West Bengal Health Scheme (2023-24): Enrollment Process, Eligibility and Benefits
West Bengal Health Scheme
West Bengal Health Scheme:- Under the West Bengal Health Scheme, the West Bengal government offers government employees, pensioners, and their families financial assistance for medical treatment. Recipients are eligible for cashless medical care at any government or affiliated private hospital. Additionally, they are eligible for reimbursement for services rendered in specific WB non-impanelled hospitals.
Contents
An Overview of the West Bengal Health Scheme
With this health program, the West Bengal state government hopes to pay for the medical care that its pensioners and government employees require. It makes it possible for eligible patients to receive cashless medical care from any accredited hospital or healthcare facility (HCO).
In the first phase, coverage was limited to retired pensioners and their families. However, the WB government modified the plan to include coverage for all government employees, including IAS, IPS, and IFS.
Enactment of WBHS 2008
The West Bengal Finance Department is in charge of overseeing the West Bengal Health Scheme, 2008. A cashless medical treatment program must be issued and implemented by the government. The government creates and formulates all laws, rules, and policies pertaining to health plans and sets fees for medical procedures.
The West Bengal Cashless Medical Treatment Scheme’s characteristics and advantages include:
The following are the WBHS scheme’s salient features:
1) Cashless Indoor Services In an impaneled hospital, the beneficiary is eligible for cashless indoor treatment up to Rs. One lakh. The beneficiary is responsible for paying any additional amount on the bill if the cost exceeds the cap.
2) OPD Intervention Depending on the waiting period and other program requirements, you may be eligible for reimbursement for your out-of-pocket care.
3) A non-impanelled hospital Treatment received in a non-impaneled hospital may be eligible for reimbursement of a portion of the costs, subject to certain restrictions.
4) Not inside the state Provided that the facility is acknowledged as an impaneled hospital, hospitalization costs may be reimbursed in the event that medical care is received in a hospital situated in a different state.
The modified WBHS program offers the following main advantages:
The plan provides coverage for over a thousand medical procedures. The type of procedure and cover extent are shown in the following table.
Benefits
Cover
Specialized surgeries
Up to 12 days
Major surgeries
7 to 8 days
Laparoscopic or endoscopic surgeries, normal deliveries
Every person employed by the state and their dependents
Every pensioner from the state government and their families
All India Services (AIS) officers, pensioners of West Bengal Indian Administrative Service (IAS) officers, and their families are eligible only if they fulfill the following requirements:
They voluntarily signed up to attend WBHS.
The Central Government Health Scheme should not provide them with healthcare benefits (CGHS)
Officers of the Indian Police Services (IPS) and their families are eligible if they meet the following requirements:
They voluntarily signed up to attend WBHS.
The Central Government Health Scheme should not provide them with healthcare benefits (CGHS)
Officers of Indian Forest Services (IFS) and their families who meet the following requirements are qualified:
They voluntarily signed up to attend WBHS.
The Central Government Health Scheme should not provide them with healthcare benefits (CGHS)
West Bengal Health Scheme Benefits
Treatment facility with no cash up to Rs. 1,50,000:
A cashless treatment facility worth up to Rs. 1,50,000 per indoor treatment is provided if the care is received in an accredited hospital. If the Drawing and Disbursing Officer (DDO) or Public Sector Administration (PSA) approves the claim, beneficiaries may also be eligible for reimbursement for indoor treatment costs exceeding Rs. 1,50,000.
Payment of therapy expenses following release:
The beneficiaries are qualified to receive reimbursement for any out-of-pocket costs incurred thirty days before admission and thirty days after discharge for in-office outpatient treatment.
Cost reimbursement for OPD treatment:
Reimbursement of OPD treatment costs for 17 specific diseases treated in affiliated hospitals is available to beneficiaries.
Payment of the subsequent medical treatment expenses:
Beneficiaries may be qualified for reimbursement of follow-up medical costs for a few listed diseases provided they receive care in accredited hospitals.
Payment for medical care in non-impanelled hospitals:
Beneficiaries receiving treatment in non-impaneled hospitals in West Bengal State are eligible to receive 60% (80% in cases where there are more than 80 beds) of the approved cost or the actual amount paid, whichever is less. However, according to the West Bengal Clinical Establishment Act and Rules on the treatment date, these hospitals need to have a current license.
Cost reimbursement for the investigation:
Beneficiaries may request reimbursement for specific investigation costs based on the outpatient prescriptions of doctors who have been consulted about any illnesses in accredited hospitals. However, these investigations must be conducted in accredited hospitals or diagnostic facilities.
Payment for medical care at specific hospitals outside of West Bengal:
When receiving treatment at one or more designated specialty hospitals outside of the state of West Bengal, beneficiaries are eligible to receive reimbursement for the full cost of their care, including transportation expenses for one companion.
