- NET Web Desk
The Sikkim Government is all set to roll-out it’s landmark health service scheme, ‘Su-Swastha Yojana’ from October 1, 2021.
Regular government employees of the state including various PSUs and central government establishments who have enrolled for the scheme can avail the services.
This was informed by the Secretary, CM Office (CMO), S.D. Dhakal in a press conference held at Tashiling Secretariat,
Dhakal informed that a total of 56,280 beneficiaries have been enrolled under the scheme till date, which includes 21062 primary memberships.
The Secretary stressed that Su-Swastha Yojana has been devised by the State Government after a series of consultations with concerned stakeholders.
It has been initiated to derive the best possible health care support for the state government employees.
He added the scheme is offered at the lowest premium and highest coverage.
Besides, one can also access the facility of cashless treatment in over 400 reputed hospitals across the country.
He explained that significant implementations of the scheme will be monitored by a Steering Committee headed by the Chief Secretary.
DG-cum-Secretary, Health, Dr. Pempa T. Bhutia informed the scheme will cover all primary beneficiary and five other members of the family as per the criteria laid down.
He urged the beneficiaries to use the services judiciously.
Besides, the scheme incorporates of two aspects, namely – cashless treatment, and reimbursement.
He said that beneficiaries can avail the cashless treatment in reputed private hospitals.
While the reimbursement facility can be availed in case of mission hospitals, semi-government and government hospitals.
He stated that Government employees who have not enrolled on the scheme will not be entitled for the reimbursement facility.
Su-Swastha Yojana, a cashless health plan covers 400+ top tier hospitals for all routine and critical illnesses for 1+5 dependents to the employees of Sikkim Government.
It offers Cashless Inpatient (IPD) medical treatment of upto 10 lakhs & 20 lakhs for critical illnesses.
This has been considered as one of the highest coverage in the nation.
Meanwhile, In-Patient treatment covers hospitalization expenses for all admissions related to medical and surgical treatments for a large number of illnesses.
With no referral procedure, an employee can avail treatment from the hospital of his/her choice from a list of empanelled hospitals.
Besides, one do not need to wait for a specific 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.
The Parents (Mother/Father) and Parents-in-law (mother-in-law/father-in-law) of applicants can also be aged 100 years, in order to avail the service.
Age limit for unmarried & unemployed sibling brother/sister) is 30 years.
The age limit for an unmarried & unemployed son should be about 30 years of age.
However, no age limit is mentioned 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 also available (in case of birth of a child, marriage, death of a member etc.).
Beneficiaries can access the facilities through a 24 X 7 helpdesk and call centre for all hospitalization assistance.
A Helpdesk is present in all hospitals for further support and assistance of the aforementioned matter.
Members can avail post-hospitalization benefits for 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 the enrollment process.
This scheme will cover Daycare procedures such as Dental and Ophthalmic treatment (non-cosmetic), Dialysis, Radiotherapy, Chemotherapy for Cancer patients, Angiography, Endoscopic treatment etc.
Vehicular accidents and Trauma are also covered.
In case of an emergency hospital admission, cashless reimbursement will be issued.
The details of the Scheme and enrolment procedure is available on the website www.suswasthasikkim.com.