The Swasthya Sathi Card Scheme is a health Scheme introduced by the chief minister of West Bengal, Ms. Mamta Banerjee. The main objective of this scheme is to provide health benefits to people through financial support. This article will provide a review of the Swasthyasathi Scheme and all of its details.
Overview:
The Swasthya Sathi Card is a new health-related scheme that has been introduced by the chief minister of West Bengal, Mamta Banerjee. This scheme would be accessible to the permanent residents of the state of West Bengal. West Bengal’s government implements several schemes in response to the needs of ordinary citizens. The Swasthyasathi scheme is one of them, and it provides people with health-related benefits.
Individuals interested in applying for this scheme can read the entire application procedure scheme here. Therefore, a resident of West Bengal could apply for the Swasthya Sathi Card Scheme without any hurdles. This blog contains a step-by-step process demonstrating how to apply for the same.
Swasthya Sathi Scheme
In 2020, West Bengal’s government introduced a movement recognised as the “Duare Sarkar” campaign. The meaning of this term is “government at your doorstep.” In this movement, the state government is now prepared to offer the benefits of approximately 12 schemes to state residents. The Swasthyasathi Scheme also falls under the criteria of such a campaign by the government of West Bengal. This scheme provides the people of West Bengal with a smart card that allows them to access healthcare coverage worth up to ₹500,000. Initially, in the year 2016, this Swasthya Sathi card scheme was introduced. It is a cashless health scheme that provides all healthcare cost benefits.
The West Bengal government has introduced this scheme exclusively for citizens of the state. Online applications for the scheme can be submitted with ease. Once enrolled, you will receive access to healthcare services under the program.
This scheme is governed by the State-Level Implementation Committee. Additionally, Swasthya Sathi Samiti is another institution that is responsible for monitoring the effective implementation of the scheme. The primary goal of this Swasthyasathi Card scheme is to offer financial support to the people of West Bengal. The government is offering these advantages notwithstanding the status, profession, and economic condition of the people.
| Name of the Scheme | Swasthya Sathi Card |
| Introduced by | Chief Minister of West Bengal (Mamta Banerjee) |
| Advantage | To offer health Facility up to ₹500,000 |
| Work Under | The government of West Bengal |
| Aim of this Scheme | Offering health services by the scheme |
| Beneficiary | Resident of West Bengal |
| Website | swasthyasathi.gov.in |
Update on the Swasthyasathi Card Scheme
The state government has provided the most recent update to this scheme, stating that all citizens of the state can now take advantage of its benefits. This project is expected to cost approximately ₹2000 crore per year. In addition to this, the entire funding of this scheme is offered at 100% by the government of West Bengal. It does not share any connection with the central government.
Objective of Swasthya Sathi Scheme
Swasthyasathi aims to offer cashless treatment to West Bengal residents, alleviating the burden of high medical expenses. The State Government is actively working to enhance the healthcare system by establishing specialty hospitals in rural and semi-urban areas, Fair Price diagnostic centers, pharmacies, and critical care facilities within a 50 km radius. These initiatives will ensure affordable access to quality healthcare services.
Features of the West Bengal Sathi Card
- The names of the insurance partners who would offer the insurance cover in this Swasthya Sathi Card scheme are Oriental Insurance Company, National Insurance Company, and United India Insurance Company, which would cover nine, six, and eight districts in respective manners in distinct clusters.
- The benefit amount of the insurance is ₹150,000.
- The amount of basic health cover that would be provided to each family in the state of West Bengal is ₹500,000.
- The amount of health coverage would be disbursed in an annual manner.
- It is a cashless procedure founded on the smart card facility.
- The scheme includes the entire pre-existing disease as well.
- There are no restrictions on family size. Advantages would not change as per the size of the family.
- The scheme involves the beneficiaries’ parents and both spouses.
- For making payments in this scheme, the government of West Bengal is responsible. The beneficiary in this scheme is not required to make any payment.