West Bengal Health Scheme Hospital List:-
The following is a list of hospitals under the WBHS that have impaneled:
The West Bengal government and other state governments are in charge of overseeing all hospitals, labs, clinics, and diagnostic centers.
The West Bengal State’s municipalities, municipal corporations, and other local bodies are in charge of overseeing all hospitals, diagnostic centers, and clinics.
Hospitals with state assistance:
Kolkata’s Ramakrishna Mission Seva Pratishthan
Islamia Hospital in Kolkata
Kolkata’s Marwari Relief Society Hospital
Kolkata’s Institute of Child Health
Kolkata’s Chittaranjan Cancer Hospital and Balananda Brahmachari Hospital
Kolkata’s Ramakrishna Sarada Mission Matribhavan
Kolkata’s Dr. M. N. Chatterjee Memorial Eye Hospital
Kolkata’s J.N. Roy Sishu Seva Bhavan
Kalimpong, Darjeeling: Kalimpong Leprosy Hospital
Darjeeling’s Charteris Hospital in Kalimpong
Khardah’s Sri Balaram Seva Mandir
B.C. Roy Sishu Sadan and Ramkrishna Matri Mangal Pratisthan, Ariadaha
West Bengal State’s accredited private medical facilities, diagnostic centers, and assisted living facilities
The following is a list of specialty hospitals outside of the state that are part of the WBHS:
New Delhi’s All India Institute of Medical Sciences
Gastroenterology Institute of Asia, Hyderabad, Andhra Pradesh
Chandigarh’s Post Graduate Institute of Medical Education and Research
New Delhi’s Primus Superspeciality Hospital
West Bengal Health Scheme Registration Process
The procedures to sign up for the West Bengal Health Scheme are as follows:
You must access the Finance Department of the Government of West Bengal’s Health Scheme Portal using a laptop or computer and a functional internet connection.
The “online enrollment” option must be chosen from the website’s main page.
You will need to choose the “Govt. Pensioner” option from a drop-down menu.
Upon loading a new page, you are prompted to indicate if you have a P.P.O. No. and, if yes, to input it.
Choose “OK” after that. Then, an application form will appear on the screen, which you must complete with details about your district, name, gender, date of birth, address, phone number, email address, and proof of identity, as well as the department name, last office location, and other pertinent information.
Submit a JPEG form signed by you along with a 10 to 50 kg digital photo.
Verify the details you provided and attach any more files.
West Bengal Health Scheme: How to Register Online for College
First, go to the official website of the West Bengal Health Scheme.
The home page will appear in front of you when it opens.
After selecting Online Enrollment on the homepage, you need to select Beneficiaries of Grant in Aid College.
You will now be taken to a new page where you must enter your HRMS ID. Once there, you must click the “OK” button.
You will now see a registration form on your screen.
Complete this registration form by entering all necessary information, then click the submit button.
West Bengal Health Scheme: University Online Registration
Visit the official website of the West Bengal Health Scheme.
The home page will appear in front of you when it opens.
Now is the time to choose the online enrollment tab.
Selecting Recipients of Grant in Aid University is the next step.
You will now see a new page where you must enter your 10-digit PAN number. You must then click the “Ok” button.
Following that, a registration form will appear in front of you. You must fill it out with all the necessary information and press the submit button.
West Bengal Health Scheme: View Online Claim Of Government Beneficiary
Visit the West Bengal Health Scheme’s official website.
The main page will appear in front of you
It is necessary for you to select the online claim tab from the homepage.
You must now select the link for government beneficiaries.
You will be prompted to enter your password and user ID on a new page.
You must now select “ok.”
Download All The Important Forms
Visit the West Bengal Health Scheme’s official website first.
The main page will appear in front of you
It says on the homepage that you must click on downloads.
This link will cause a new page to open in front of you.
This new page allows you to view all of the important downloads.
To download these forms, select the “Download” option.
West Bengal Health Scheme: Helpline Number
For any technical query, you can contact us at 033-2254-4123/ 4034 between 10.30 am to 5.30 pm or 18001028014 anytime.
You may also email for help @support.wbmedicalcell@nic.in or support.hshed-wb@nic.in.
FAQ’s
Q. What is WBHS’s maximum limit?
ANS-The following are the WBHS scheme’s salient features:- In an impaneled hospital, the beneficiary is eligible for cashless indoor treatment up to Rs. One lakh. The beneficiary is responsible for paying any additional amount on the bill if the cost exceeds the cap.
Q. What is WBHS 2023’s cashless limit?
ANS- Just Rs 1,50,000/- (one lakh fifty thousand). All IPD treatments where the date of admission in a private hospital with state accreditation is July 1, 2023, will be eligible for this facility of increase in the cashless limit.