Swasthya Sathi Scheme West Bengal PDF

PDF Name	Swasthya Sathi Scheme West Bengal
No. of Pages	31
PDF Size	13.78 MB
Language	English
Tags	Sarkari Yojana
PDF Category	Government
Source / Credits	Multiple Sources
Uploaded By	Pradeep

Swasthya Sathi Scheme West Bengal - Summary

Swasthya Sathi Scheme in West Bengal is a significant initiative aimed at providing health coverage to the citizens of the state. Launched on 17th February 2016 through Cabinet No – 2625, it is supported by Finance Department notification no – 1104-F (P) dated 25th February 2016. A State Level Implementation Committee (SLIC), chaired by the Chief Secretary, was formed to oversee the scheme, and a registered society named “Swasthya Sathi Samiti” (Registration no S/M/4377 OF 2016-2017, dated 15.11.2016) was established to monitor it.

Main Features of the Swasthya Sathi Scheme:

Provides basic health cover for secondary and tertiary care up to Rs. 5 lakh per annum for each family.
Offers up to Rs 1.5 lakh through Insurance Mode, with coverage extending from 1.5 lakh to 5 lakh through Assurance Mode.
The scheme commenced on 01.02.2017, initially partnering with National Insurance Company in 9 districts and United India Insurance Company in 11 districts until 28.02.2018. Assurance mode was implemented in March 2018.
From 01.04.2018 to 15.01.2020, Bajaj Allianz was selected as the Insurance Partner in 18 districts, while IFFCO TOKYO covered 5 districts until 31.12.2019. The Assurance Mode service in these 5 districts continued until 15.01.2020.
On and after 16.01.2020, new insurance companies joined the scheme: National Insurance Company in 6 districts (Cluster-I), Oriental Insurance Company in 9 districts (Cluster-II), and United India Insurance Company in 8 districts (Cluster-III).
The scheme operates paperlessly, is cashless, and uses a smart card system.
There is no restriction on family size, and the parents of both spouses are included. All dependent physically challenged individuals are also covered.
All pre-existing medical conditions are included, ensuring comprehensive health coverage.
The entire premium cost is covered by the state government, with no financial contribution required from beneficiaries.
On the day of enrollment, each family receives an online Swasthya Sathi Smart card that captures details such as family member information, photographs, biometric data, address, mobile number, and SECC ID.
The management of the scheme has been entirely digitized since its inception.
Hospitals are empaneled and graded online based on their services and infrastructure.
Pre-authorisation is 100% online with a turnaround time of 24 hours.
Beneficiaries receive SMS alerts and instant notifications regarding the status of their smart cards.
E-health records of beneficiaries are uploaded in real time upon discharge from hospitals.
Hospitals receive claim reimbursements within 30 days; otherwise, interest is charged for delayed payments.
A 24X7 toll-free call center (18003455384) is available for assistance and feedback.
There is an online mechanism for monitoring grievances.
Fraud alerts are generated online, accompanied by an escalation matrix for timely action.
Beneficiaries can access help through an Android-based Swasthya Sathi Mobile app.

For more information, you can download the Swasthya Sathi Scheme West Bengal in PDF format using the link provided below. Don’t miss out on this vital resource for your health needs!

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