Swasthyasathi/Swasthya Sathi Scheme-Recent Updates 2020

Swasthya Sathi Scheme|Swasthyasathi(With Recent Updates)|Swasthya Sathi Card|Swasthya Sathi Form

Swasthya Sathi or Swasthyasathi is the most popular and free Group Health Insurance Scheme launched by the Government of West Bengal vide Notification No–1104-F(P) dated 25th February 2016, of the Finance Department.

This scheme was officially inaugurated by the Honourable Chief Minister of West Bengal on 30.12.2016. The said Swasthya Sathi scheme came into operation from 1st February 2017.

This scheme is considered to be one of the largest flagship Group Health Insurance Schemes available right now in India.

This scheme is being implemented rigorously by the Department of Health & Family Welfare, Government of West Bengal.

In this post, many areas of Swasthya Sathi Scheme will be discussed such as What is Swasthya Sathi scheme? What are the main Features of the Swasthya Sathi Scheme? Who is eligible for Swasthya Sathi?

How to register in Swasthya Sathi Scheme? How can I apply for Swasthya Sathi? Is Swasthya Sathi cashless? Eligibility of Swasthya Sathi for Teachers and etc.

What is Swasthya Sathi Scheme?

Swasthya Sathi scheme is a flagship Group Health Insurance Scheme, a great initiative by the Government of West Bengal.

This Group Health Insurance Scheme is solely meant for the extended family members of the Government.

Yes! You read it right. The extended family members of the Government of West Bengal.

There are lots of different projects being implemented by the Govt. each and every year and the Govt. machinery alone is not sufficient for these projects to be implemented successfully.

So, Govt. needs help from different categories of workers cum volunteers such as Civic Police Volunteers, Gree Police Volunteers, Civil Defense Volunteers, Village Police Volunteers, Self Help Groups(SGH), Disaster Management Workers, Home Guards, NVF, Asha Workers, ICDS Workers and many other contractual and casual workers.

This workforce remained deprived for a very very long time from the basic health care needs. So, this has made the Govt. think of an all-round Group Health Insurance Scheme.

So, the Govt. has introduced this Swasthyasathi health scheme which came into operation on and from 01.02.2017.

There are numerous multi-speciality and super speciality hospitals in West Bengal. But these informal sectors workforce can not afford such high-cost treatment.

This cashless treatment at these hospitals offered by the of the Govt. with free of cost, came as a boon to this workforce as mentioned above.

You may read the following:

What are the main Features of the Swasthya Sathi Scheme?

Swasthya-Sathi-Scheme

The main features of the Swasthyasathi Scheme are as follows:

1. Coverage:

Swasthya Sathi Benefits

This scheme provides health coverage benefits up to Rs.5 Lakh per family per year irrespective of any existing ailments.

2. Cashless:

Swasthya Sathi Scheme

Swasthyasathi Scheme is completely Cashless Smart Card based(Swasthya Sathi Card) scheme. No cost is to be borne by the beneficiaries.

The cost will be borne by the Govt. fully. This means the treatment is fully free of cost to the beneficiaries.

3. Paperless:

Swasthya Sathi Scheme

One of the main features of this Swasthyasathi scheme is that it is completely paperless. You don’t need to produce any papers while visiting the hospitals.

Only you need to produce Swasthya Sathi Card which is also known as Smart Card.

4. Zero Contribution

Swasthya Sathi Zero contribution

An important feature of this scheme is that it is completely free. No contribution is taken from the beneficiaries including the cost of the Smart card.

5. 100% Online

Swasthya Sathi 100% online

This scheme is a 100% online scheme. No offline mode is allowed here. Data are stored on a real-time basis in the cloud server.

6. 100% Pre-authorized

Swasthya Sathi pre authorized

It is 100% pre-authorized or pre-approved scheme. This means no prior medical test needed or all pre-existent ailments are covered under this Swasthyasathi scheme.

7. SMS Alert

Swasthyasathi scheme SMS alert

All information or transactions are informed to the beneficiaries through dedicated SMS alerts. This scheme has been able to provide SMS alerts successfully by so far.

8. No cap on Family Members

Swasthya Sathi No cap on Family Members

There is no cap or ceiling on the number of family members under this scheme. This means this scheme does not provide any limit on the family size.

All eligible family members are entitled to get health benefit under this scheme. Even the in-laws of both the spouses are included here.

9. 24X7 Call Centre facility

 Swasthya Sathi 24X7 Call centre

This scheme has the feature of providing 24X7 call centre cum help desk facility. Beneficiaries require no cost for this.

