SU-SWASTHA YOJANA

"Su-Swastha Yojna" provides comprehensive and affordable healthcare coverage to the employees of the Government of Sikkim and their families. Cashless hospitalization at top-tier hospitals across India is provided to eligible beneficiaries with the best-in-class healthcare.

Launched in April 2021, the scheme "Su-Swastha Yojna" by the Department of Health & Family Welfare, Government of Sikkim aims to provide comprehensive and affordable healthcare coverage to the employees of the Government of Sikkim and their families. Through this scheme, cashless hospitalization at top-tier hospitals across India is provided to the eligible beneficiaries. The scheme covers regular employees in service of the Government of Sikkim and dependent family members up to a maximum of 5 dependents in a scheme that provides 10 lacs of cover to the family per year.

The applicant should be a regular employee in service of the Government of Sikkim or the dependent family members of such employee (spouse; brother and/or sister; children (own or legally adopted); parents of self or spouse) (up to a maximum of 5 dependents).

Cashless Convenience: Cashless admission and discharge across network hospitals eliminate the burden of arranging funds during hospitalization.

Access to Top-Tier Healthcare: Beneficiaries gain access to best-in-class healthcare by leveraging a network of top-tier hospitals and institutes across India.

Quality Assurance: The Su-Swastha Facilitation Center ensures quality of care by overseeing medical services provided to beneficiaries.

Transparent Billing: Standardized tariffs with hospitals based on infrastructure and quality of care promote transparency in billing.

Patient-Centric Approach: Communication with patients and their families is maintained throughout the care journey.

Wide Network Coverage: Beneficiaries can avail of the scheme's benefits at over 400+ empanelled hospitals within the Su-Swastha Yojna network.

Comprehensive Coverage:

• Base Cover - 10 lacs base cover.
• Critical Care Coverage - 10 lacs additional critical care coverage for the entire family, regardless of the number of dependents.

In-Patient Treatment: Covers hospitalization expenses exceeding 24 hours.

Road Ambulance Assistance: Covers road ambulance expenses up to ₹3500 per hospitalization, with a maximum of 3 claims per year.

Pre-existing Disease Coverage: Covers all pre-existing diseases from the first day of enrollment.

Post-Hospitalization Care: Covers medical expenses incurred within 30 days of hospital discharge.

Specialized Coverage: Includes coverage for special conditions, treatments, implants, vehicular accidents, and trauma.

Maternity Benefits: Covers delivery expenses up to ₹50,000, including newborn baby cover.

Dental and Ophthalmic Care: Covers daycare dental and ophthalmic treatments, including implants.

Organ Donor Expenses: Covers expenses incurred for organ transplantation from a donor to a Su-Swastha beneficiary, subject to claim eligibility criteria.