Swasthaya sathi Health Insurance Scheme

New updates! Sastha Sathi for All. Government of West Bengal has decided to extend Sastha sathi benefits to all residents of State, except those who has already covered under any Government sponsored Health Insurance or Assurance scheme. Also the family in recipt of Medical Allowance as a part of their salary from the Government, are also excluded.

 

There is no shortage of multi-specialist private nursing homes in state. However the treatment price is on the far side the reach of poor individuals. They rely on the govt. hospitals. Not all treatments are offered freed from price at these government treatment centers. People, from financially weak backgrounds cannot pay the fees. The state government has launched a replacement medical insurance scheme for such individuals. The beneficiaries of Swasthya Sathi scheme can attain free treatment at specific hospitals.

 

Launch details of the scheme

 

Name of the scheme	Swasthya Sathi Scheme
Launched in	West Bengal
Launched by	Mamata Banerjee
Date of launch	December 2016
Target beneficiaries	Poor people of the state(all people of the State from Dec 1, 2020)
Supervised by	West Bengal Health and Welfare Department
Helpline number	1800-345-5384
Official portal	swasthyasathi.gov.in

 

Key features of the Swasthya Sathi Scheme

 

Free treatment insurance polity – The scheme was implemented as a medical insurance policy that will help people to attain proper treatment, without worrying about the bill.

 

Amount of insurance offered – The families, registered under this scheme will receive Rs. 5 lakhs for their medical requirements per year. If the treatment bill is a smaller amount than or equal to Rs. 1.5 lakhs, then the claim are settled via Insurance Mode. it'll modification to Assurance Mode if the bill crosses this mark.

 

Total number of beneficiaries – The implementation of this scheme brought 45 lakh eligible families under the medical insurance policy. State suggested that 2.5 crore individuals will be benefited directly from this scheme.

 

Registered insurance companies – The treatment fee claims will be settled through two established insurance companies, one is IFFCO TOKYO that will operate in five districts. Other eighteen districts will come under Bajaj Allianz operations.

 

Number and type of treatment centers – Around 500 treatment centers have already been registered under the scheme. Both government and personal treatment centers are going to be allowed to register. These hospitals can placed below A, B or C grade, betting on the treatment facilities they'll be ready to offer.

 

Paperless and simple process – The applicants need not fill in any form to get the benefits. This makes it paperless, less time-consuming and simple.

 

Smart card – Smart cards will be issued by the state to every beneficiary. Every one have to show this smart card to attain the benefits.

 

Premium payment – An annual premium needs to be paid to keep the insurance scheme active. This price will be given by West Bengal government.

 

SMS alerts – Beneficiaries will also receive SMS alerts, when their claims have been settled. Any modifications in the scheme rules will also be notified through SMS. Candidates will get notifications if the smart card gets blocked.

 

Real-time data monitoring – Patients’ data and medical treatment related information will be monitored through an IT platform. This real-time data monitoring will assure better implementation of the scheme.

 

Settlement of claims – It has been highlighted in the scheme draft that the insurance companies will settle the medical bills within 30 working days.

 

Eligibility Criteria for Swasthya Sathi Scheme application

 

Residents of West Bengal – As this scheme has been implemented by the West Bengal government, it will only allow the participation of legal residents of this state.

 

BPL candidates – Poor people cannot pay the high medical fee. Presons, who are registered under the BPL category and RSBY, will be allowed to apply.

 

Medical professionals – ASHA workers, ICDS members will also get the free medical treatment.

 

SHG members – All the registered members of the self-help groups and their family members will automatically come under this scheme.

 

Civic volunteers, Teachers – People, who are associated with the civil defense department and work as a civic volunteer will also be able to get free treatment.

 

Documents necessary for SwasthyaSathi Scheme in WB

 

Residential proof – Submitting a legal residential document is a must during the application process.

 

Income certificate – Only financially weak applicants, possessing the BPL certificate will be able to attain the benefits of this medical scheme.

 

Professional certificate – As all primary medical support staff will be included under the scheme, they must submit a copy of documents that highlight the department and post.

 

Aadhar card – Identification is a must for all the applicants. Thus, the Aadhar card needs to be show at the time of registration.

 

How to attain application form and register?

Though there is an official portal for the scheme, applicants must apply through the government hospital or primary medical centers in the villages.

 

Interested applicants must bring their documents and the Aadhar card during registration.

 

One person will be put in charge of the enrollment process.

 

He/she will check the documents, collect the biometric details and fill in the registration form on behalf of the applicant.

 

Once the application process is over, the scheme smart card will be issued through the official portal.

 

To attain this smart card, beneficiaries must click on the link WB Swasthya Sathi Scheme Portal.

 

When the portal opens, beneficiaries need to click on the “Log In” option with their user ID and passwords.

 

After successfully logging in, they can retrieve the online smart card for the Swasthya Sathi Scheme.

 

How can hospitals register and check status?

As mentioned, government and personal treatment centers can ought to apply on-line for obtaining the green signal from the west bengal government. Once these medical institutes get the required certification, they're going to be able to serve patients and obtain the treatment fee from the govt coffers. The appliance methods are going to be done on-line, through the official portal. Once the hospital admin lands on the page, he/she has to click on the link that's marked as “Hospital Registration.” it'll open a replacement page, wherever the admin has to type in the hospital details. Once the form has been filled, the admin should click on the “Submit” button.

 

To check the registration status of the application, the various hospital admin has to log in on the licensed portal, and click on on the link that's marled as “Check Reg. Status.” As the admin clicks on this link, a replacement page can open up. Here, the admin should type in the registered mobile number of the hospital and click on the “Search” button. This can highlight the current status of the hospital’s application.

Registered list of hospitals

Not all government and personal hospitals can get the chance to serve the individuals under this scheme. One will get the list of all such medical centers, that are registered below the scheme. to accumulate this info, beneficiaries need to log in on the official page, then click on the option “Active Hospital List.” it'll trigger the site to open a new page, wherever beneficiaries need to choose the district and hospital type. Then the candidates need to click on the “Submit” button. It’ll mention the entire list of registered government and private hospitals, which is able to supply free treatment, as per the rules of this scheme.

Check the details of the medical package

Several secondary and tertiary ailments are listed under the scheme. Additionally, those that need surgery or treatment for serious diseases also can look at the main points of the treatment packages. To access these details, candidates need to click on the link that will take them to the official portal of the scheme. Here, they're going to see AN option that's marked as “Package details.” As soon as beneficiaries click on this tab, they're going to get the treatment package connected details they obtain.

Official scheme app

Recently, the govt. of WB has launched the Swasthya Sathi App. This application can facilitate the beneficiaries to collect info regarding the newest scheme related updates. Additionally, they'll conjointly access the medical insurance smart card from this application. The app is out there for free on the Google Play Store. One will transfer it from Swasthya Sathi scheme wb Mobile App. Once the app is downloaded and saved, the user should register with the phone number and alternative details to activate it.

The state authority has been creating necessary changes for the higher implementation of this scheme. The success of this scheme can pave the trail for the development of the medical progress.