West Bengal Health Scheme 2024: Hospital List, Benefits, Eligibility

West Bengal Health Scheme:- To provide cashless medical treatment to state government employees, All India Services (AIS) personnel, and retirees, the West Bengal government launched the West Bengal Health Scheme (WBHS). This program acts as welfare health insurance coverage at the state level.  Read below to check the detailed information related to the West Bengal Health Scheme like Objectives, Benefits & Features, Diseases covered, List of Empanelled Hospitals, Eligibility Criteria, Steps to Apply as a Government Employee, as a Government Pensioner, Steps to Claim the scheme, and much more

West Bengal Health Scheme

West Bengal Health Scheme 2024

The West Bengal government launched the state-level health insurance welfare plan known as the West Bengal Health Scheme and it is administered by the Department of finance. This initiative intends to provide better medical services to state government employees. Periodically updating its health program to encompass a broader spectrum of society has been the WB government’s approach. For medical costs incurred at a select few hospitals in this state, a beneficiary of this scheme may be entitled to reimbursement. The expenses of OPD therapy for 15 illnesses are also covered by this plan.

Bangla Shasya Bima Yojana

WB Health Scheme Objective

West Bengal Health Scheme’s main goal is to improve health care options for state government workers. Eligible recipients of this program are entitled to reimbursement for costs associated with inpatient care at connected hospitals in West Bengal and at some affiliated hospitals outside the state.

Benefits & Features of West Bengal Health Scheme

Some of the key features and benefits of the West Bengal Health Scheme are as follows:

  • In all West Bengali hospitals that are affiliated with the state, you are eligible to get reimbursement for inpatient care. Eleven enlisted hospitals outside of West Bengal also offer treatment.
  • When receiving treatment in an accredited hospital, a cashless treatment facility worth up to Rs. 1.5 lakh is offered for each indoor treatment.
  • As per the list specified in the WBHS scheme clause, estimate out how much treatment will cost for seventeen disorders.
  • In an affiliated hospital, the beneficiary is eligible for cashless indoor treatment up to Rs. 1 lakh.
  • Depending on the waiting period and other programme requirements, you may be eligible for reimbursement for your out-of-patient care. This covers routine medical costs as well as wellness-maintaining preventative care.

Diseases covered under West Bengal Health Scheme

The following diseases are eligible for payment under this programme based on outpatient treatment costs:

  • Tuberculosis
  • Malignant diseases
  • Hepatitis B/C and other liver diseases
  • Renal failure
  • Type-1 insulin-dependent diabetes
  • Neurological disorders or cerebrovascular disorders
  • Thallasaemia, bleeding orders or platelet disorders
  • Heart diseases
  • Malignant malaria
  • Rheumatoid arthritis
  • Injuries caused by accident (including animal bites)
  • Chronic Obstructive Pulmonary Disease (COPD)
  • COVID
  • Systematic Lupus Erythematous (LUPUS)
  • Ankylosing spondylitis
  • Crohn’s disease
  • Endodontic treatment (Root canal treatment)

West Bengal Digital Ration Card

List of Empanelled Hospitals

The List of Empanelled Hospitals under WB Health Scheme are as follows:

  • The Calcutta Medical Research Institute
  • Nightingale Hospitals
  • R N Tagore International Institute of Cardiac Sciences
  • Desun Hospitals and Heart Institute
  • Apollo Gleneagles
  • Mission of Mercy Hospital
  • Susrut Eye Foundation
  • Ruby General Hospital
  • Medica Super-specialty Hospital
  • BM Birla Heart Research Centre

Eligibility Criteria for West Bengal Health Scheme

The applicants applying for West Bengal Health Scheme must fulfill the following eligibility criteria:

  • Employees of the state government, their families, and retired government employees who are eligible for pension benefits.
  • This coverage is also available to retirees and officers of the India Services.
  • Those who choose this plan using their medical allowance are also eligible to get its advantages.
  • Parents, Spouses, dependent children, and dependent siblings of the beneficiary are all included in the family coverage.

Steps to Apply for West Bengal Health Scheme as a Government Employee

To Apply for WB Health Scheme as a Government Employee, the user needs to follow the below-given steps:

  • First of all, go to the official website of the West Bengal Health Scheme i.e., https://wbhealthscheme.gov.in/
  • The homepage of the website will open
  • Click on the Online Enrolment tab
  • Now, click on the Government Employee option
  • A new page will open
  • Now enter the Date of entry into Govt. Service,  PRAN/GPF number
  • Then, click on the OK button
  • The application form will open
  • Now, fill in the form with all the required details like personal details, address details, contact number, date of birth, district, and employee number
  • Then, click on the continue button
  • After that, upload your photograph and click on the Save button to complete the process
  • Finally, take the print out of the application form for future reference

Steps to Apply for West Bengal Health Scheme as a Government Pensioner

To Apply for West Bengal Health Scheme as a Government Pensioner, the user needs to follow the below given steps:

  • First of all, go to the official website of the West Bengal Health Scheme i.e., https://wbhealthscheme.gov.in/
  • The homepage of the website will open
  • Click on the Online Enrolment tab
  • Now, click on the Government Pensioner option
  • A new page will open
  • Now enter the Date of Retirement from Govt. Service, P.P.O Number
  • Then, click on the OK button
  • The application form will open
  • Now, fill in the form with all the required details like personal details, address details, contact number, date of birth, district, and employee number
  • Then, click on the continue button
  • After that, upload your photograph and click on the Save button to complete the process
  • Finally, take the print out of the application form for future reference

Steps to Claim the WB Health Scheme

  • When a patient is admitted for treatment at a hospital with an empanelment, present the cashless card
  • The Government Authorised Agency (GAA) will receive an authorization request from Health Care Organisations.
  • GAA will review the information and grant the request.
  • The hospital or HCO will submit the bill to the GAA following the procedure. Required paperwork, such as a medical report, a physician’s certificate, a discharge summary, etc., must be included with the bill.
  • GAA will examine the submitted paperwork.
  • The money will be transferred to HCO by GAA.
Contact Details

For further details or in case of any query or complaint related to the West Bengal Health Scheme, feel free to contact on the below-given details:

Helpline Number: (033) 2254-4123 or (033) 2254-4034

Email Id: support.WBMedicalCell@nic.in

FAQ’s
What is the official website to apply for West Bengal Health Scheme?

The official website to apply for scheme is https://wbhealthscheme.gov.in/

Does the plan consider the spouse of the participant as a beneficiary?

Yes, the spouse of the member may be considered a beneficiary.

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