Advantages of the Sathi Card Scheme
The newly introduced Swasthya Sathi card scheme would provide benefits to around ₹7.5 crore individuals in West Bengal. Additionally, it aims to include all the families in the state in the scheme. The scheme provides a smart card issued by the government in the name of a female family member. Without making any payment, an individual could undergo any form of treatment with the card. Moreover, insurance coverage is also obtained by civil volunteers.
Moreover, the scheme also provides distinct services, and entire services are accessible via the digital medium. This aspect contributes to the scheme being paperless. The following services are provided by the scheme:
- Grading of hospitals on the basis of infrastructure and services
- Real-time data
- Cashless process
- Empanelment of hospitals
- On delay of payment, interest is levied.
- Card blocking message alert
- Resolve complaints online or by phone 24 hours a day, seven days a week.
- Smaller Turnaround Time: 30 Days
- Mobile application to support beneficiaries
Eligibility Criteria of the Swasthyasathi Scheme
The government of West Bengal has chosen to expand the reach of this Scheme to encompass all residents of the state, except those who are already covered by any government-sponsored health Insurance Scheme. Furthermore, individuals who receive medical allowances as part of their salary will not be eligible to receive the coverage benefits provided by the Scheme.
Coverage Benefits of the Swasthya Sathi Scheme
- Coverage up to ₹5 Lakh: Each family receives basic health insurance coverage of up to ₹5 lakh for both tertiary and secondary medical care.
- Pre-existing Disease Cover: Swasthyasathi Card scheme includes coverage for all pre-existing diseases of the beneficiaries.
- Family Cover: There is no limit on the family size, and coverage extends to in-laws and any dependent physically challenged family member.
- Premium: The State Government bears the cost of the premium, ensuring no financial burden for the beneficiaries.
- Cashless Hospitalization: The Swasthyasathi Scheme covers expenses incurred on doctor’s consultations, diagnostic tests, and medicines one day before hospital admission. Post-treatment expenses for medicines are covered for up to five days for the same treatment or surgery.
Smart Card Under the Swasthya Sathi Card Scheme
This scheme also included the purchase of a Swasthyasathi card (smart card). Individuals who would become beneficiaries of this scheme are eligible to get these smart cards. As a part of the scheme, one card would be provided to every family in the state. In addition to this, in private and government hospitals, these cards are ready for use. It would have entire family details, including information such as the number of family members, mobile phone number, photographs, address, and others.
The Admissible Person Under Swasthya Sathi Card Scheme
To take advantage of the scheme, one must meet only a few eligibility criteria. Any person who wishes to apply shall check the overall conditions and apply for an application. The following conditions must be met in order to benefit from this scheme:
- A person must be a resident of West Bengal.
- They shall not be registered under any other healthcare scheme of the government of West Bengal.
- Family members of the family are the only ones eligible to get the smart cards.
- They must meet the criteria of being below the poverty line.
- They shall register under the RSBY.
Documents Required for Swasthyasathi Scheme
The following documents are needed for getting registration under the Swasthya Sathi Card:
- Aadhar Card
- Certificate of Poverty Level (BPL)
- Identity proof of a person such as a ration card, voter card, and others
- Proof of permanent residence
- Registration certificate from the healthcare organisation
How to Apply for the Swasthya Sathi Health Scheme?
- Step 1: Go to the official website.
- Step 2: Locate and click on the ‘Apply Online’ option in the top menu bar. From the drop-down menu, select ‘Form B for Registration under Swasthyasathi’.
- Step 3: Print out the registration form and accurately fill in all the required details.
- Step 4: Submit the completed Swasthya Sathi registration form along with the necessary documents at the nearest Duare Sarkar Camp.
Swasthya Sathi Registration Process
The following steps must be taken to register for the Swasthya Sathi Card Scheme online:
- It is required of the applicant to visit the official website of the scheme, such as swasthyasathi.gov.in
- After this, the homepage would open
- Further, it is required to click on the link to apply online provided in the main menu.
