Swasthya Sathi (স্বাস্থ্য সাথী) — West Bengal's Free Health Insurance Scheme

Swasthya Sathi is West Bengal's flagship universal health insurance scheme providing ₹5 lakh per family per year of completely free, cashless hospitalisation. Launched in December 2016, it now covers over 2.42 crore families across the state with 2,800+ empanelled hospitals.

Similar to Ayushman Bharat at the national level, but Swasthya Sathi covers all West Bengal families — not just BPL households.

Who Is Eligible?

Swasthya Sathi is a universal scheme — almost every family in West Bengal qualifies:

• All families with a West Bengal ration card (digital or physical)
• No income limit — covers APL and BPL families alike
• No cap on family size — parents of both spouses are included
• Dependent physically challenged family members are also covered
• 100% government-funded — zero contribution from the beneficiary

You are eligible if:

1. You are a resident of West Bengal
2. Your family holds a valid ration card issued by the West Bengal government

That's it. No income proof, no BPL certificate needed.

What Does Swasthya Sathi Cover?

Coverage Amount

What's Included

• ✅ All pre-existing diseases — covered from day one
• ✅ Hospitalisation (IPD) — room, nursing, ICU, medicines
• ✅ Surgeries — general, orthopaedic, cardiac, cancer, neuro, etc.
• ✅ Pre-hospitalisation expenses (up to 15 days before admission)
• ✅ Post-hospitalisation follow-up (up to 15 days after discharge)
• ✅ Medicines, diagnostics, and consumables during treatment
• ✅ Maternity and newborn care
• ✅ Dialysis, chemotherapy, radiotherapy

What's NOT Covered

• ❌ OPD (outpatient) consultations (unless converted to IPD)
• ❌ Cosmetic surgery
• ❌ Substance abuse treatment
• ❌ Dental treatment (unless hospitalisation is required)

How to Get Your Swasthya Sathi Smart Card

The Swasthya Sathi card is a biometric smart card issued in the name of the woman head of the family.

Step-by-Step Process

1. Attend a Duare Sarkar (দুয়ারে সরকার) camp — these are held regularly at the block/ward level across West Bengal
2. Carry these documents:
   • Ration card (mandatory)
   • Aadhaar card of all family members
   • Mobile number
3. Biometric enrolment — fingerprints and photographs of all family members are captured on-site
4. Instant card issuance — the smart card is printed and handed over on the same day
5. Card is issued in the woman head's name — empowering women as the family's health guardian

Can't find a camp?

• Call the toll-free helpline: 1800-345-5384 (24×7)
• Visit your nearest Block Development Office or Municipal office
• Check the official website for camp schedules

How to Use Swasthya Sathi at a Hospital

At the Time of Admission

1. Go to any empanelled hospital (government or private)
2. Show your Swasthya Sathi smart card at the Swasthya Sathi help desk
3. Deposit the card at the hospital within 24 hours of admission (mandatory)
4. The hospital will verify your identity via biometric/photo and block the required amount on your card
5. No payment needed — treatment is completely cashless

During Treatment

• All medicines, diagnostics, and procedures are covered under the package rate
• You will receive SMS alerts on your registered mobile for every transaction
• If you need to check your remaining balance, use the Swasthya Sathi mobile app (available on Google Play)

At Discharge

• The hospital settles the claim directly with the government
• You receive a discharge slip showing the amount deducted
• Your smart card is returned to you
• An e-health record is uploaded online in real-time

Finding Empanelled Hospitals

With 2,800+ hospitals empanelled (both government and private), finding one near you is easy:

• Online: Visit swasthyasathi.gov.in → Hospital Search
• Mobile App: Download "Swasthya Sathi" from Google Play Store → tap "Active Hospitals"
• Helpline: Call 1800-345-5384 (toll-free, 24×7)

Hospital Grades

Hospitals are graded based on facilities and infrastructure:

You are free to choose any empanelled hospital regardless of grade.

Claim Process

You don't need to file any claim yourself. The process is fully cashless and paperless:

1. Hospital submits a pre-authorisation request online
2. The request is approved within 24 hours
3. After discharge, the hospital submits the final claim
4. Government reimburses the hospital within 30 days (interest charged on delays)
5. 98.45% of claims have been settled successfully (as of December 2025)

If You Face Issues

• Call the 24×7 helpline: 1800-345-5384
• File a grievance online at swasthyasathi.gov.in
• The scheme has an online grievance monitoring mechanism with escalation matrix

Renewal and Validity

• The Swasthya Sathi card renews automatically every year — no separate renewal process
• Coverage resets to ₹5 lakh at the start of each policy year
• If you add a new family member, visit the next Duare Sarkar camp to update your card
• Lost card? Call the helpline or visit a camp for a replacement

Swasthya Sathi vs Ayushman Bharat — Key Differences

Note: West Bengal has opted out of the central Ayushman Bharat (PM-JAY) scheme. Swasthya Sathi is the state's own alternative with broader coverage.

Quick Reference

Frequently Asked Questions

Is Swasthya Sathi really free?

Yes. The entire cost is borne by the West Bengal state government. You pay nothing — no premium, no co-pay, no deductible.

Can I use it at private hospitals?

Yes. Both government and private hospitals that are empanelled under the scheme accept Swasthya Sathi cards.

Is OPD covered?

No. Only hospitalisation (IPD) is covered. However, if an OPD visit leads to hospitalisation, the entire treatment cost is covered.

What if my card balance runs out?

The ₹5 lakh limit resets every year. If you exhaust it within a year, you'll need to pay out-of-pocket or wait for the next policy year.

Can I use Swasthya Sathi outside West Bengal?

The scheme primarily covers treatment at empanelled hospitals within West Bengal.

Do I need Aadhaar for Swasthya Sathi?

Aadhaar is required for enrolment and biometric verification at hospitals.