Schemes

State-specific schemes

Welfare Schemes of West Bengal

West Bengal Swasthyasathi Health Insurance Scheme

Scheme

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<p>Swasthya Sathi is a Group Health Insurance scheme of the Government of West Bengal. The Scheme was launched in December 2016.</p>
<h3>Scope of the scheme</h3>
<p>All the districts of West Bengal are covered under the scheme.</p>
<p>Open to all residents of West Bengal.</p>
<h3>Main Features of the Scheme</h3>
<ul>
<li>Basic health cover for secondary and tertiary care up to Rs. 5 lakh per annum per family.</li>
<li>Coverage for inpatient care and a transport allowance of 200 INR per hospitalisation, up to 2000 INR annually.</li>
<li>Paperless, Cashless, Smart Card based 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.</li>
<li>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.</li>
<li>All pre-existing diseases are covered.</li>
<li>The entire premium is borne by the State Government and no contribution from the beneficiary.</li>
<li>More than 2800 Hospitals and Nursing Homes already registered under the scheme through online empanellement portal.&nbsp;</li>
<li>100% online Pre-authorisation with turn around time of 24 Hrs.</li>
<li>SMS triggers and instant alerts to the beneficiaries on blocking of card.</li>
<li>Real-time uploading of E-health record of the beneficiaries on discharge.</li>
<li>24X7 toll free Call Centre (18003455384) with feedback option</li>
<li>Online grievance monitoring Mechanism</li>
<li>Android based Swasthya Sathi Mobile app for assistance to the beneficiaries</li>
</ul>
<h3>Important links</h3>
<p><strong>For citizens</strong></p>
<ol>
<li><a title="External website that opens in new window" href="https://ssai.swasthyasathi.gov.in/OnlineBenRegistration/BeneficiaryDataEntryOnlineIndex" target="_blank" rel="noopener">Online application to obtain the Smart card</a></li>
<li><a title="External website that opens in new window" href="https://helpline.swasthyasathi.gov.in/ssHospitalDdetails.aspx" target="_blank" rel="noopener">List of active Hospitals</a></li>
<li><a class="ext-link-icon" title="External website that opens in new window" href="http://swasthyasathi.gov.in/statedistrictwisehospitaldetails.aspx" target="_blank" rel="noopener">Hospitals registered and their status</a></li>
<li><a class="ext-link-icon" title="External website that opens in new window" href="http://swasthyasathi.gov.in/PackageDetails.aspx" target="_blank" rel="noopener">Swasthaya Sathi Packages under Assurance Mode</a></li>
<li><a class="ext-link-icon" title="External website that opens in new window" href="http://swasthyasathi.gov.in/ViewHopitalFacilities.aspx" target="_blank" rel="noopener">Expertise / Facility available in hospitals under Swasthaya Sathi</a></li>
<li><a class="ext-link-icon" title="External website that opens in new window" href="http://swasthyasathi.gov.in/ViewHospitalServiceDetails.aspx" target="_blank" rel="noopener">Services available in hospitals under Swasthaya Sathi</a></li>
</ol>
<p><strong>For Hospitals</strong></p>
<ol>
<li><a class="ext-link-icon" title="External website that opens in new window" href="http://swasthyasathi.gov.in/Registration.aspx" target="_blank" rel="noopener">Online Hospital Registration for Swasthaya Sathi</a></li>
<li><a class="ext-link-icon" title="External website that opens in new window" href="http://swasthyasathi.gov.in/HospitalRegStatus.aspx" target="_blank" rel="noopener">Check the status of Hospital Registration for Swasthaya Sathi</a></li>
</ol>
<p><strong>Source : <a class="ext-link-icon" title="External website that opens in new window" href="https://swasthyasathi.gov.in/" target="_blank" rel="noopener">Swasthaya Sathi website</a></strong></p>
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