The Swasthya Sathi Scheme is a flagship health initiative by the West Bengal government, providing free health insurance coverage of up to ₹5 lakh per family annually. Launched in 2016 and revamped in subsequent years, this program ensures cashless treatment at empanelled hospitals, benefiting millions of residents, particularly those from economically weaker sections.
Summary of Swasthya Sathi Benefits
| Feature | Details |
|---|---|
| Coverage Amount | ₹5 lakh per family annually |
| Premium | Fully funded by the government |
| Family Size | No cap |
| Pre-existing Conditions | Covered |
| Smart Card | Biometric-enabled, paperless system |
| Application Fee | Free |
Key Features of Swasthya Sathi Scheme 2024
- Coverage Amount:
- Offers health insurance of ₹5 lakh per family for secondary and tertiary care.
- Split into ₹1.5 lakh through insurance mode and the remainder through assurance mode.
- Paperless and Smart Card-Based System:
- Beneficiaries receive a biometric smart card containing personal details.
- Entire process operates on a paperless IT platform, ensuring transparency and quick service.
- No Cap on Family Size:
- The scheme includes all family members, including parents of both spouses.
- No exclusions based on pre-existing medical conditions.
- Comprehensive Benefits:
- Covers all expenses related to treatment, including pre-admission medicines, hospital stays, surgeries, and follow-ups.
- Provides free food, check-ups, and medicines during hospitalization.
- Offers ₹200 for post-hospitalization travel expenses.
- Government-Borne Premium:
- Beneficiaries contribute nothing, as the entire premium is funded by the state government.
Eligibility Criteria
To avail of the Swasthya Sathi benefits, applicants must meet the following requirements:
- Residency: Applicants must be permanent residents of West Bengal.
- Universal Coverage: Income level does not matter, and all categories of workers are eligible, including:
- Day laborers
- Self-help group members
- Anganwadi and ASHA workers
- Civic volunteers and village-level workers
- Inclusivity: The scheme is open to all, irrespective of financial status.
Application Process
Steps to Apply for Swasthya Sathi Card:
- Visit the official Swasthya Sathi portal (swasthyasathi.gov.in).
- Download the application form and fill in the required details.
- Submit the form at your nearest registration center along with proof of residency and ID documents.
- Upon verification, a smart card will be issued.
Smart Card Activation:
- The smart card includes a photograph, SECC ID, and biometrics.
- It is activated online, and services can be availed immediately after issuance.
Benefits for Beneficiaries
The scheme aims to alleviate the financial burden of medical expenses for low-income families. Some notable benefits include:
- Cashless Treatment: Empanelled hospitals offer treatments without any upfront costs.
- Emergency Support: Covers critical illnesses and complex treatments.
- Wider Access: Beneficiaries can seek treatment in both private and government hospitals listed under the scheme.
Empanelled Hospitals
The Swasthya Sathi scheme covers over 2,000 hospitals across West Bengal, ensuring beneficiaries have access to quality care. Hospitals are listed online based on infrastructure and services provided, enabling real-time pre-approval for treatment.
FAQs
1. Who can apply for the Swasthya Sathi Scheme?
All permanent residents of West Bengal are eligible, irrespective of income or financial status.
2. Is there an age limit for beneficiaries?
No, the scheme covers all family members, including dependents and senior citizens.
3. How can I check empanelled hospitals?
Visit the Swasthya Sathi website for the updated list of empanelled hospitals.
4. Does the scheme cover critical illnesses?
Yes, it provides cashless coverage for secondary and tertiary care, including treatments for complex diseases.
5. What is the validity of the smart card?
The smart card is valid for life and can be used whenever required.
6. Are treatments at private hospitals included?
Yes, the scheme covers both private and government hospitals listed under Swasthya Sathi.
Conclusion
The Swasthya Sathi Scheme 2024 stands as a revolutionary health initiative, providing financial protection to millions of families in West Bengal. With its comprehensive coverage, cashless treatment, and inclusivity, the scheme ensures that quality healthcare is accessible to all. Whether you’re a day laborer or a senior citizen, this scheme guarantees medical assistance without financial strain.
For more details, visit the official website: Swasthya Sathi Official Site.