The main features of the Scheme are :
(i) The scheme will have basic health cover for secondary and tertiary care upto Rs. 1.5 Lakhs per annum.
(ii) There will be no cap on the family size.
(iii) Critical illness like, Cancer, Neuro surgeries, Cardiothoracic surgeries, liver diseases, blood disorders etc. will be covered upto Rs. 5 lakh.
(iv) All pre-existing diseases will be covered.
(v) The entire premium will be borne by the State Government with no contribution from the beneficiaries
5. The scheme will be implemented by the Department of Health & Family Welfare, Government of West Bengal. The details of the scheme will be finalised by the Health & Family Welfare Department in consultation with the Finance Department.
ain Features of the Scheme:
• Basic health cover for secondary and tertiary care up to Rs 1.5 Lakh per annum through Insurance mode (PSU) and Critical illness like Cancer, Neuro surgeries, cardiothoracic surgeries, liver diseases, blood disorders etc. up to Rs 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 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, ADHAAR No ( if available)
• 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 turn around 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
• Android based Swasthya Sathi Mobile app for assistance to the beneficiaries
(iii) Critical illness like, Cancer, Neuro surgeries, Cardiothoracic surgeries, liver diseases, blood disorders etc. will be covered upto Rs. 5 lakh.
(iv) All pre-existing diseases will be covered.
(v) The entire premium will be borne by the State Government with no contribution from the beneficiaries
5. The scheme will be implemented by the Department of Health & Family Welfare, Government of West Bengal. The details of the scheme will be finalised by the Health & Family Welfare Department in consultation with the Finance Department.
ain Features of the Scheme:
• Basic health cover for secondary and tertiary care up to Rs 1.5 Lakh per annum through Insurance mode (PSU) and Critical illness like Cancer, Neuro surgeries, cardiothoracic surgeries, liver diseases, blood disorders etc. up to Rs 5 Lakh through Assurance mode.
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•
NIC as insurance partner in 9 District and UIIC in 11 Districts.
Premium per family ranges from Rs 3549 In Kolkata to Rs 1729 in
Dakshin Dinajpur• Paperless, Cashless, Smart Card based.
• There is no cap on the family size and Parents from both the Spouse are included.
• 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, ADHAAR No ( if available)
• 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 turn around 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
• Android based Swasthya Sathi Mobile app for assistance to the beneficiaries
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