Su Swasthya Yojana

Su Swasthya Yojana is a flagship healthcare services scheme launched by the Sikkim government in April 2020. It aims to provide cashless healthcare services to the Sikkim government employees and their dependents at empaneled hospitals across the country. Sikkim Su Swasthya Yojana covers up to Rs. 10 lakh per year for medical treatment of the beneficiary and their dependents. The scheme covers expensive treatments like cancer care, vehicular accidents, trauma, and also infertility. The scheme has envisioned placing the healthcare of the Sikkim government’s employees and their families as the top priority and aims to ensure that quality healthcare is easily accessible and also affordable.

Su-Swasthya Yojna Salient Features

The main features of the Su-Swasthya Yojana are the following: 

 

  • It provides cashless health care services to government employees of Sikkim and their dependents. 

  • It provides healthcare cover up to Rs. 10 lakhs and an additional Rs 10 lakh as critical care cover. 

  • It covers expensive treatments like IVF, trauma care, critical illnesses, and cancer from day one after enrollment.

  • There is no age limit for physically or mentally challenged children, siblings, or unmarried unemployed dependent daughters.

  • Pre-existing illnesses are also covered from Day one after successful enrolment under the scheme

Su Swasthya Yojana Coverage Benefits

The Sikkim Su Swasthya Yojana offers a wide range of benefits that ensures you will be covered for all kinds of treatments and ensures that it remains affordable and accessible at the same time. Here is a list of benefits offered under the scheme:

 

  • In the case of in-patient treatment, the scheme covers hospitalisation expenses for a period of more than 24 hrs. 

  • The Sikkim Su Swasthya Yojana scheme covers the expenses incurred for transportation by private ambulance service from home or from one hospital to another hospital. 

  • The scheme covers the post-hospitalisation medical expenses incurred up to 30 days from the date of discharge from the hospital.

  • The scheme covers daycare dental and ophthalmic treatment as well.

  • The scheme also covers expenses incurred for organ transplantation. 

 Who is Eligible for Su Swasthya Yojana?

The basic eligibility criteria to avail the benefits of the Sikkim Su Swasthya Yojana are:

 

  1. You must be a permanent resident of Sikkim.

  2. You must be an employee of the Sikkim government.

  3. Any of the following family members who are dependent on the employee are eligible: 

  • Parents of the primary member or spouse. Step-parents are excluded. 

  • Legally wedded spouse of the primary beneficiary member. A legally divorced spouse cannot be added as a dependent. 

  • Biological or legally adopted children of the primary beneficiary as below:

  1. Unemployed unmarried male child upto the age of 30 years.

  2. Unemployed unmarried female child of any age.

  3. Unmarried unemployed child suffering from certified mental or certified physical disability preventing gainful employment of either gender upto any age till the tenure of employment of the primary beneficiary member.

  4. Unmarried and unemployed biological brother and/or sister age of 30 years.

  5. Unmarried and unemployed biological brother and/or sister suffering from certified mental or certified physical disability preventing gainful employment of upto any age till the tenure of employment of the primary beneficiary member.

 

The primary beneficiary can register a maximum of five dependents under the scheme.  The beneficiary is, however, at liberty to select any combination of family members from the list of eligible dependents and enrol five dependents in the scheme.

Documents Required 

Here is a list of important documents needed to avail the benefits of Su Swasthya Yojana: 

 

a. Passport Size Photo

 

b. Identity Proof

 

Anyone of these documents is needed as proof of identity of the employee and their dependents:

 

  • Voter’s Card.

  • Aadhar Card.

  • Driver’s licence.

  • Passport.

  • Any other government ID.

c. Anyone of these documents is needed as proof of relationship between the employee and dependent:

 

  • Aadhar Card.

  • Voter’s ID.

  • PAN Card.

  • Passport.

  • Driver’s Licence.

  • Hospital Discharge Card attested by a gazetted government official for newborn babies.

  • Birth Certificate.

  • Immunization Certificate.

  • School Certificate attested by the school authority and gazette government official.

