Swasthya Sathi Empanelled Hospitals in Kolkata

The Swasthya Sathi scheme, a flagship health initiative by the Government of West Bengal, provides significant financial protection to families across the state. Launched in 2016, this group health insurance scheme offers a basic health cover of up to ₹5 lakh per family per year for secondary and tertiary medical care. It is designed to be accessible and user-friendly, operating on a paperless, cashless, and smart card-based system. This ensures that beneficiaries can receive necessary medical attention without the immediate burden of out-of-pocket expenses.

A key feature of the Swasthya Sathi scheme is its inclusivity. The entire premium is borne by the State Government, making it free for enrolled families. Furthermore, there is no cap on the family size, meaning the head of the family, their spouse, parents, in-laws, and all dependent children can be covered under a single card. The scheme also notably covers all pre-existing diseases from day one, removing a common barrier to accessing health insurance. This page focuses specifically on the network of empanelled hospitals in Kolkata, providing beneficiaries with a guide to accessing care within the city.

Navigating healthcare options can be challenging, and knowing which hospitals accept your health card is the first step. This guide provides a list of some hospitals in Kolkata that are part of the Swasthya Sathi network. It also offers essential information on how to use the scheme, verify a hospital's current status, understand the coverage details, and what steps to take if you encounter any issues during the admission process. The goal is to empower beneficiaries with the knowledge needed to utilize their Swasthya Sathi benefits effectively.

Swasthya Sathi Empanelled Hospitals in Kolkata (Partial List)

This is not an exhaustive list. The empanelment status of hospitals can change. Please verify the current status using the official Swasthya Sathi portal or toll-free number before admission.

• AMRI Hospitals — Multiple Locations
• Apollo Multispeciality Hospitals — 58, Canal Circular Road
• B.M. Birla Heart Research Centre — Alipore
• Belle Vue Clinic — Loudon Street
• Charnock Hospital — Teghoria
• Chittaranjan Seva Sadan & Sisu Sadan — S.P. Mukherjee Road
• Daffodil Hospital — Lake Town
• Desun Hospital and Heart Institute — E.M. Bypass
• Fortis Hospital — Anandapur
• ILS Hospital — Dum Dum
• Institute of Psychiatry — Gobra
• Medica Superspecialty Hospital — Mukundapur
• Peerless Hospitex Hospital and Research Center — Panchasayar
• R. G. Kar Medical College & Hospital — Belgachia
• Rabindranath Tagore International Institute of Cardiac Sciences — Mukundapur
• Ruby General Hospital — Kasba Golpark, E.M. Bypass
• School of Tropical Medicine — Chittaranjan Avenue

Rates shown are as per the Government of West Bengal (2024) and are subject to periodic revision. Always verify the latest approved rates on the official source.

How to Use Your Swasthya Sathi Card in Kolkata Hospitals

Using your Swasthya Sathi card for cashless treatment at an empanelled hospital in Kolkata is a straightforward process. Upon arrival at a network hospital for a planned or emergency admission, you must present your Swasthya Sathi smart card at the hospital's dedicated help desk or billing counter. The hospital staff will use a card reader to verify your identity and the card's validity. Your photograph and other details stored on the card will be matched with the patient.

Once your card is verified, the hospital will initiate a pre-authorisation process with the Swasthya Sathi authorities. This involves submitting the details of the required treatment and estimated costs. After approval, the hospital can proceed with providing cashless services. The patient or their family does not need to pay for the covered treatments up to the ₹5 lakh limit. It is important to ensure that the card is carried by the beneficiary at all times when seeking hospitalisation.

Verifying a Hospital's Current Empanelment Status

The list of hospitals empanelled under the Swasthya Sathi scheme is dynamic, with new hospitals being added and, occasionally, some being removed. Therefore, it is crucial to verify a hospital's current empanelment status before proceeding with admission. Relying on outdated lists can lead to confusion and potential denial of cashless services. The most reliable method for verification is through the official channels provided by the government.

The Government of West Bengal maintains an official portal for the scheme, which features a real-time search tool. Beneficiaries should visit the Swasthya Sathi website (swasthyasathi.gov.in) and navigate to the 'Active Hospital List' section. This online tool allows you to search for empanelled hospitals by district and type (public or private), providing the most current information. Alternatively, you can call the scheme's 24x7 toll-free helpline at 1800-345-5384 to confirm if a specific hospital in Kolkata is currently part of the network.

