Swasthya Sathi Scheme West Bengal: Benefits & Guide

Posted on: Oct 16, 2025 | 3 mins | Written by: None

Swasthya Sathi Scheme West Bengal: Benefits & Guide

Healthcare expenses have become a growing concern for families across India. A few years back, if someone were suffering from a mere cold and cough, the prescription and consultation charges would come to around ₹300–500. But now, for the same illness, you might end up spending a few thousand rupees. To address the financial hurdles related to medical crises, many state governments have started offering health insurance schemes to their resident citizens. One such scheme that we will discuss today is the West Bengal Swasthya Sathi Health Scheme.

What is the Swastha Sathi Scheme?

The Swastha Sathi scheme is an initiative by the West Bengal government to offer cashless healthcare facilities of up to ₹5 lakh per family on an annual basis. To offer coverage, beneficiaries are provided with a smart health card that has their biometric and demographic details. To date, the scheme covers over 2.5 crore families and has pre-approved over 95 lakh hospitalisations.

Features of the Swasthya Sathi Scheme

Some of the key features of the Swasthya Sathi Scheme include:

• The empanelment committee approves the hospitals offering the Swasthya Sathi scheme after reviewing multiple parameters. To date, the scheme is provided at over 2800 hospitals.

• Within 24 hours of your admission, all the treatment and procedures required for your well-being are pre-authorised.

• Your health records are updated and uploaded immediately after you are discharged from the hospital and are reflected on the portal.

• In case your health card is suspended for any reason, or for any treatment you receive on it, a notification is sent immediately.

• You can get 24/7 assistance by calling the toll-free number 1800-345-5384.

• You also have the option of raising a complaint in the grievance section of the Swasthya Sathi application or portal.

• The scheme to date has settled 98.07% of the claims out of the total claims received.

Benefits of the Swasthya Sathi Health Scheme

Swasthya Sathi scheme offers the following perks:

• The scheme offers basic medical coverage for both tertiary and secondary care for up to ₹5 lakhs.

• The scheme offers cashless cover; you only need to show your smart health card at the reception counter, and from there, they will take care of the rest.

• Even if you have a pre-existing disease, the scheme covers that as well.

• The scheme offers no restriction on family size, and besides your parents, your parents-in-law are also covered.

• The coverage also extends to physically able family members.

• The state government will bear the entire cost, and you, as a beneficiary, do not have to make any contribution.

Eligibility Criteria for the Swasthya Sathi Scheme

To access the Swasthya Sathi coverage, you must satisfy the following criteria.

• You must be a resident of West Bengal.

• A self-help group can also apply.

• If you are an Integrated Child Development Services (ICDS) or Social Health Activists (ASHA) worker, you qualify.

• In some cases, contractual employees also qualify.

• If you belong to a low-income family under the deprivation criteria outlined in the Socio-Economic Caste Census (SECC), you are eligible.

Note: From December 1, 2020, the scheme offers universal coverage to include all residents, irrespective of their caste, religion, and profession. However, exemptions still apply to high-income families or those who have medical coverage under different government schemes.

How Do You Apply for the Swasthya Sathi Scheme Online?

To apply for a Swasthya Sathi card online, follow the steps below:

• Step 1: Visit the Swasthya Sathi portal.

• Step 2: Go to the drop-down menu and choose your district, municipality, and caste category.

• Step 3: Share your name, address, pincode, and details of the head of the family.

• Step 4: Share your employment details, if applicable. Confirm if any family member is covered under any other government health scheme.

• Step 5: Enter your family members’ details, such as their UID number, ration card details, and a few others.

• Step 6: Provide the required details.

• Step 7: Submit your application. Your screen will display a unique registration number; keep it handy for future reference.

What Documents are Required to Apply for the Swastha Sathi Scheme?

To apply for this medical insurance scheme, you will need the following documents:

• Submit your Aadhar card to prove your identity.

• If Aadhar is not available, you need to submit a government-issued photo ID card.

• A domicile certificate to prove your residence status

• If you belong to a low-income family, a ration card is required

• Recent photographs

• SECC ID card (if applicable)

Conclusion

The Swasthya Sathi scheme offers medical coverage to residents of West Bengal. However, sometimes the coverage of ₹5 lakhs may fall short. This is where you will feel the need for comprehensive critical health insurance. With an individual or family floater plan, you have the flexibility to choose the sum insured. Individual and family plans also cover pre- and post-hospitalisation expenses necessary for recovery.

FAQs

1. Who is eligible for the Swastha Sathi Scheme?

The scheme is available to all permanent residents of West Bengal. It has no limit on the number of covered family members. The coverage also extends to the parents-in-law of the cardholder.

2. How does cashless treatment work?

To avail medical services, the beneficiary needs to show their smart health card at the empanelled hospital. The hospital will then pre-authorise the treatment and settle the bill directly under the scheme.

3. What documents are required for registration?

To register, the eligible person must present their Aadhaar card, Voter ID card, Ration card, proof of residence in West Bengal, and a passport-size photo.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

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