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Swasthya Sathi Card 2020-2021 apply online process has been started by the West Bengal government. In this scheme, the state govt. provides basic health cover for secondary and tertiary care upto Rs. 5 lakh per annum per family. The health insurance coverage is paperless, cashless, smart card based. People can now apply by filling the WB Swasthya Sathi Card application form which can be downloaded in PDF format. To download the form PDF for registration, applicants can visit the official website at swasthyasathi.gov.in
This Swasthya Sathi Scheme was firstly announced in Cabinet No – 2625 (dated 17 Feb 2016) and Finance dept. notification number – 1104-F (P) dated 25 February 2016. The scheme was officially launched by honourable CM on 30 December 2016.
WB Swasthya Sathi Card 2020-2021 – How to Apply Online
As per the official notification, Swasthya Sathi Scheme has been extended for all citizens. Govt of West Bengal has decided to extend Swasthya sathi benefit to all residents of West Bengal state, except those who are already covered under any Govt, Sponsored Health Insurance or Assurance Scheme. Also the family in receipt of Medical allowance as part of their salary from WB govt. are also excluded.
In this article, we will tell you about the Swasthya Sathi card, features of scheme, active hospitals list, how to download mobile app, application / registration form PDF, login, apply or fill up process, package list, URN verification, login, how to find your name, helpline number and complete details.
WB Swasthya Sathi Card Application Form PDF Download
Here is the complete process to download WB Swasthya Sathi Card Application Form PDF through online mode:-
STEP 1: Firstly visit the official website at https://swasthyasathi.gov.in/
STEP 2: At the homepage, scroll over the “Apply Online” tab in the main menu and then click at the “Form B for Registration under Swasthya Sathi” link.
STEP 3: Direct Link to Download Swasthya Sathi Application Form PDF through online mode – https://swasthyasathi.gov.in/Content/HomeTabItems/FormB_NEW_02-12-2020.pdf, or https://www.malda.gov.in/sites/default/files/forms/2019-12/SS%20FORM.pdf
STEP 4: The Swasthya Sathi Application Form PDF will appear as shown below:-
STEP 5: All the applicants can download this Swasthya Sathi Scheme Application Form PDF and take a printout.
This form must be submitted at the earliest to the concerned authorities to avail the Swasthya Sathi Scheme benefits. The Swasthya Sathi application form fill up process or standard operating procedure for swasthya sathi Enrollment under Duare Sarkar initiative can be checked here. The direct link to check Swasthya Sathi form fill up 2020-2021 process is https://wb.gov.in/duare_sarkar/Swasthya-Sathi.pdf. All the enrolled beneficiaries will get Swasthya Sathi Scheme Smart Card.
Swasthya Sathi Registration for Treatment in Hospitals Located Outside of West Bengal
To make Swasthya Sathi Registration for Treatment in Hospital(s) Located Outside of West Bengal, check the form fill up process. Visit the same official website at https://swasthyasathi.gov.in/. At the homepage, scroll over the “Apply Online” tab in the main menu and then click at the “Registration for Treatment Outside of West Bengal” link. The Swasthya Sathi Scheme Registration Form for treatment outside WB state will appear as below:-
Afterwards, people can make registration for treatment using URN, mobile number and OTP outside West Bengal state.
Salient Features of the Swasthya Sathi Card Scheme
Here are the salient features of the Swasthya Sathi Card Scheme launched by the West Bengal government:-
- Basic health cover for secondary and tertiary care up to Rs. 5 lakh per annum per family.
- Up to Rs 1.5 Lakh through Insurance Mode and beyond 1.5 lakh to 5 Lakh through Assurance Mode.
- The scheme was rolled out from 01.02.2017. National Insurance Company was insurance partner in 9 Districts and United India Insurance Company in 11 Districts up to 28.02.2018. The scheme was implemented under assurance mode for the month of march, 2018.
- From 01.04.2018 to 15.01.2020, Bajaj Allianz selected as Insurance Partner in 18 Districts and from 01.04.2018 to 31.12.2019, IFFCO TOKYO selected as Insurance Partner in 5 Districts. The service of 5 districts has been extended by Swasthya Sathi Assurance Mode up to 15.01.2020.
- The service is continued by new Insurance Company from 16.01.2020. National Insurance Company is selected as Insurance Partner in 6 Districts (Cluster-I), Oriental Insurance Company is selected as Insurance Partner in 9 Districts (Cluster-II), United India Insurance Company is selected as Insurance Partner in 8 Districts (Cluster-III).
- Paperless, Cashless, Smart Card based.
- There is no cap on the family size and Parents from both the Spouse are included. All dependent physically challenged persons in the family are also covered.