You can submit your feedback as well regarding your experience.

10. Premium Payment

Swasthyasathi premium payment by Govt.

The premium for this group health insurance scheme is paid by the Govt. of West Bengal. So, you have a completely free health insurance policy provided by the Govt.

Swasthya Sathi Scheme-Healthcare for All

Who is eligible for Swasthya Sathi Scheme?

A large number of contractual workers/volunteers from the informal sectors as mentioned above are primarily covered under this health protection scheme.

Not only the workers but also their parents(including in-laws) and other family members are also eligible to get the benefits from this health insurance scheme.

List of eligible members who will be covered under this health benefit scheme at a glance:

  1. The workforce of the Self Help Groups;
  2. Civic Police Volunteers, Green Police Volunteers, Civil Defense Volunteers, Village Police Volunteers,
  3. Disaster Management Workers, Home Guards and NVF;
  4. Asha Workers, ICDS Workers, ANM workers;
  5. People who were previously enrolled under the RSBY in 2014 & 2015;
  6. Families under SECC deprivation criteria;
  7. Teachers, para teachers of different Govt. and Govt. sponsored primary schools, High schools, Madrasas;

Now let’s see department wise the list of eligible members under the Swasthyasathi scheme.

Home Department

  • Civic Police Volunteers

  • Green Police Volunteers

  • Village Police Volunteers

Civil Defence & NVF Department

  • Civil Defense Volunteers

  • Disaster Management Workers

  • Home Guards

  • NVF

Women & Child Development

  • ICDS Workers

  • ICDS Helpers

Self Help Groups

  • Members of SHGs

P&RD

  • Contractual/casual workers in PRI bodies covered under Finance Department

Municipal Affairs

  • Self Help Groups in Municipal areas

  • HNW/ASHA workers

  • Contractual/casual workers in ULB  bodies covered under Finance Department

Health & Family Welfare

  • ASHA workers

Labour Employment

  • Unorganized workers of any category as may be agreed.

Finance

  • Contractual/casual workers in Government Departments  covered under Finance Department

How to register in Swasthya Sathi Scheme?

To register in Swasthyaathi Scheme the following procedures are to be followed:

  1. First, you have to be an eligible member;
  2. Visit your nearest Block Development Office(BDO) if you reside under Grampanchayat area or visit the nearest Municipality Office if you reside under the Municipality area;
  3. Thereafter, you are supposed to collect Format-B, fill it up and submit to the concerned office of which you are a member;
  4. You have to provide the name of all eligible family members/ beneficiaries in the prescribed Format B;
  5. List of the eligible family members or beneficiaries are given below:-
  • Beneficiary (Self).
  • Spouse.
  • Unmarried dependent Daughter.
  • Unmarried dependent Son.
  • Mother of Beneficiary.
  • Father of Beneficiary.
  • Mother in Law of Beneficiary.
  • Father in Law of Beneficiary.
  1. After your form submission, you will be called/notified by the concerned BDO / Municipality Office ;
  2. Remember, all family members or beneficiaries as mentioned above are to be enrolled through Biometric thumb impression which will be captured in the Swasthya Sathi Card.

How can I apply for Swasthya Sathi?/How to apply for Swasthya Sathi card online

There is no procedure to apply for the Swasthyasathi card online. You have to fill up the Format B form physically and submit to the concerned office for enrollment of beneficiaries.

The concerned office then uploads all the data online. So, you can apply for Swasthyasathi scheme in offline mode only. So basically, you can apply for Swasthya Sathi card online.

Is Swasthya Sathi cashless?

Yes! Swasthya Sathi Scheme is completely cashless. You need not pay any amount either as insurance premium or as the cost of treatment.

Swasthya Sathi for Teachers

Since the Teachers are not covered under the West Bengal Health Scheme, they have been covered extensively under this scheme.

Therefore, this scheme is a great relief for the Teacher fraternity of the West Bengal, as far as their health insurance is concerned.

What are the Recents Updates in Swasthyasathi Scheme?

The very recent updates in this Swasthyasathi scheme are as below:

  • Rs.5 Lakh coverage for all under this scheme
  • Age restriction for dependent children has been abolished
  • RSBY beneficiaries enrolled in 2014 & 2015 are also covered
  • Families as per SECC deprivation criteria are covered
  • Hospitals below 30 bed are admissible now under this scheme
  • Permanent enrolment centres in each Block & Municipality
  • A district can modify beneficiaries details like name, age, category etc.
  • Cost of lost Smart Card is to be paid by the Beneficiaries now