West Bengal Health Scheme 2023: Eligibility, Coverage, Benefits

West Bengal Health Scheme: The West Bengal Health Scheme has been designed to provide financial protection and healthcare benefits to the citizens of West Bengal. The scheme covers a wide range of medical expenses, including hospitalization, diagnostics, and treatment. It is available to all government employees, pensioners, contractual employees, and their dependents. The West Bengal Health Scheme aims to ensure that everyone has access to quality healthcare without having to worry about the financial burden. The process of enrolling in the scheme is simple and straightforward. Once enrolled, members can avail of cashless treatment at empanelled hospitals across the state. In case of any difficulties or queries related to the scheme, there is a dedicated helpdesk that can be reached out for assistance. By providing affordable healthcare services to its citizens, the West Bengal Health Scheme is helping build a healthier and more equitable society in the state.

The West Bengal Health Scheme is a government initiative aimed at providing affordable healthcare to the people of West Bengal. Under this scheme, eligible individuals can access a range of medical services, including hospitalization, surgery, and diagnostic tests, at little to no cost. The West Bengal Health Scheme covers all residents of West Bengal who are government employees or pensioners, as well as their dependents. To enroll in the scheme, individuals must submit the necessary documents and complete the registration process. Once enrolled, they will receive a health card that they can use to access medical services at empaneled healthcare providers across the state. The West Bengal Health Scheme is an excellent resource for those seeking quality healthcare at an affordable price, and we encourage all eligible individuals to take advantage of its benefits.

West Bengal Health Scheme 2023

The West Bengal Health Scheme is a comprehensive health insurance program designed to provide affordable healthcare services to the residents of West Bengal. The West Bengal Health Scheme covers a wide range of medical expenses, including hospitalization, surgery, diagnostic tests, and treatment for chronic diseases. It also provides coverage for pre-existing medical conditions and maternity care. The scheme is available to all state government employees, pensioners, and their dependents. With the rising cost of healthcare services, the West Bengal Health Scheme is a much-needed initiative that helps alleviate the financial burden on families and ensures that they have access to quality healthcare services when they need it most.

The West Bengal Health Scheme is a comprehensive healthcare program that provides coverage for government employees, pensioners, and their dependents. The scheme covers a variety of medical expenses, including hospitalization, diagnostic tests, surgeries, and outpatient services. It also provides benefits for pre-existing conditions and maternity care. One of the key advantages of the West Bengal Health Scheme is that it offers cashless treatment at empanelled hospitals, reducing the financial burden on beneficiaries. The scheme is designed to ensure that all eligible individuals have access to quality healthcare services without facing financial hardship. Overall, the West Bengal Health Scheme is an important initiative that helps to improve the health and well-being of government employees and their families in the state of West Bengal.

West Bengal Health Scheme

West Bengal Health Scheme Overview 2023

Article Name West Bengal Health Scheme 2023: Eligibility, Coverage, Benefits
Category Sarkari Yojana
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West Bengal Health Scheme Click here

What is the West Bengal Health Scheme?

The WBHS is a welfare insurance program run by the state. 2008 marked the beginning of this scheme. However, it was renamed the West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme in 2014 following a rebranding. The two plans have been combined. Patients who meet the eligibility requirements can take advantage of this plan’s cashless treatment options in the specified list of hospitals, which are also known as empanelled hospitals and Health Care Organizations (HCOs). A Rs. 500 cashless treatment is available to those who qualify. One million

Features and Benefits of the West Bengal Cashless Medical Treatment Scheme:

Here are the key features of the WBHS scheme:

1) Cashless Indoor Treatment

लाभार्थी रुपये तक कैशलेस इनडोर उपचार का लाभ उठा सकता है एक सूचीबद्ध अस्पताल में एक लाख। यदि लागत सीमा से अधिक है, तो बिल में अतिरिक्त राशि का भुगतान लाभार्थी द्वारा किया जाएगा।

2) OPD Treatment

आप योजना की प्रतीक्षा अवधि और अन्य शर्तों के अनुसार ओपीडी उपचार के लिए प्रतिपूर्ति का लाभ उठा सकते हैं।

3) Hospital That is Non-empanelled

यदि गैर-सूचीबद्ध अस्पताल में उपचार लिया जाता है, तो नियम और शर्तों के अनुसार राशि का एक निश्चित प्रतिशत प्रतिपूर्ति की जा सकती है।

4) Out-of-state Hospitalization

यदि किसी दूसरे राज्य से संबंधित अस्पताल में उपचार का लाभ उठाया जाता है, तो व्यय को कवर किया जा सकता है, बशर्ते इसे एक सूचीबद्ध अस्पताल के रूप में सूचीबद्ध किया गया हो।

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Here are the Key Benefits of the Updated WBHS Scheme:

More than 1000 medical procedures are covered by the scheme. The following table is about the type of procedure and the extent of the cover.

