Swasthya Sathi Prakalpya in West Bengal

 

Introduction:

The Department of Health & Family Welfare, Govt. of West Bengal, has launched a gaggle insurance Scheme named “Swasthya Sathi”, being implemented within the state for a bigger section of the Society. The scheme is implemented by Swasthya Sathi Samiti, a registered society under the control of the Department of Health & Family Welfare. The scheme will have basic health protect secondary and tertiary care up to five lakhs once a year per family, out of which 1.50 lakh once a year per family is going to be covered by the Group insurance Provider while claims above 1.50 lakh up to five .0 lakh per family once a year are going to be covered under Assurance Mode by the Swasthya Sathi Samiti on floater basis. All pre-existing diseases are going to be covered. the whole premium is going to be borne by the government with no contribution from the beneficiaries. there'll be no cap on the family size. Management of the scheme right from issue of Swasthya Sathi card for every beneficiary family to patient admission, keeping records of treatment and hospital claims settlement is being administered through paperless hassle-free IT platform.

 

The scheme is meant to profit identified categories of regular/contractual/casual employees of various departments of West Bengal also as a gaggle of workers directly engaged for implementation of Govt. Schemes. Projects/Programmes cover all the 23 districts This tender is invited to hide an estimated number of 64 lakh such families of these 23 districts of West Bengal, which can be extended up to 1.5 Crore families of the State. District wise vis-a-vis Cluster wise details of the estimated number of families proposed to be covered under this tender are given in Section – I of this Tender Document.

 

The objective of this scheme is to enhance access of identified families to guard them against the financially debilitating effect of illness and adverse health conditions and to supply cashless, paperless, quality medical aid for the treatment of diseases involving hospitalization through an identified network of health care providers.

 

Eligibility Criteria for Swasthya Sathi Scheme application

 

1. The applicant must be a legal and permanent resident of West Bengal.

 

2. it's pertinent that the applicant falls within the BPL category. If he/she is registered under RSBY, only then the individual can apply.

 

3. The applicants related to ASHA, ANM and ICDS, will get the perks of this scheme. an equivalent will apply to self-help group members.

 

4. If the applicant works as a civil volunteer, then he/she will attain this medical coverage.

 

The criteria for empanelling private hospitals and health care facilities would be as follows:

 

a. Out-Patient Services (OPD) for Swasthya Sathi Beneficiaries within the Empanelled Hospitals are going to be freed from Cost;

 

b. Hospitals are going to be categorized into different grades, viz., Grade A, Grade B, Grade C and Grade R taking into consideration the Specialty /Super-speciality Services available within the Hospitals;

 

c. the power should have a minimum of 30 functioning inpatient beds or as determined by State Nodal Agency, an operational pharmacy and diagnostic services, or having tie-up with an equivalent in close vicinity so on provide “cashless” service to the patient; however, the facilities having bed-strength within the range of 10 to 29 can also be empanelled as Grade R with access to limited packages as prescribed by the SNA;

 

d. Those facilities undertaking surgical operations should have a totally equipped operating room of their own.

 

e. the power should have fully qualified doctors (at least MBBS) and qualified nursing staff under its employment around the clock.

 

f. the power should maintain necessary records as needed and supply necessary records of the insured patient to the Insurer or his representative/Government/Nodal Agency as and when required.

 

g. the power should have registration with the tax Department.

 

h. the power should have Telephone and Internet facilities.

 

Documents necessary for Swasthya Sathi Scheme in West Bengal

 

1. Residential papers – it's important that the applicant produces his/her legal domicile documents.

2. BPL certificate – All applicants must furnish their BPL certificates.

3. Registration certificate from medical associations and SHGs – The SHG and medical organizations’ registration certificate is important.

4. Civil volunteer certificate – The candidates must submit a licensed document that has been issued by the West Bengal government.

 

How can hospitals register and check status?

 

To Register

* attend the official website of Swasthya Sathi scheme

* the house page will open ahead of you

* On the homepage, you're required to click on the apply online tab

* Now you've got to click on the hospital registration

* Now a form will open ahead of you where you've got to enter all the specified information like state name, District name, NABH accredited, hospital type, category of the hospital, speciality name, hospital name, etc

* then click on the submit button.

* By following this procedure, you'll do hospital registration

 

To check the status

 

* Visit the official website of the Swasthya Sathi scheme

* the house page will open ahead of you

* On the homepage, you're required to click on the apply online tab

* Now you've got to click on check hospital registration status

* a replacement page will display before you where you've got to enter a registered mobile number

* then, you've got to click on the search

* Hospital registration status is going to be on your display screen

 

Registered list of hospitals

 

* First of all, Applicants need to open the official website that's swasthyasathi.gov.in with the assistance of the web

* From the house page applicants need to Hospital Information option

* Now they need to click on the “Active Hospital List”

* a replacement page will open on your display screen

* Select your state, District, hospital type & Hospital Grade

* Finally, click on the submit button.

 

Check the small print of the medical package

 

Interested applicants and beneficiaries can gather information about the medical treatments, which are included within the scheme. The applicant can click on the link to urge to the official website. On the left side of the webpage, you'll see an index option. As you scroll down, you'll see the choice that's marked as “Package Details.” once you click on this tab, you'll be redirected to the page where you'll find the ailment and treatment package information.

 

Official scheme app

 

For better dissemination of scheme related details, the state authority has already developed and launched an app for the health project. you'll download the Swasthya Sathi App by clicking on the Swasthya Sathi Scheme App Download. you'll look for the app in Google Play Store with the name. Users needn't pay any charges for utilizing this app. For app activation, you would like to type within the registered mobile number and Aadhar code. Once the app has been activated, you'll get access to the appliance dashboard and obtain pertinent information.

 

The insurance scheme will assist the poor and vulnerable individuals to achieve the required medical treatments at good hospitals. The Chief Minister of West Bengal wants to upgrade the health facilities. The launch of this scheme may be a potent step towards achieving this target. The CM has also mentioned that the scheme guidelines are going to be revised within the future as per requirements.

 

* Visit the Google Play Store on your Mobile.

* Enter the Swasthya Sathi within the search box.

* It then displays relevant results.

* Click on the Install under the Swasthya Sathi App.

* It then installs and downloads the app on your mobile.

* Open the app downloaded on the mobile and luxuriate in the services of the Swasthya Sathi App.