- All pre-existing diseases are covered for treatment through Swasthya Sathi Card.
- The entire premium is borne by the State Government and no contribution from the beneficiary.
- Online Swathya Sathi Smart card is provided to each family on the day of Enrollment. Smart Card captures the details of the family members , Photographs, biometric, address, Mobile Number, SECC ID.
- Management of the scheme is in paperless IT platform from day one.
- Online empanelment & gradation of Hospitals based on the services and infrastructure available
- 100% online Pre-authorisation with turn around time of 24 Hrs.
- SMS triggers and instant alerts to the beneficiaries on blocking of card.
- Real-time uploading of E-health record of the beneficiaries on discharge
- Claim reimbursement to the hospital with TAT of 30 days else interest are being charged for delayed payment.
- 24X7 toll free Call Centre (18003455384) with feedback option for Swasthya Sathi Card Scheme.
- Online grievance monitoring Mechanism
- Online triggers and alerts to detect probable frauds with escalation matrix..
- Android based Swasthya Sathi Mobile app for assistance to the beneficiaries
To know about the Swasthya Sathi Card Scheme, click the direct link – https://swasthyasathi.gov.in/AboutScheme
Swasthya Sathi App Download for Android Mobile Phone Users
Here is the direct link to download Swasthya Sathi App from google play store for android mobile phone users: https://play.google.com/store/apps/details?id=com.wb.swasthyasathi&hl=en_IN&gl=US
The page to download Swasthya Sathi App from google play store for all android smartphone users will appear as below:-
Swasthya Sathi is a flagship scheme launched by Hon’ble CM of West Bengal to provide cashless secondary and tertiary care treatment from the empanelled government and private hospitals. The Swasthya Sathi App involves the following features – empanelled private and pubic hospitals, information of Doctors, hospital facility details, hospital services, swasthya sathi packages, URN verification, photo / video gallery & other information of Swasthya Sathi Card.
Hospital Registration / Check Hospital Reg Status at Swasthya Sathi Portal
To make Hospital Registration at Swasthya Sathi Portal, visit the official website at https://swasthyasathi.gov.in/. At the homepage, scroll over the “Apply Online” tab in the main menu and then click at the “Hospital Registration” link or directly click https://helpline.swasthyasathi.gov.in/Registration.aspx. The Swasthya Sathi Scheme Online Hospital Registration Form will appear as below:-
All the applicants can even check the Hospital Registration Status in the “Apply Online” section in the homepage and then clicking at the “Check Hospital Reg. Status” link. The page to check Hospital Registration Status under Swasthya Sathi Scheme will appear as shown below:-
Hospitals can enter their registered mobile number and then click at the “Search” button to check Hospital Registration Status.
WB Swasthya Sathi Hospital List / Active Hospitals Details
The direct link to check West Bengal Swasthya Sathi Hospital List or the Active Hospitals details is given here – https://helpline.swasthyasathi.gov.in/ssHospitalDdetails.aspx
The page where Active Hospitals List for Swasthya Sathi Scheme is present will appear as shown below:-
Here applicants can select the state, district, hospital type, hospitals grade and then click at the “Submit” button to check the Swasthya Sathi Active Hospital Details.
Download Package List for WB Swasthyasathi Scheme 2020-2021
Here is the direct link to download the Swasthyasathi Package List – https://tms.swasthyasathi.gov.in/portal/SSPPackage.asp.
Here applicants can enter the grade, procedure and click at the “Show Data” button to check the Swasthya Sathi Package List.
Find Your Name in WB Swasthya Sathi List of Beneficiaries / Data Search Login
Here is how people can find their name in West Bengal Swasthya Sathi List of beneficiaries – https://data.swasthyasathi.gov.in/SSDataSearchLogin.aspx
The SS Data Search Login page to find you name in WB Swasthya Sathi List of beneficiaries will appear as shown below:-
WB Swasthyasathi Scheme URN Verification
Here is the direct link for WB Swasthyasathi Scheme URN Verification – https://helpline.swasthyasathi.gov.in/SearchURN.aspx. The page to verify URN for Swasthya Sathi will appear as shown below:-
Here applicants can select the state, district, enter the URN and click at “Submit” button to verify their URN.
Insurance Company / TPA / SCSP under Swasthya Sathi Card Scheme
The complete details of Insurance Company, TPA and SCSP under Swasthya Sathi Card Scheme Insurance Mode can be checked using the link – https://swasthyasathi.gov.in/OurTeam/ContactUs. The IC / TPA / SCSP Setup page under Swasthyasathi will appear as shown below:-
At this page, people can check the insurance organization name, TPA, SCSP in district wise manner under Swasthya Sathi Scheme.