  • Marriage Certificate.

  • Affidavit attested by a gazetted government official in lieu of no government issue proof.

Process To Apply For Sikkim Su Swasthya Yojana

There are several online and offline options available if you want to apply for Sikkim Su Swasthya Yojana. While online methods save time and energy, offline application methods may require more effort.

Paper Applications

The Su Swasthya Yojana application form can be downloaded from the official website and filled in clear handwriting, and submitted with necessary documents and photos to the department nodal officer. Each governmental department in Sikkim has a nodal officer in charge of the enrollment of employees in their respective departments.

Email Application

The application form can be downloaded from the official website. It needs to be filled out and can be submitted via email to support@suswasthasikkim.com, along with all documents and photos attached.

Online Application

If you are a permanent resident of Sikkim and if you are an employee of the Sikkim government, you can apply online for Sikkim Su Swasthya Yojana. Here is how you can apply online for the scheme:

 

As an Employee

 

  • Visit the official website of Su Swasthya Yojana.

  • Click on the option of “I’m An Employee”.

  • Enter your Mobile Number and click on send OTP option.

  • Enter the OTP sent to your mobile number.

  • Enter the details asked in the registration form.

  • Attach your documents.

  • Click on the Submit option.

I’m An Employer

 

  • Visit the official website of Su Swasthya Yojana and click on the option of, “I’m An Employer.”

  • Enter your Mobile Number and click on Send OTP option.

  • Enter the OTP that is sent to your mobile number.

  • The registration form will appear. Enter the details that are asked in the form.

  • Attach your documents.

  • Click on the Submit option.

As A Provider

 

  • Visit the official website of Su Swasthya Yojana.

  • Click on the option of “I’m A Provider.”

  • Now enter your Mobile Number and click on Send OTP option.

  • Enter the OTP sent to your mobile number.

  • Enter the details in the registration form that now appears in front of you.

  • Attach all your important documents.

  • Click Submit.

Sikkim Su-Swasthya Yojana Login Procedure

If you have registered yourself for Sikkim Su Swasthya Yojana, here is how you can login: 

As An Employee

  • Visit the official website of Su Swasthya Yojana.

  • On the homepage, look under the Login section.

  • Click on the option of Employee.

  • Then enter your Mobile Number and click on Send OTP option.

  • Enter the OTP sent to your phone and click on the Login option.

As An Employer

  • Visit the official Website of Su Swasthya Yojana.

  • On the homepage, look under Login and click on the Employer option.

  • Enter your Mobile Number and click on Send OTP option.

  • You will receive an OTP on your mobile number.

  • Enter the OTP and click on the Login option.

As A Hospital

  • Visit the Official Website of Su Swasthya Yojana.

  • On the homepage, look under the ‘Login’ section.

  • Click on the option of Hospital.

  • Enter your Mobile Number and click on Send OTP option.

  • You will receive an OTP on your mobile number.

  • Enter the OTP and click on the Login option.

Find A Hospital Under Sikkim Su-Swasthya Yojana

If you want to find a hospital under Sikkim Su Swasthya Yojana, you can refer to the below process:

 

  • Visit the official website of Su Swasthya Yojana.

  • On the homepage, click on Find A Hospital.

  • A new webpage will appear with a list of hospitals.

Process To Search A Member ID

You can search a member’s ID by following the following steps:

  • Visit the official website of Su Swasthya Yojana.

  • On the homepage, look under the section of Services.

  • Then click on the option of Member ID.

  • Then click on the Login option.

  • Here you will get the member ID.

Process To Start A New Claim

If you are registered under Sikkim Su Swasthya Yojana and you want to initiate a new claim, you can do so by following the following steps:

 

  • Visit the official website of Su Swasthya Yojana.

  • On the homepage, look under the section of Services.

  • Here click on the option of Start A New Claim.

  • Then click on ‘Apply For New Claim’.

  • A claim form will appear.

  • Enter the details asked in the form.

  • Click on the Submit option after you have entered the details.

  • When you click the ‘submit’, your new claim is submitted.

