Swasthya Sathi Covers 74.5% of State Population; Rs 13,740 Crore in Claims Settled

MP, 15 Feb 2026, Kolkata: The West Bengal government’s flagship health insurance scheme, Swasthya Sathi, has emerged as one of the largest state-funded healthcare programmes in the country. According to official figures, 2.45 crore families have been brought under its ambit, which constitutes 74.5% of the total population of the state, while over 8.51 crore people are now secured under the scheme.

More than 2,900 hospitals and nursing homes have been empanelled, enabling beneficiaries to avail cashless treatment across the state. The government also claims that over 1.04 crore people have already received medical services under the initiative, with claims worth Rs 13,740 crore settled so far.

Launched as a universal health coverage programme, Swasthya Sathi provides up to Rs 5 lakh per family per year for secondary and tertiary care. The smart card for the scheme is issued in the name of the woman head of the household, a move the state government describes as a step towards strengthening women’s empowerment within families. Unlike income-based schemes, Swasthya Sathi covers all residents of the state who are not already enrolled in other government health insurance programmes, positioning healthcare as a right rather than a conditional benefit.

In a recent development, the state government has allowed four additional surgeries to be conducted in private hospitals under the Swasthya Sathi scheme. People in Bengal will now be able to undergo hernia operations, hydrocelectomy, fissurectomy, and arthroscopic surgeries in private hospitals under the state government’s flagship health scheme. The inclusion of these procedures is being seen as a significant step in widening the scope of services available to beneficiaries.

The expansion comes amid renewed political debate over the comparative merits of Swasthya Sathi and the Centre’s Ayushman Bharat. The ruling Trinamool Congress has repeatedly maintained that the state’s model is more inclusive in both intent and execution. Party leaders argue that while Ayushman Bharat is bound by multiple eligibility criteria, Swasthya Sathi extends coverage without exclusions based on asset ownership or socio-economic filters.

They also contend that issuing cards in the name of women reflects a conscious welfare design that prioritises gender equity—an aspect they claim is absent in the central scheme. TMC leaders have further asserted that Swasthya Sathi’s universal approach and direct state funding ensure smoother implementation and wider reach.

As the scheme continues to expand its coverage and add new services, the state government maintains that it represents a more comprehensive and humane alternative, reinforcing its claim that Swasthya Sathi stands superior in serving the healthcare needs of West Bengal’s population.