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Main Features of the Scheme :

  • 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

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.
  • The entire premium is borne by the State Government and no contribution from the beneficiary.
  • Online Swathyasathi Smart card is provided to each family on the day of Enrolment. 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 turnaround 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
  • 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.

Services Provided at Swasthya Sathi Kiosk :

  • Enrollment of beneficiaries.
  • Addition of dependents’ names on the beneficiaries’ cards.
  • Re-print of cards (in case of lost OR damaged OR chip error).

Services Provided at Swasthya Sathi Cell :

  • Arrangement of providing Swasthya Sathi cards to the beneficiaries on urgent basis.
  • Correction of name, age, aadhar number etc in the server against Swasthya Sathi URN.
  • Searching of names of eligible beneficiaries using UID, Ration Card No, Phone number.

Arrangement of providing the duplicate re-printed cards(in case of lost OR damaged OR Chip error).

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