Sikkim Su-Swasthya Yojana

The Sikkim Su-Swasthya Yojana scheme aims to facilitate cashless healthcare services for Sikkim government employees and their dependents at affiliated hospitals nationwide. Under this scheme, beneficiaries and their dependents are provided coverage of up to Rs. 10 lakh annually to address various medical needs, including costly treatments such as cancer care, trauma, vehicular accidents, and infertility.

SSSY aims to bridge the gap in healthcare access by offering financial protection against catastrophic health expenses, ensuring that no individual working for the Sikkim government has to forgo necessary medical treatment due to financial constraints.

The scheme aims to ensure that quality healthcare is readily accessible and affordable by emphasising the health and well-being of Sikkim government employees and their families.

Also, by integrating both preventive and curative aspects of healthcare, Sikkim Su-Swasthya Yojana not only addresses immediate healthcare needs but also works towards building a healthier and more resilient population for the future.

To be eligible for the Sikkim Su-Swasthya Yojana application, individuals must satisfy the following criteria:**

• Residency Requirement: Applicants must be permanent residents of Sikkim.

• Employment Status: Applicants should be employees of the Sikkim government.

Additionally, eligible family members must fulfil the following criteria under the Su-Swasthya Yojana:

• Parents: Parents or spouses of the primary member are eligible, excluding step-parents.

• Spouse: Legally wedded spouses are eligible; however, divorced spouses are not considered eligible beneficiaries.

• Children: Biological or legally adopted children are eligible, including:**

  • Unemployed unmarried daughters of any age.

  • Unemployed and unmarried biological brothers and/or sisters up to the age of 30.

  • Unemployed unmarried sons up to the age of 30.

  • Unmarried and unemployed children with certified and diagnosed physical or mental disabilities that prevent them to attain gainful employment are eligible, not restricted to a certain age up to any age during the employment tenure of primary beneficiary.

  • Unmarried and unemployed biological brothers and/or sisters with certified mental or physical disabilities that prevent them from gaining employment are considered eligible up to no particular age during the primary beneficiary's employment tenure.

  • Furthermore, it's essential to note that the beneficiary can enrol a maximum of five dependents, with the flexibility to select any family members for coverage from the provided list.

1. The following outlines the documents necessary for enrollment in the Sikkim Su-Swasthya Yojana:

• To Prove Personal Identification:

• Submit a passport-sized photograph of yourself.

• For identity verification, any of the following documents can be used:

• Driver’s Licence

• Aadhar Card

• Passport

• Voter’s Card

• Any other government-issued ID

2. To Prove Establishing a Relationship with Dependents:

• Driver’s Licence

• PAN Card

• Aadhar Card

• Voter’s ID

• Passport

• Marriage Certificate

• Hospital Discharge Card newborn babies, attested and passed by a gazetted government official

• Immunisation Certificate

• In the absence of any government-issued proof, an affidavit attested by a gazetted government official

• Birth Certificate

• School Certificate gazetted by government officials and attested by the school authority.

• Top-tier hospitals and institutions across India are enlisted to provide high-quality healthcare services to beneficiaries of the Sikkim Su-Swasthya Yojana.

• Hospital charges are standardised and based on factors such as infrastructure and treatment quality to ensure fairness and consistency.

• The Su-Swastha Yojna aims to provide medical coverage for employees working for the Government of Sikkim and their dependent family members. Each primary beneficiary can enrol a maximum of 5 dependents under the program, extending coverage to a broader population.

• A network of hospitals affiliated with the scheme offers cashless admission and discharge to simplify payment management during hospitalisation.

• The scheme’s Facilitation Centre ensures high quality treatment provided to Su-Swastha beneficiaries. It oversees the medical care delivered by hospitals to ensure standards are maintained.

• Patients and their families are kept informed at every stage of care. This ensures transparency and allows families to be involved in decision-making regarding the patient's treatment.