Benefits Cover
Specialized surgeries Up to 12 days
Major surgeries 7 to 8 days
Laparoscopic or endoscopic surgeries, normal deliveries 3 to 4 days
OPD and minor surgeries 1 day

Benefits of West Bengal Health Scheme 2008 Extended to IAS, IFS and IPS Officers:

Officers from the Indian Administrative Service (IAS), Indian Forest Service (IFS), and Indian Police Service (IPS) received certain benefits in subsequent years of the 2008 scheme.

Benefits for IAS Officers

IAS Officers and their Family Members can Avail the Benefits of the Scheme as per the Following Conditions:

  • योजना का हिस्सा बनना वैकल्पिक है।
  • उनका संबंधित प्रशासनिक विभाग कार्मिक और प्रशासनिक सुधार विभाग होगा।
  • अखिल भारतीय सेवा नियमावली, 1954 के अनुसार सुविधाओं का लाभ उठा सकते हैं।
  • उन्हें केंद्र सरकार की स्वास्थ्य योजना (सीजीएचएस) का हिस्सा नहीं होना चाहिए।

Benefits for IPS Officers

The following conditions must be met before IPS officers and their families can take advantage of the program:

  • They are free to participate in the scheme.
  • The Home Department Police Service Cell would be the IPS officers’ administrative department.
  • The All India Services Rules of 1954 also provide facilities.
  • Officers covered by the Central Government Health Scheme (CGHS) are not eligible to participate in the state plan.

Benefits for IFS Officers

The following conditions must be met before IFS officers and members of their families can participate in the program.

  • It is up to them if they sign up.
  • The Department of Forests would be their department with responsibility for this scheme.
  • Facilities are available to them under the All India Services Rules of 1954.
  • Officers who are covered by the Central Government Health Scheme (CGHS) cannot participate in this state program.

List of Diseases and Treatments Covered under West Bengal Health Scheme:

इस योजना में 1014 चिकित्सा उपचार शामिल हैं। यह भारतीय मुद्रा में प्रत्येक प्रक्रिया के लिए अधिकतम स्वीकृत पैकेज दर भी बताता है। विवरण यहां देखा जा सकता है।

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OPD Treatment Diseases List:

इस योजना में महत्वपूर्ण बाह्य रोगी विभाग की बीमारियाँ शामिल हैं। यहां पश्चिम बंगाल स्वास्थ्य योजना 2008 की ओपीडी उपचार सूची दी गई है

  • रूमेटाइड गठिया
  • एंडोडोंटिक उपचार (रूट कैनाल उपचार)
  • प्रणालीगत एक प्रकार का वृक्ष Erythematosus (LUPUS)
  • क्रोहन रोग हृदय रोग
  • न्यूरोलॉजिकल विकार / सेरेब्रोवास्कुलर विकार
  • घातक मलेरिया
  • सीओपीडी (क्रोनिक ऑब्सट्रक्टिव पल्मोनरी डिजीज)
  • घातक रोग
  • यक्ष्मा
  • हेपेटाइटिस बी / सी और अन्य यकृत रोग
  • इंसुलिन-आश्रित मधुमेह (टाइप-2 मधुमेह मेलिटास को इंसुलिन-निर्भर मधुमेह नहीं माना जाता है)
  • थैलेसीमिया / ब्लीडिंग ऑर्डर / प्लेटलेट विकार
  • वृक्कीय विफलता
  • दुर्घटना के कारण लगी चोटें (जानवरों के काटने सहित)

Online Registration Process for University

  • To begin, you must visit the Finance Department of the West Bengal Government’s official website. You will then see the website’s home page open in front of you.
  • On the landing page of the site, you need to tap on the choice of “recipients of award in Help College” from the segment of “Online Enrolment”. The following page will appear in front of you.
  • On this page, you need to enter the 10-digit Skillet number and snap on “Alright”. After this, the enlistment structure will open before you.
  • Presently you need to enter the subtleties of the data asked in the structure and tap on submit.
  • Your university application will be successful in this way.