Coverage and Benefits under the Swasthya Sathi Scheme

The Swasthya Sathi scheme provides a robust package of benefits designed to cover major medical expenses. The primary benefit is the health cover of up to ₹5 lakh per family per annum for secondary and tertiary care hospitalisation. This amount can be used by any or all members of the enrolled family. The scheme covers a wide range of medical and surgical procedures, including costs associated with treatment.

Key aspects of the coverage include:

The scheme covers expenses related to hospitalisation, such as bed charges, nursing fees, consultation fees, surgical fees, and the cost of medicines, implants, and diagnostics. It also covers all pre-existing conditions without any waiting period. Another significant advantage is the absence of a cap on family size. The policy covers the primary beneficiary, spouse, children, and dependent parents from both sides. The entire premium is paid by the state government, meaning families receive these benefits at no personal cost.

Documents Needed for Cashless Admission

To ensure a smooth and quick admission process using the Swasthya Sathi scheme, it is important to have the necessary documents ready. The single most important document is the Swasthya Sathi smart card, which contains all the essential details of the enrolled family members.

When visiting an empanelled hospital for treatment, you should carry the following:

The Swasthya Sathi smart card is mandatory. The patient whose name is on the card must be present. While the card itself is the primary tool for verification, some hospitals may ask for a government-issued photo ID, such as an Aadhaar card or Voter ID, for cross-verification. Having a phone with the number linked to the scheme can also be helpful for any OTP-based verification processes the hospital might use. Keeping these items ready will help expedite the cashless approval and admission procedure.

What to Do if an Empanelled Hospital Refuses the Card

In the rare event that a hospital listed as empanelled refuses to provide cashless services with a valid Swasthya Sathi card, it is important not to panic. Beneficiaries have recourse in such situations. The government has established clear grievance redressal mechanisms to address such issues and ensure that beneficiaries are not wrongfully denied their entitlements.

If you face a refusal, your first step should be to immediately contact the Swasthya Sathi 24x7 toll-free helpline at 1800-345-5384. Inform the representative about the hospital's name, location, and the reason provided for the refusal. Note down the time of your call and the name of the person you spoke with for your records. The support team can often intervene directly by speaking with hospital authorities to resolve the issue. Reporting such incidents is crucial not only for your own treatment but also for holding the hospitals accountable to their agreement with the scheme.

Frequently Asked Questions

Is there a limit on the family size for the Swasthya Sathi scheme?

No, there is no cap on the family size under the Swasthya Sathi scheme. It covers the beneficiary, their spouse, children, and dependent parents of both the beneficiary and their spouse, regardless of the number of members.

Does Swasthya Sathi cover pre-existing diseases?

Yes, one of the major benefits of the Swasthya Sathi scheme is that it covers all pre-existing diseases from the very first day of policy enrollment. There is no waiting period for coverage of these conditions.

How can I find the most up-to-date list of empanelled hospitals in Kolkata?

The most reliable method is to use the 'Active Hospital List' search tool on the official Swasthya Sathi website (swasthyasathi.gov.in). You can also call the 24x7 toll-free helpline at 1800-345-5384 to confirm a hospital's current empanelment status.

What is the total coverage amount provided under the Swasthya Sathi scheme?

The scheme provides a basic health cover of up to ₹5 lakh per family per annum for secondary and tertiary care. This amount can be utilized by any or all members of the family for eligible hospitalisation expenses.

Can I use the Swasthya Sathi card for treatment in hospitals outside West Bengal?

Yes, the scheme offers portability for treatment in certain empanelled hospitals outside of West Bengal. It is essential to check the list of such hospitals and confirm coverage by contacting the Swasthya Sathi helpline before seeking treatment.

What should I do if my Swasthya Sathi card is lost or damaged?

If your card is lost or damaged, you should report it and apply for a duplicate card through the designated government channels. You can contact the Swasthya Sathi helpline or visit a registration center for assistance with the re-issuance process.

Related

• Swasthya Sathi in West Bengal: eligibility and how to enrol
• Government hospital OPD appointment guides in West Bengal
• Mukhyamantri Swasthya Bima Yojana: which state scheme is it?

Medical Disclaimer

The information provided in this article is for general informational and educational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.