SASTHYASATHI

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Swasthya Sathi for Education Department

Swasthya Sathi Treatment in CMC, Vellore (terms)

Mandatory Production of Swasthya Sathi Card during IPD in Govt Hospitals |

Declaration regarding Swasthya Sathi and WBHS (Purulia) |

Option for coverage under Swasthya Sathi Scheme [5624-F(P) dated 27/09/2019]DIFFERENCE BETWEEN SWASTHYA SATHI & WB HEALTH SCHEME |

LIST OF HOSPITALS UNDER SWASTHYA SATHI |

APPLICATION FORM

Exclusion of M.A. for the Swasthya Sathi enrolled staffs |

Clarification Regarding deduction of M.A.

Raising the Financial limit for basic health cover for secondary and tertiary care from the existing limit of Rs 1.5 lakh to 5 lakh per family per annum for all cases under SWASTHYA SATHI

Government of West Bengal

Finance Department

Audit Branch

No. 5594-F(P) Dated, the 6 th day of September, 2017.

NOTIFICATION

Sub: Extension of Coverage of “Swasthya Sathi” Scheme

The State Government has introduced “Swasthya Sathi”, a Comprehensive Group Health Insurance scheme for different categories of volunteers / workers vide Finance Department No. 1104-F(P) Dated 25th February 2016. The Scheme already covers ASHA Workers, ICDS Workers, ICDS Helpers, Home Guards / NVF, Civic Police Volunteers, Civil Defence Volunteers, Village Police Volunteers at Gram Panchayats, Self Help Group members of WBSRLM, Self Help Group Members of Urban Development & Municipal Affairs Department, Disaster Management workers, contractual / casual / daily rated workers in various Departments, three-tier Panchayat Members and other contractual employees of Panchayat & Rural Development Department, and part-time lecturers and contractual staff of Colleges and Universities.

2. It has been under active consideration of the Government to expand the coverage of Swasthya Sathi to include other employees / workers / volunteers / teachers engaged in government work. Accordingly, after careful consideration, the Governor is pleased hereby to decide that the following groups of employees / workers / volunteers / teachers etc. as mentioned against the corresponding Administrative Department as in the table below be covered under “Swasthya Sathi” with immediate effect in addition to those already covered under the Scheme:-

Table

Department Employees	Workers I Volunteers I Teachers etc.
Higher Education / School Education	Para Teachers
	Siksha Bandhu
	Special Educators
	Contractual staff of Sarba Siksha Mission including Circle level Resource Centre
	Teachers and non-teaching employees of Primary and Secondary Schools
Panchayat & Rural Development	Samprasarak / Samprasarika of Shishu Shiksha Kendras
	Samprasarak / Samprasarika of Madhyamik Shiksha Kendras
	Contractual Homeopathic Doctors / Compounders at Gram Pamchayat level
Minority Affairs & Madrasah Education	Samprasarak / Samprasarika of Madrasa Shiksha Kendras, Shishu Shiksha Kendras and Madhyamik Shiksha Kendras.
Minority Affairs & Madrasah Education	Teachers and non-teaching employees of recognised aided Madrasahs
Animal Husbandry	Pranibandhu
Fire & Emergency Services	Fire and Auxiliary Workers
Self-Help Group & Self Employment	Prakalpa Sahayaks & Supervisors
Health and Family Welfare	Rogi Sahayaks
	Auxiliary Nurse Midwife of National Health Mission
	Other Contractual staff of National Rural Health Mission & National Urban Health Mission including ASHA supervisors and Rashtriya Bal Swasthya Karyakram doctors
	Contractual staff of Rashtriya Swasthya Bima Yojna & Swasthya Sathi
	Contractual Staff of West Bengal Health & Family Welfare Samity
	Contractual Homeopathic, Ayush and Unani Doctors and compounders at Gram Panchayat level
Urban Development	Elected representatives of Municipalities
	Employees of Development Authorities not covered under West Bengal Health Scheme & Municipal Affairs
	Employees of Urban Local Bodies not covered under West Bengal Health Scheme
	Sanitary workers and workers engaged under West Bengal Urban Employment Scheme in Urban Local Bodies

3. Employees / workers / teachers who are in receipt of monthly medical allowance can opt for the Scheme by forgoing the monthly medical allowance.

4. It has also been decided that apart from contractual/casual/daily rated workers covered under No. 4570-F(P) dated 31.08.2016, all contractual/casual/daily rated employees engaged by any Department with specific approval of the Finance Department and drawing remuneration from the treasuries or from grant-in-aid shall also be eligible to be enrolled under Swasthya Sathi scheme.

[H. K. DWIVEDI]

Principle Secretary to the Government of west Bengal

Extension of Coverage of “Swasthya Sathi” Scheme

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Differences between “Swasthya Sathi” and “WB Health Scheme”

WB Health Scheme	SWASTHYA SATHI
1) There is no upper limit of cost in WB Health Scheme (1lakh cashless and above that will be paid as Reimbursement of which 80% can be taken as Advance).	1) SWASTHYA SATHI has a upper limit of 1.5 lakh and 5 lakh (for critical illness).
2) WB Health Scheme is actually meant for Government Employees.	2) SWASTHYA SATHI meant for unorganised sector.
3) All OPD expenses are paid in WB Health Scheme.	3) All OPD expenses are NOT paid in SWASTHYA SATHI.
4) Almost all Private, PPP & Government Hospitals are listed under WB Health Scheme	4) Where only few Private Hospitals are listed under SWASTHASATHI, e.g. only three Private in Kolkata they are Park, Medica & RN Tagore,
5) The Family premium to the Insurance company (National Insurance and United Insurance) ranges between Rs. 1729/- to Rs. 3549/- depending on district (Minimum for Dakshin Dinajpur and Maximum for Kolkata) but Medical Allowance is Rs-3600/- per year.

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Extension of Coverage of “Swasthya Sathi” Scheme

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