• The scheme covers expensive treatments costs such as critical illnesses, cancer care, IVF, trauma cae, etc., from the day of enrollment.

• Pre-existing illnesses are covered starting from day one after successful enrollment in the scheme.

• The SSSY scheme provides health insurance policy coverage of up to Rs. 10 lakhs for the family regardless of the number of dependants selected.

• Physically or mentally challenged children, siblings, and unmarried, unemployed, dependent daughters have no age restrictions for eligibility.

• Sikkim government employees and their dependents benefit from cashless healthcare services.

There are multiple avenues available for applying to the Sikkim Su-Swasthya Yojana, offering both online and offline methods. Here's a guide on how you can proceed with your application:

Paper Applications

• Step 01: Begin by downloading the Su-Swasthya Yojana Sikkim form from the official website.

• Step 02: Fill out the form neatly and submit it, along with the required documents and photos, to the department nodal officer in your respective governmental department.

Email Application

• Step 01: Download the application form from the official website.

• Step 02: Fill out the form and send it via email to support@suswasthasikkim.com. Attach all the required documents and photos.

Online Application

If you are a Sikkim government employee or employer or a permanent resident of the state you can apply online:**

• Step 01: Get started by visiting the official website of Su-Swasthya Yojana for your Su-Swasthya Yojana Sikkim login.

• Step 02: Now, choose the option that best describes you:** Are you an employee or an employer?

• Step 03: The website will ask for your mobile phone number to verify your identity; enter it.

• Step 04: You'll receive an OTP (One-Time Password) on your mobile. Type it in when you're ready.

• Step 05: Please provide the required information in the Su-Swasthya Yojana Sikkim registration form, and remember to attach your documents.

• Step 06: Once everything looks good, hit that 'Submit' button, and you're all set.

Having SSSY coverage in Sikkim provides financial stability to government employees during medical emergencies. Additionally, having a mediclaim policy is essential for non-government employees in the region, offering crucial financial support during unexpected healthcare needs.

Various insurance plans, ranging from critical illness insurance to elder care to dental insurance, cater to diverse individual requirements. Tata AIG's health insurance plan includes hospitalisation coverage, in-patient treatment, daycare procedures, and more.

Moreover, individuals can opt for add-ons to bolster their protection. With our cashless medical insurance facility, policyholders can access medical services at their preferred hospitals without bearing out-of-pocket expenses.

The Sikkim Su-Swasthya Yojana reflects several healthcare insurance initiatives implemented by both central and state governments in recent years. Its primary aim is to provide health insurance coverage to Sikkim government employees and their dependents.

While the scheme's vision and objectives are commendable, its ultimate success depends on its effective implementation at the grassroots level. The true measure of its impact will be determined by how well it is executed and the tangible benefits it delivers to the intended beneficiaries.

Sikkim's commitment to enhancing healthcare facilities, coupled with initiatives like Sikkim Su-Swasthya Yojana, reflects a holistic approach towards ensuring the well-being of its citizens, fostering a healthier and more prosperous society amidst the serene beauty of the Himalayas.

1. What is the Chief Minister Medical Assistance Scheme Sikkim?

Chief Minister Mr. Prem Singh Tamang declared that 1,30,000 Below Poverty Line (BPL) households will imminently gain access to health insurance via the Chief Minister’s Medical Assistance Scheme.

This initiative will empower them to seek reimbursement for medical costs of up to ₹30 lakhs. The Chief Minister also urged both citizens and government officials to consider procuring health insurance policies for their welfare.

2. What are the health issues in Sikkim?

Heart and cardiovascular diseases, alcohol consumption, accidents, suicides, respiratory conditions, cancer, and tuberculosis have emerged as significant contributors to mortality rates in the state.

Unfortunately, these health issues often go undiagnosed and untreated due to limited access to essential healthcare services in rural areas. Despite Sikkim's commendable primary healthcare system, the emphasis is primarily on reproductive, maternal, neonatal, child, and adolescent health.