- Now, keep an eye on the list in the Apply Online option.
- Then, choose the fourth option provided in the list, which is Form B for registration under this scheme.
- Then, a PDF format would appear, and the applicant would be required to fill in the essential details and attach the documents as well.
- At last, click the submit button to complete the registration procedure.
- Afterwards, a registration number would be received by the person, and it should be saved for further use.
Swasthya Sathi Card Registration Fee
It costs nothing at all to sign up for the Swasthyasathi Scheme. There are no fees associated with the registration process for applicants.
Process for Swasthya Sathi Hospital Registration
- Step 1: Go to the official Swasthya Sathi Scheme online portal.
- Step 2: Click on the ‘Apply Online’ button in the top menu bar and choose ‘Hospital Registration’ from the drop-down menu.
- Step 3: Provide the requested information, including district name, category of hospital, hospital name, address, contact number, and other required details.
- Step 4: Attach the necessary documents and click on ‘Submit’ to finalize the Swasthya Sathi hospital registration process.
Swasthya Sathi Card Hospital Registration Status Check
- Step 1: Go to the official Swasthya Sathi Scheme website.
- Step 2: Click on the ‘Apply Online’ button located in the top menu bar and choose ‘Check Hospital Reg. Status’ from the drop-down menu.
- Step 3: Enter your registered mobile number and click on ‘Search’ to retrieve the hospital registration status.
How to Register for Treatment Outside West Bengal?
- Step 1: Visit the official Swasthya Sathi Card online portal.
- Step 2: Click on ‘Apply Online’ in the top menu bar and select ‘Registration Outside of West Bengal’ from the drop-down menu.
- Step 3: Provide your Swasthya Sathi URN number and mobile number to proceed.
- Step 4: Fill in the required details on the page and submit the form.
- Step 5: Attach the necessary documents, such as proof of ID, investigation report, etc., and upload them.
- Step 6: Regularly check the registration status to see if your case has been approved.
- Step 7: In the case of an approved registration, an acknowledgement receipt will be provided.
How to View Your Name in the Beneficiary List?
- Step 1: Visit the official Swasthya Sathi Card website.
- Step 2: Click on the ‘Find Your Name’ option in the top menu bar.
- Step 3: Enter your mobile number and select the appropriate option if you are searching for your name.
- Step 4: Check the beneficiary list to see if your name is included.
How to Login to the Swasthya Sathi Portal?
- Step 1: Go to the official Swasthya Sathi Card Scheme website.
- Step 2: Click on the ‘Login’ option located in the top right corner of the page.
- Step 3: Enter your username and password to log in to the official portal.
How to Register for Vellore CMC?
- Step 1: Visit the official Swasthya Sathi online portal.
- Step 2: Choose ‘Registration for Vellore CMC’ and follow a similar process to registering for treatment outside West Bengal.
- Step 3: Provide your Swasthya Sathi URN number and mobile number to proceed.
- Step 4: Enter the required details on the page and submit the form.
- Step 5: Attach the necessary documents and upload them.
- Step 6: Check the registration status to determine if your case has been approved.
- Step 7: In the case of an approved registration for Vellore CMC, an acknowledgement receipt will be provided.
How to Download the Swasthya Sathi App?
Here are the step-by-step instructions for download Swasthya Sathi card app:
- Open the Google Play Store on your smartphone.
- In the search box, type “Swasthya Sathi” to find the application.
- Look for the official Swasthya Sathi app with the official logo and click on it to download and install it on your device.
Download Swasthya Sathi Reports
- Go to the official Swasthya Sathi portal.
- Scroll down to locate the ‘Reports’ section.
- In the ‘Reports’ section, you will find monthly Swasthya Sathi reports.
Key Functionalities of Swasthya Sathi Card Prokolpo
- Wide Network of Cashless Hospitals: Over 2290 empanelled hospitals are accessible for Swasthya Sathi beneficiaries to receive medical care.
