Swasthya Sathi

Swasthya Sathi was officially launched by the Honorable Chief Minister of West Bengal on 30th December 2016 to provide financial protection against major health expenses for families across the state. The scheme has been operational under different insurance partners, with services continuing under a new insurance arrangement from  January 16, 2020.

Under the current structure, National Insurance Company Limited serves as the insurance partner for 6 districts (Cluster I), The Oriental Insurance Company Limited for 9 districts (Cluster II), and United India Insurance Company Limited for 8 districts (Cluster III).

This guide walks you through the features, eligibility, application process, benefits, and limitations of Swasthya Sathi, helping you understand whether it is sufficient or should be complemented with a comprehensive private health insurance plan.

Key Features of Swasthya Sathi

• Basic health cover for secondary and tertiary care up to ₹5 lakh per family per annum.
• There is no restriction on family size, and parents from both spouses are included.
• All dependent physically challenged family members are covered.
• All pre-existing illnesses are included from day one.
• The entire premium is borne by the State Government; beneficiaries are not required to contribute.
• The online Swasthya Sathi Smart Card is issued to each family on the day of enrollment.
• The empanelled hospital also provides medicines and necessary assistance for five days after discharge.

Eligibility and Application Process for Swasthya Sathi

Eligibility Criteria: 

• Should be permanent residents of West Bengal.
• Should not receive medical allowance with the salary.
• Should not already be covered under other government-sponsored health insurance schemes (subject to state guidelines).

 Source: Swasthya Sathi Website

Online Application Process

Step 1: Go to the official Swasthya Sathi Website.

Step 2: Click on "Apply Online" and enter your mobile number to receive an OTP.

Step 3: Complete Form B (the registration form). You will need to provide:

• District, Block/Municipality, and Village/Ward details.
• Category (SC/ST/OBC).
• Department/Office details if any member is a contractual/government employee.

Step 4: List all family members with their Aadhaar Numbers and Ration Card numbers.

Step 5: Once submitted, you can track the application status using your registration number.

Documents Required To Apply For Swasthya Sathi

To apply for the Swasthya Sathi scheme in West Bengal, whether online or offline, you need a few key documents:

• A valid Aadhaar card for identity and address proof for all family members
• An additional identity proof, such as a voter ID or a ration card
• Where applicable, a Khadyasathi card may be requested to confirm eligibility. 
• Although Aadhaar usually serves as proof of residence, some local enrollment centres may ask for additional documents, such as a domicile certificate or ration card, especially for offline applications.

When you apply offline, your application may get rejected due to submission of incomplete forms, mismatch in Aadhaar or ration card details, incorrect or unverified family information, or duplicate enrolment attempts.

Take Note: You can contact Swasthya Sathi by calling the toll-free helpline number 1800-345-5384. The helpline provides support for enrollment queries, smart card issues, hospital and package information, claim-related concerns, and other scheme-related assistance.

Swasthya Sathi vs Private Insurance: Is It Enough on Its Own?

Government schemes like Swasthya Sathi provide offer cashless treatment at affordable or nominal contributions, which helps reduce the burden of major hospital expenses. However, public healthcare infrastructure may not always be adequate and does not guarantee continuity.

On the other hand, private health insurers like HDFC Ergo provide comprehensive coverage and continuity independent of government policy changes. Many families, therefore, use a government scheme as base coverage and supplement it with a comprehensive personal health plan.

Note: You can check the list of active hospitals by visiting the official Swasthya Sathi website. Choose the required filters, such as district, sub-division, type, and grade, to view the updated list of hospitals where cashless treatment is available under the scheme.

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Conclusion

Swasthya Sathi serves as a strong healthcare safety net, offering financial protection to families at no cost to beneficiaries. It ensures access to essential medical treatment without the burden of premium payments.

However, if you are looking for a health plan from insurers with established track records, we recommend comprehensive plans, which align with your long-term goals.

Note: Ditto has no affiliation with this scheme. Our assessment here is completely independent and based solely on publicly available data and the evaluation framework we use for all insurers. If you want to understand how Ditto reviews insurers across claims, complaints, business strength, and product suitability, you can read our methodology here. The information provided is for general awareness and should not be used for financial or legal decisions. Please refer to the Swasthya Sathi official website for the latest details.