What is Not Covered Under the Scheme?

इस योजना में कॉस्मेटिक सर्जरी और गैर-चिकित्सा उपचार शामिल नहीं हैं इनके अलावा, सूचीबद्ध अस्पतालों में प्रमुख उपचारों को कैशलेस तरीके से कवर किया जाना चाहिए।

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Eligibility for West Bengal Health Scheme:

योजना का हिस्सा बनने के लिए पात्रता मानदंड नीचे सूचीबद्ध हैं।

  • यह योजना राज्य सरकार के कर्मचारियों, पेंशन पाने वाले सरकारी कर्मचारियों और उनके परिवारों के लिए है।
  • जिन लोगों ने चिकित्सा भत्ता के अनुसार इस योजना का विकल्प चुना है, वे भी इसके लिए पात्र हैं।
  • इस कवर का लाभ अखिल भारतीय सेवा के अधिकारी और पेंशनभोगी उठा सकते हैं।
  • परिवार के लिए उल्लिखित कवर में पति/पत्नी, माता-पिता, लाभार्थी पर आश्रित बच्चे और लाभार्थी पर आश्रित भाई-बहन शामिल हैं।

How to Enrol and Register in West Bengal Health Scheme?

To begin the enrollment and registration procedure, you can go to the website of the West Bengal Health Department. You can enroll as a government employee, a government pensioner, a beneficiary of a grant-in-aid college, or a beneficiary of a grant-in-aid university from that point on. It also makes it easier to register a new hospital.

Here’s how you can Enrol as a Government Employee?

  • चरण 1 – पश्चिम बंगाल स्वास्थ्य योजना पोर्टल पर जाएं
  • चरण 2 – शीर्षक अनुभाग से ऑनलाइन नामांकन पर क्लिक करें और सरकारी कर्मचारी का चयन करें।
  • चरण 3 – यदि आपके पास PRAN/GPF नंबर है, तो Yes बॉक्स को चेक करें और विवरण दर्ज करें। यदि आपके पास विवरण नहीं है, तो NO बॉक्स को चेक करें और गैर-जीपीएफ चुनें।
  • चरण 4 – आवासीय जिले और जन्म तिथि जैसे विवरणों का उल्लेख करें। डब्ल्यूबी हेल्थ पोर्टल में रजिस्टर करने के लिए जानकारी सेव करें और बाकी प्रक्रिया के लिए नेक्स्ट पर क्लिक करें।
  • चरण 5 – व्यक्तिगत विवरण जैसे नाम, पता, मोबाइल नंबर, कर्मचारी संख्या आदि का उल्लेख करें।
  • चरण 6 – कार्यालय विवरण का उल्लेख करें।
  • चरण 7 – पारिवारिक विवरण का उल्लेख करें।
  • चरण 8 – फोटोग्राफ और हस्ताक्षर अपलोड करें आयामों के संबंध में निर्दिष्ट नियमों का पालन करना सुनिश्चित करें।
  • चरण 9 – लाभार्थी से संबंधित विवरण का उल्लेख करें।
  • चरण 10 – प्रधान कार्यालय के विवरण का उल्लेख करें।
  • चरण 11 – विवरण सहेजें और भविष्य के संदर्भ के लिए रिपोर्ट प्रिंट करें।

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How to Download West Bengal Health Scheme Application Form?

वेल्थ बंगाल हेल्थ स्कीम फॉर्म आधिकारिक वेबसाइट से डाउनलोड किए जा सकते हैं। यहां बताया गया है कि आप विभिन्न वर्गों के लिए ऐसा कैसे कर सकते हैं।

The process to Download Forms for State Government Employees

  • चरण 1 – पश्चिम बंगाल स्वास्थ्य योजना पोर्टल > डाउनलोड अनुभाग पर जाएं
  • चरण 2 – “श्रेणी चुनें” ड्रॉप-डाउन मेनू से ‘कर्मचारी’ चुनें
  • चरण 3 – प्रासंगिक फ़ॉर्म डाउनलोड करें

The process to Download Forms for State Government Pensioners

  • चरण 1 – पश्चिम बंगाल स्वास्थ्य योजना पोर्टल > डाउनलोड अनुभाग पर जाएं
  • चरण 2 – “श्रेणी चुनें” ड्रॉप-डाउन मेनू से ‘पेंशनभोगी’ चुनें
  • चरण 3 – प्रासंगिक फ़ॉर्म डाउनलोड करें

How to Claim the West Bengal Health Scheme?