- Quick Claim Settlement: Health insurance claims are monitored online and settled within 30 days to ensure timely payments.
- Real-Time Health Record Updation: Beneficiaries’ e-health records are updated in real-time after discharge.
- Disclosure of Monthly Analytical Report: Monthly analytical reports are publicly available for easy access and feedback.
- Online Grievance Monitoring: The scheme provides an online grievance monitoring mechanism on the official portal.
- Easy-to-Use Online Portal: The Swasthya Sathi Prokolpo website offers user-friendly features, including general query assistance and an FAQ section.
- Pre-authorization for Treatment Facility: Medical procedures and treatments are pre-authorised within 24 hours.
- Transparent Hospital Gradation System: Hospitals are graded based on evaluations by Third Party Administrators or insurers, and the empanelment committee approves them accordingly.
- Cashless Hospitalisation Facility: Swasthya Sathi covers diagnostic, consultation, and medication expenses up to 1 day before hospitalisation and 5 days after discharge.
- Transportation Allowance: Patients receive a ₹200 transport allowance upon discharge, with additional allowances applicable for hospitalisation in State Government hospitals.
- Outreach Via 24×7 Toll-Free Number & Social Media: Beneficiaries can seek assistance through the 24×7 toll-free number and reach out via social media platforms.
- Swasthya Sathi Mobile App: Beneficiaries can download the Swasthya Sathi mobile app for scheme information, grievance filing, and helpline connection.
- SMS Alerts: Immediate SMS alerts notify beneficiaries if their health card gets blocked.
- Swasthya Sathi Packages: A total of 2092 packages are available under the scheme, with rates determined by the selection committee.
- Pre-Existing Ailment Cover: Pre-existing illnesses are covered from day 1 under the scheme.
- No Limit on Family Size: There is no restriction on family size, and parents of both spouses can be covered under Swasthya Sathi.
- Zero Premium Burden: The State Government bears the insurance premium, relieving beneficiaries of the financial burden.
- Completely Online Platform: Swasthya Sathi Prokolpo operates on a paperless, cloud-based online platform.
Conclusion
Overall, the Swasthya Sathi Card Scheme has been launched by the government of West Bengal to provide financial assistance for health-related issues to the residents of the state. To take advantage of the scheme, the application form must be submitted online via the official website. If you want to know more about this scheme or need help applying for this scheme, connect with the legal experts of Vakilsearch.
FAQs
Is there a list of hospitals where the beneficiaries under the Swasthya Sathi scheme can visit for treatment?
Yes, there is a list of empanelled hospitals available for beneficiaries under the Swasthya Sathi scheme. These hospitals have been approved by the scheme and provide cashless treatment to the beneficiaries.
What kinds of hospitals are qualified under the Swasthya Sathi scheme?
Various types of hospitals are qualified under the Swasthya Sathi scheme, including government hospitals, private hospitals, nursing homes, and specialty hospitals. These hospitals need to be empanelled with the scheme to provide treatment to the beneficiaries.
Do beneficiaries under the Swasthya Sathi scheme need to pay anything to the hospital for treatment?
No, beneficiaries under the Swasthya Sathi Card do not need to pay anything to the hospital for the treatment. The scheme covers the medical expenses, and the treatment is provided on a cashless basis.
Can both OPD (Outpatient Department) and IPD (Inpatient Department) expenses be covered under the Swasthya Sathi Scheme?
Yes, both OPD and IPD expenses are covered under the Swasthya Sathi Scheme. Beneficiaries can avail of cashless treatment for both outpatient and inpatient medical care.
Whose fingerprint is required at the time of hospital admission under the Swasthya Sathi Scheme?
The fingerprint of the beneficiary is required at the time of hospital admission under the Swasthya Sathi Card Scheme. This is done to ensure proper identification and authentication of the beneficiary for availing the scheme's benefits.