Process To Track Claim

If you have submitted a claim and want to track your claim, here are the steps that you have to follow: 

 

  • isit the official website of Su Swasthya Yojana.

  • On the homepage, look under the section of Services.

  • Click on the option of Track Claims.

  • Enter your Claim ID.

  • After entering the details, click on the Search option.

  • The claim status will appear on your screen.

Conclusion

Sikkim Su Swasthya Yojana is a cashless health care scheme for employees of the Sikkim government and their dependent family members. The scheme aims to provide quality health services and cover expensive treatments immediately after enrolling. Su Swasthya Yojana is an extraordinary welfare scheme drafted with a vision to secure the lives of citizens without putting a financial burden on their families. 

 

While this scheme covers Sikkim government employees and their dependents, it proves the importance of health insurance schemes in safeguarding lives during times of unforeseen crises. If you want to financially safeguard yourself and your family with a health insurance policy, Bajaj Markets platform provides a wide range of health insurance policies and a hassle-free, smooth purchasing experience. 

FAQs

  • ✔️ What is Sikkim Su Swasthya Yojna?

    Sikkim Su Swasthya Yojana is a healthcare welfare scheme launched by the Sikkim government in April 2020. It provides financial cover for treatment to Sikkim government employees and their dependents.

  • ✔️ Who benefits from Su Swasthya Yojana?

    Employees of the Sikkim government and their dependent family members benefit from this scheme.

  • ✔️ Does Su Swasthya Yojana cover organ transplantation?

    Yes, Sikkim Su Swasthya Yojana covers the expenses incurred for organ transplantation from the donor to their beneficiary recipient. The scheme also covers the expenses incurred by the donor if the donor suffers any complication resulting in surgery or ICU admission. It will cover the donor’s expenses with a maximum expense of Rs. 10 lakh, and anything beyond the claim shall be borne by the beneficiary.

  • ✔️ How much financial cover does the Su Swasthya Yojana offer?

    The Su Swasthya Yojana covers Sikkim government employees and their dependent family members, up to a maximum of five dependents, and provides Rs 10 lakh of cover to the family per year.

  • ✔️Does this scheme cover expenses for dental implants?

    Yes, Su Swasthya Yojana covers expenses incurred for implants on acute treatment to a natural tooth or teeth by a licenced dentist for a maximum of Rs 25,000 per implant for a maximum of four implants only. 

  • ✔️ Is a newborn child covered under the Su Swasthya Yojana?

    Yes, a newborn child is covered under the scheme till the age of one year. After the completion of one year, the child must be enrolled in Su Swasthya Yojana as a dependent.

  • ✔️Does this scheme cover the post-hospitalisation expenses?

    Yes, Su Swasthya Yojana does cover the post-hospitalisation expenses for a period of up to 30 days from the date of discharge. 

  • ✔️Does Su Swasthya Yojana cover pre-existing diseases?

    Yes, the scheme covers pre-existing diseases immediately after successful enrollment.

  • ✔️ Does Su Swasthya Yojana cover my expenses incurred from medical diagnostic purposes?

    No, Su Swasthya Yojana does not cover hospital admission primarily for investigation or diagnostic purposes.

  • ✔️ Does this scheme cover for treatment outside India?

    No, Su Swasthya Yojana does not cover for treatment outside India.

  • ✔️How many hospitals are empanelled with Su Swasthya Yojana?

    There are more than 400 hospitals across India that are empanelled with Su Swasthya Yojana.

  • ✔️Who is eligible to be a dependent under the Su Swasthya Yojana?

    Here is a list of eligible dependents under the Sikkim Su Swasthya Yojana: 

    1. Parents of the primary member or spouse.

    2. Legally wedded spouse of the primary beneficiary.

    3. Unemployed unmarried male child upto the age of 30 years.

    4. Unemployed unmarried female child with no age bar.

    5. Unemployed child suffering from certified mental or physical disability. Age no bar. 

    6. Unemployed unmarried biological brother or sister upto the age of 30 years.