Gangtok: Su-Swastha Yojana, the health service scheme initiated by the state government, will roll out from October 1. Regular government employees of the state, including various PSUs and central government establishments on deputation who have enrolled for the scheme can avail of the services.
At a press conference, senior government officials informed that a total of 56,280 beneficiaries have been enrolled under the scheme to date, which includes 21,062 primary memberships of government employees.
Su-Swastha Yojana is a cashless health plan that covers 400+ top-tier hospitals for all routine and critical illnesses for 1+5 dependents to the employees of the Government of Sikkim. It offers cashless Inpatient (IPD) medical treatment of up to Rs 10 lakh and up to 20 lakh for critical illnesses, the highest coverage in India. In-patient treatment covers hospitalisation expenses for all admissions related to medical and surgical treatments for a large number of illnesses. There is no referral procedure.
An employee can avail treatment from the hospital of his/her choice from a list of empanelled hospitals. There is no waiting period for coverage. Pre-existing diseases of the beneficiaries are also covered from day one for an enrolled member. It provides healthcare security to employees and their dependents. An employee can add up to five family members (1+5) as dependents to avail of benefits under this scheme. Parents (Mother/father) and parents-in-law (mother-in-law/father-in-law) of applicants can be up to 100 years of age. Age limit for unmarried & unemployed sibling brother/sister) is 30 years. The age limit for an unmarried & unemployed son is 30 years. There is no age limit for unmarried & unemployed daughters. Likewise, there is no age limit for dependent children and siblings with certified mental or physical disabilities.
A beneficiary can choose from any of the leading hospitals in all major cities across India that are empanelled with Su Swastha Yojana. Option of mid-term addition and deletion of members is available (in the case of birth of a child, marriage, death of a member etc.) 24 X 7 helpdesk and call centre for hospitalization assistance is provided.
A help-desk is present in all hospitals for support and assistance. Members avail of post-hospitalisation benefits of up to 30 days from the date of hospital discharge. This covers post-discharge expenses like medicine, follow-up treatments and tests. There is an emphasis on women’s health with maternity benefits up to Rs 50,000/- for normal & caesarean delivery, and IVF (In-Vitro Fertility) treatment with coverage up to 2.0 lakhs. For a newborn child, health coverage of the child starts from day one of enrolment.
Further details of the scheme and the enrolment procedure is available on the website.
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