Swasthya Sathi – A Group Health Insurance Scheme

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Swasthya Sathi – A Group Health Insurance Scheme: A Group Health Insurance scheme named Swasthya Sathi was announced by the Government of West Bengal. The Swasthya Sathi scheme was officially launched by Hon’ble CM on 30th December 2016. A State level Implementation Committee (SLIC) under the chairmanship of the Chief Secretary formed to oversee the scheme and there is a registered society named Swasthyasathi Samiti for monitoring the scheme. Additional information regarding Purpose of Swasthya Sathi scheme & Main features of the Scheme is given below in the following paragraph.



Purpose of Swasthya Sathi – A Group Health Insurance Scheme
Group Health Insurance scheme named Swasthya Sathi for workers/ volunteers like the Members of Self Help Groups, Civic Police Volunteers, Green Police Volunteers, Civil Defence Volunteers, Village Police Volunteers at Gram Panchayat, Disaster Management workers, Home Guard/ NVF, ASHA workers, ICDS workers and other Contractual/ Casual/ Daily rated workers.

A large section of volunteers and other workers engaged in various development programmes of the State Government are not covered under any Health Insurance or similar other schemes. It has been under Active consideration of the Government for some time past to provide a comprehensive health insurance coverage to this large section of the volunteers and other workers and their families to protect them from the financially debilitating effect of illness and adverse health conditions.



Objective of Swasthya Sathi Scheme

To improve access of identified families to protect them from the financially debilitating effect of illness and adverse health conditions and to provide cashless, paperless, quality medical care for treatment of diseases involving hospitalization through an identified network of health care providers.

Beneficiaries

The scheme is intended to benefit identified categories of contractual/ casual employees of different departments of West Bengal spread over all the 20 districts. This tender is invited to cover an estimated number of 64 lakh such families of the 20 District of West Bengal.

The Main Features of the Swasthya Sathi Scheme

1. The scheme will have basic health cover for secondary and tertiary care up to Rs. 1.5 Lakh per annum.
2. Critical illness like Cancer, Neuro surgeries, cardiothoracic surgeries, liver diseases, blood disorders etc. will be covered up to Rs. 5 Lakh.
3. There is no cap on the family size and Parents from both the Spouse are included.
4. NIC as insurance partner in 9 District and UIIC in 11 Districts. Premium per family ranges from Rs. 3549/- In Kolkata to Rs. 1729 in Dakshin Dinajpur.
5. All pre-existing diseases are covered.
6. The entire premium is borne by the State Government and no contribution from the beneficiary.
7. Management of the scheme is in paperless IT platform from day one.
8. Online empanelment & gradation of Hospitals based on the services and infrastructure available.
9. 100% online Pre-authorisation with the turn around time of 24 Hrs.

The Swasthya Sathi scheme will be implemented by the Department of Health & Family Welfare, Government of West Bengal. The details of the scheme will be finalized by the Health & Family Welfare Department in consultation with the Finance Department.

Details About Swasthya Sathi – A Group Health Insurance Scheme

Organization Name: Swasthya Sathi, Health & Family Welfare Department, West Bengal
Organization Websiteswasthyasathi.gov.in
Name of The Scheme: Swasthya Sathi
The scheme launched: 30.12.2016
Notice For: Scheme



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