Key Functionality of Swasthya Sathi Scheme
Here are the key features of the Swasthya Sathi Scheme launched by CM Mamata Banerjee:-
a) All Pre Existing Diseases Covered: All the pre-existing diseases and conditions are covered in the Scheme from day one.
b) No Cap on Family Size, Parents for both Spouse included& Gender Empowerment: There is no cap in family size and parents from both the spouse are covered. Cards is issued preferably in the name of eldest women family member as Head of family.
c) No Beneficiary Contribution: No contribution is to be made towards insurance premium or card cost on the part of the beneficiary as entire premium which including cost of smart cards is borne by the Government of West Bengal.
d) All Transactions Smart Card Based Transactions: The beneficiary avails the services in the form of Paperless, Cashless and entirely on the 64 Kb Smart Card which contains digitally encrypted information printed in the card and distributed to the beneficiary during the time of enrollment. Smart card valid for lifetime and auto renewed in each year.
e) Entire System on IT Platform: The entire system of the scheme is paperless and based on hassle free cloud based IT platform. Online monitoring of the scheme saves valuable time and resources apart from speedy delivery of the services.
f) Compulsory Pre-Authorization for Treatment: All the medical procedures/treatments of Swasthya Sathi beneficiaries are 100% pre-authorized within 24hrs TAT (turnaround time).
g) Transparent Hospital Gradation: The hospitals are graded based on marks obtained on the facilities and services available which are physically verified by the IC/TPA (Insurance Company/Third Party Administrator). The Empanelment committee approves the grade and empanels the hospital under Swasthya Sathi.
h) Complete Cashless Hospitalization: Expenses incurred for consultation, diagnostic test and medicines up to 1 day before the admission of the patient and cost of diagnostic test apart from food during hospitalization and medicine up to 5 days after discharge from the hospital for the same ailment / surgery are also provided to the beneficiary.
i) Rational PackageRates: 2092 Swasthya Sathi packages are available in the scheme. Package rates are dynamic and Package Selection committee rationalizes package rates as and when required.
j) SMS Alerts: SMS triggers to the beneficiaries during hospitalization and also after the discharge from the hospital.
k) Swasthya Sathi Mobile App: Downloadable from Google Play Store and queries can be raised for information, grievance, etc. This also includes a one-touch feature which directly connects to the 24X7 Help Line.
l) Easy Outreach for All through Toll Free Call Centre and Social Media: The 24X7 toll free Call Center (18003455384) for assistance is displayed on the back of Smart Card. The beneficiaries can also reach out through social media platform such as Facebook, Twitter, and WhatsApp
m) Transport Allowance after Discharge: Package includes cost of Transport Charges of Rs 200 payable to the patient at the time of discharge. In case of Patient admitted in State Government run Hospitals, additional transport allowance over and above the Rs 200 is also provided..
n) Large network of Empanelled Hospitals: The beneficiaries can opt for services under the Swasthya Sathi scheme in more than 1500 empanelled hospitals, details of them are available in Public domain. Every day more number of hospitals are registered in the scheme spontaneously..
o) Mandatory Claims Settlement through TAT of 30 Days: The claims of the Health care providers are monitored and settled online within 30 days or else interest would have to be paid as per the Agreement.
p) Compulsory E- HR (E-Health Record) uploaded on portal: The e-Health records of the patient is stored in the server and can be consulted as and when required by the physicians through their login credentials.
q) Proactive Disclosure of Monthly Analytical report: This is available in public domain for perusal and suggestions from all including the stakeholders.
r) Online Grievance Monitoring Mechanism: Stakeholders can post their grievance on the Swasthya Sathi online portal.
s) Identification of Triggers and outliers through Machine Intelligence as well as Human Intervention: There are System Based Triggers against Hospital/TPA/Insurance which includes hospital with high admissions, number of high value packages blocked, higher package blocked and claimed but actually not done, unnecessary surgery done or kept under ICU, same packages blocked for many patients on particular day, etc.
t) Interactive Website: as on 30 November, 2019- 34, 43,436 number of persons viewed the website. There is interactive “May I Help You” option for general queries of the viewer. Common people can also view their eligibility, enrollment details in the web portal.
Swasthya Sathi Key Functionality – https://swasthyasathi.gov.in/KeyFunctionality
Swasthya Sathi Scheme Helpline Number
Helpline Number – 18003455384 (Toll Free)
For making comment – https://helpline.swasthyasathi.gov.in/FAQ.aspx
To check Frequently Asked Questions – https://swasthyasathi.gov.in/FAQ
Swasthya Sathi Login – https://helpline.swasthyasathi.gov.in/loginpage.aspx
For complete details about the scheme – https://swasthyasathi.gov.in/