What is the Difference Between Swasthya Sathi and WBHS?
Know Difference Between Swasthya Sathi and WBHS
Swasthya Sathi and the West Bengal Health Scheme (WBHS) are government-sponsored health programs. The WBHS focuses mainly on state government employees and pensioners. Meanwhile, Swasthya Sathi provides health coverage for a wider section of the population, including family members associated with self-help groups and ASHA workers.
Although these initiatives aim to ensure better healthcare access, they differ in terms of eligibility, coverage, and overall reach. Identifying the distinction between these schemes can help individuals choose the most suitable option according to their needs.
Let's check out their differences!
How Do Swasthya Sathi and WBHS Differ from Each Other?
Although both Swasthya Sathi and WBHS schemes seek to offer a wide range of healthcare coverage, they differ in several respects, including eligibility, coverage, and financial assistance.
The tabular representation below provides a detailed comparison of the two schemes:
| Aspects | Swasthya Sathi Scheme | WBHS Scheme |
| Year of Launch | The Swasthya Sathi Scheme was launched in 2016. | The West Bengal Health Scheme (WBHS) was launched in the year 2008. |
| Target Audience | Open to all inhabitants of West Bengal, excluding those already covered by other government health insurance schemes or those receiving medical benefits as part of their income. | Primarily aimed at state government employees, pensioners, and their families, as well as All India Services officers and pensioners. |
| Eligibility | The scheme is available to every family in West Bengal without restrictions on occupation, except those already covered under other government insurance schemes. | Eligibility is restricted to government employees, pensioners, and their immediate family members, including dependent parents, children, and siblings. |
| Coverage | Amount Provides coverage of up to ₹5 lakhs per family annually for both secondary and tertiary care, with the entire premium paid by the state government. | Provides cashless treatment up to ₹2 lakhs for indoor treatments in empaneled hospitals. |
| Type of Medical Treatments Covered It covers primary, secondary, and tertiary care, including pre-existing conditions, but it does not cover outpatient (OPD) treatments. Covers a wide range of medical treatments, including surgeries, hospitalization, and certain OPD treatments, with some exclusions. | ||
| Hospital Coverage | Cashless treatment is available at both public and private empaneled hospitals throughout West Bengal, with no limitation on hospital selection as long as it is empaneled. | Beneficiaries can receive treatment only in empaneled hospitals. In the case of non-empaneled hospitals, a partial reimbursement is available. |
| Cashless Hospitalization | Completely cashless treatment for both primary and hospitalization needs, with no upper limit for covered treatments within the ₹5 lakhs family coverage. | Provides cashless treatment up to a limit of ₹2 lakhs, with beneficiaries required to cover any expenses above this amount. |
| Exclusions | It excludes cosmetic treatments and non-medical procedures but provides extensive coverage for other medical expenses, including pre-existing conditions. | Excludes cosmetic surgeries, non-medical treatments, experimental procedures, and some high-cost treatments like organ transplants. |
| Administrative Control | The scheme is managed by the state government, providing beneficiaries with smart cards for easy access to services, while claims are handled via a digital platform. | Administered by the Medical Cell under the Finance Department of the West Bengal Government, in collaboration with the Health and Family Welfare Department. |
| OPD Treatment | Does not cover OPD treatment, focusing instead on hospitalization costs for secondary and tertiary care.
| It provides coverage for OPD treatment as per the terms and conditions, with reimbursement available for regular health expenses. |
How to Enroll and Register under WBHS as a Government Employee?
To enrol and register in the West Bengal Health Scheme (WBHS) as a government employee, just follow the steps below:
Step 1: Go to the West Bengal Health Scheme Portal.
Step 2: Click on ‘Online Enrolment’ in the header and select Government Employee.
Step 3: If you have a PRAN/GPF number, mark the ‘Yes’ box and enter the necessary details. If you do not have this information, mark the ‘No’ box and select Non-GPF.
Step 4: Enter your residential area and date of birth and click next to proceed with the process.
Step 5: Enter your personal information, including your name, address, mobile number, and employee number.
Step 6: Enter your office information and family details.
Step 7: Upload your photo and signature, being in line with the size requirements set.
Step 8: Input information concerning the beneficiary.
Step 9: Provide details regarding the head office.
Step 10: Save your details and print the report for future needs.
How Can I Apply for the Swasthya Sathi Health Scheme?
To register for the Swasthya Sathi program, just follow these four easy steps:
Step 1: Visit the official Swasthya Sathi website.
Step 2: Click 'Apply Online' on the top menu, then select 'Form B for Registration under Swasthya Sathi' from the drop-down list.
Step 3: Print the form and carefully fill out all necessary information.
Step 4: Submit the completed registration form and any required documents to your closest Duare Sarkar Camp.
Even though both Swasthya Sathi and WBHS are state government-operated healthcare schemes, they cover different groups with varying benefits. Knowing these differences can assist people in making better decisions about healthcare coverage.
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