[Apply] Swasthya Sathi Scheme in West Bengal 2019-20

Swasthya Sathi Scheme in West Bengal 2019-20 [Health Coverage Insurance, Online Application Form Download, Card Renewal, Validity, Balance Check, How to Register, Eligibility Criterta, Documents, Helpline]

After the launch of the Ayushman Bharat scheme, many states came up with their own version of the medical insurance scheme. In West Bengal, a similar scheme was introduced under the name Swasthya Sathi Scheme. In this article, you will get details of its features, application process, hospital registrations and the scheme app through which, people can get pertinent information.

Swasthya Sathi Scheme in West Bengal health insurance

Launch details of the scheme

Name of the schemeSwasthya Sathi Scheme
Launched inWest Bengal
Launched byMamata Banerjee
Date of launchDecember 2016
Target beneficiariesPoor people of the state
Supervised byWest Bengal Health and Welfare Department
Helpline number 1800-345-5384
Official portalswasthyasathi.gov.in

Key features of the Swasthya Sathi Scheme

  1. 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.
  2. Amount of insurance offered – The families, registered under this scheme will receive Rs. 5 lakhs for meeting their medical requirements on a yearly basis. If the treatment bill is less than or equal to Rs. 1.5 lakhs, then the claim will be settled via Insurance Mode. It will change to Assurance Mode if the bill crosses this mark.
  3. Total number of beneficiaries – The implementation of this scheme brought 45 lakh eligible families under the medical insurance policy. State estimates suggested that 2.5 crore individuals will be benefited directly.
  4. 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. The other 18 districts will come under Bajaj Allianz operations.
  5. Number and type of treatment centers – Around 500 treatment centers have already been registered under the scheme. Both government and private treatment centers will be allowed to register. These hospitals will placed under A, B or C grade, depending on the treatment facilities they will be able to provide.
  6. 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.
  7. Smart card – Smart cards will be issued by the state to every beneficiary. One must show this smart card to attain the benefits.
  8. Premium payment – An annual premium needs to be paid to keep the insurance scheme active. This amount will be contributed by West Bengal government.
  9. SMS alerts – Beneficiaries will also receive SMS alerts, when their claims have been settled. Any changes in the scheme rules will also be notified by SMS. Beneficiaries will get notifications if the smart card gets blocked.
  10. Real-time data monitoring – Patients’ data and medical treatment related information will be monitored through an IT platform. This real-time data monitoring will ensure better implementation of the scheme.
  11. 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

  1. 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.
  2. BPL candidates – Poor people cannot pay the high medical fee. Individuals, who are registered under the BPL category and RSBY, will be allowed to apply.
  3. Medical professionals – ASHA workers, ICDS members will also get the free medical treatment.
  4. SHG members – All the registered members of the self-help groups and their family members will automatically come under this scheme.
  5. 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

  1. Residential proof – Submitting a legal residential document is a must during the application process.
  2. Income certificate – Only financially weak applicants, possessing the BPL certificate will be able to attain the benefits of this medical scheme.
  3. 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.
  4. Aadhar card – Identification is a must for all the applicants. Thus, the Aadhar card needs to be presented at the time of registration.

How to attain application form and register?

  1. Though there is an official portal for the scheme, applicants must apply through the government hospital or primary medical centers in the villages.
  2. Interested applicants must bring their documents and the Aadhar card during registration.
  3. One person will be put in charge of the enrollment process.
  4. He/she will check the documents, collect the biometric details and fill in the registration form on behalf of the applicant.
  5. Once the application process is over, the scheme smart card will be issued through the official portal.
  6. To attain this smart card, beneficiaries must click on the link WB Swasthya Sathi Scheme Portal.
  7. When the portal opens, beneficiaries need to click on the “Log In” option with their user ID and passwords.
  8. 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 private treatment centers will have to apply online for getting the green signal from the West Bengal government. Once these medical institutes get the necessary certification, they will be able to serve patients and get the treatment fee from the government coffers. The application process will be done online, through the official portal. Once the hospital admin lands on the page, he/she needs to click on the link that is marked as “Hospital Registration.” It will open a new page, where the admin needs to type in the hospital details. Once the form has been filled, the admin must click on the “Submit” button.

To check the registration status of the application, the respective hospital admin needs to log in on the authorized portal, and click on the link that is marled as “Check Reg. Status.” As soon as the admin clicks on this link, a new page will open up. Here, the admin must type in the registered mobile number of the hospital and click on the “Search” button. This will highlight the current status of the hospital’s application.

Registered list of hospitals

Not all government and private hospitals will get the opportunity to serve the people under this scheme. One can get the list of all such medical centers, which are registered under the scheme. To acquire this information, beneficiaries need to log in on the official page, and then click on the option “Active Hospital List.” It will trigger the site to open a new page, where beneficiaries need to select the district and hospital type. After this, candidates need to click on the “Submit” button. It will bring up the complete list of registered government and private hospitals, which will offer free treatment, as per the guidelines of this scheme.

Check the details of the medical package

Several secondary and tertiary ailments have been listed under the scheme. Additionally, people who require surgery or treatment for serious diseases can also check out the details of the treatment packages. To access these details, applicants need to click on the link that will take them to the official portal of the scheme. Here, they will see an option that is marked as “Package details.” As soon as beneficiaries click on this tab, they will get the treatment package related details they seek.

Official scheme app

Recently, the government of West Bengal has launched the Swasthya Sathi App. This application will help the beneficiaries to gather information about the latest scheme related updates. Additionally, they can also access the medical insurance smart card from this application. The app is available for free on the Google Play Store. One can download it from Swasthya Sathi Scheme WB Mobile App. Once the app is downloaded and saved, the user must register with the phone number and other details to activate it.

The West Bengal authority has been making necessary changes for the better implementation of this scheme. The success of this scheme will pave the path for the development of the medical progress.

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