

Step 2: Press the link to ‘Hospital Details’.

Step 3: Search for the hospital by district, by hospital type, and application status.

Step 4: Hit the ‘Submit’ Call to Action button.

Step 5: A hospital list will appear on the screen. Here you can view registration status, address, contact information, and other details.

To pinpoint the hospital, you can reach helpline number 1800-345-5384.

 

Conclusion

The Swasthya Sathi Scheme is a testament to West Bengal’s commitment to providing affordable and accessible healthcare. With its inclusive approach, zero-cost enrollment, and comprehensive coverage, the scheme has become a lifeline for millions of families. The Swasthya Sathi Card, a gateway to cashless healthcare, ensures that no one is left behind in times of medical need.

Ready to secure your family’s health with the Swasthya Sathi Scheme? Apply online or offline today and enjoy peace of mind with reliable health coverage!

Swasthya Sathi Scheme- FAQs

Does Swasthya Sathi cover both OPD and IPD Costs?

Yes, the Swasthya Sathi scheme is beneficial to people below the poverty line in West Bengal. It is a comprehensive health insurance scheme. Hence, it covers both the OPD and IPD charges.

Can I use the Swasthya Sathi Card outside West Bengal?

Yes, you can make use of Swasthya Sathi Card outside West Bengal. But there are certain conditions. The card is accessible at certain hospitals and specific medical cases.

Do Swasthya Sathi Card Holders Have to Pay the Hospital Anything for Treatment?

No, Swasthya Sathi Card Holders are not obligated to pay the Hospital anything. The state government has taken responsibility to pay premiums on behalf of beneficiaries.  

What is the Benefit Amount Under Swasthya Sathi Scheme?

Under the Swasthya Sathi Scheme, every family receives 5 lakh in benefit. The family size is unrestricted. Also, pre and post treatment expenses get covered under the scheme.

Does Swasthya Sathi Scheme Offers Cashless Treatment?

Yes, the Swasthya Sathi Scheme Offers Cashless Treatment. It includes consultation charges, diagnostic tests, medicines, and hospitalization charges.   

Is the Swasthya Sathi Scheme Applicable to individuals with other Health Insurance?

No, individuals with other stakeholders cannot apply for the Swasthya Sathi Scheme. The scheme is only for those who are with low funds.