There is no use of cash in the scheme. Hence, on the off chance that the treatment cost is under the expressed bundle, the recipient doesn’t need to settle the emergency clinic bill as the treatment will be covered according to the plan. The beneficiary and the hospital are responsible for covering any additional costs incurred if the total bill is greater than the amount stipulated in the treatment package, and there will be no reimbursement for the difference.

Here’s the Claim Process

  • चरण 1 – सूचीबद्ध अस्पताल में इलाज के लिए भर्ती होने पर कैशलेस कार्ड जमा करें।
  • चरण 2 – स्वास्थ्य देखभाल संगठन सरकार द्वारा अधिकृत एजेंसी (जीएए) को एक प्राधिकरण अनुरोध भेजेगा।
  • चरण 3 – GAA विवरणों की जांच करेगा और अनुरोध को स्वीकार करेगा।
  • चरण 4 – इलाज के बाद, एचसीओ या अस्पताल जीएए को बिल भेजेंगे। बिल के साथ जरूरी दस्तावेज जैसे मेडिकल रिपोर्ट, डॉक्टर का सर्टिफिकेट, डिस्चार्ज समरी आदि होने चाहिए।
  • चरण 5 – GAA भेजे गए दस्तावेज़ों का सत्यापन करेगा।
  • चरण 6 – GAA राशि को HCO को स्थानांतरित कर देगा।

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Empanelled Hospitals Listed Under West Bengal Health Scheme

Here’s the list of empanelled hospitals under West Bengal Health Scheme.

  • कलकत्ता चिकित्सा अनुसंधान संस्थान
  • देसन अस्पताल और हृदय संस्थान
  • नाइटिंगेल अस्पताल
  • आर एन टैगोर इंटरनेशनल इंस्टीट्यूट ऑफ कार्डियक साइंसेज
  • अपोलो ग्लेनेगल्स
  • रूबी जनरल अस्पताल
  • बीएम बिड़ला हार्ट रिसर्च सेंटर
  • मेडिका सुपर-स्पेशियलिटी अस्पताल
  • मर्सी अस्पताल का मिशन
  • सुश्रुत आई फाउंडेशन

Note that a few medical clinics probably won’t be a piece of the plan any more, subsequently it is smarter to affirm with the medical clinic or keep an eye on the underneath referenced site. The portal for the West Bengal Health Scheme contains a comprehensive list of cashless hospitals. There is information on the website about public hospitals, private hospitals, public hospitals supported by the state, and local hospitals.

West Bengal Health Scheme Helpline Number

The following table will provide you with the necessary contact details.

Email id: support.wbmedicalcell@nic.in

Contact Number: (033)2254-4123/(033)2254-4034

Regulation of the Scheme

The WBHS is run by a Medical Cell in the Finance Department of the West Bengal Government. The scheme is monitored by the Cell and the state’s Health and Family Welfare department. The Cell additionally states functional rules.

West Bengal Health Scheme FAQ’S

Who are eligible for West Bengal Health Scheme?

Individuals who are employed by the state government, as well as their dependents and families, along with state government pensioners and their families, have the opportunity to take advantage of policy benefits. Additionally, those who have opted for medical allowance are also eligible to receive policy benefits. The criteria remain unchanged.

Is West Bengal Health Scheme cashless?

Cashless indoor treatment facilities upto Rs 1,50,000/-per indoor is available provided treatment done in Private Empanelled Hospitals.

What are the schemes of West Bengal government?

The West Bengal Government has implemented several initiatives, including but not limited to Kanyashree, Rupashree, Lakshmir Bhandar, Yuvasree, Sikshashree, Jai Bangla, Lokprasar, Nijo Griha Nijo Bhumi, Swasthya Sathi, Gatidhara, Gitanjali, Khadya Sathi, Sabooj Sathi, Sabujshree, Sufal Bangla, Shishu Sathi and Sabala schemes.

Is Apollo hospital under WBHS?

The Apollo Gleneagles Hospital, Kolkata (Code no 0411004) is empanelled Health Care Organisation under West Bengal Health Scheme.

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