West Bengal Health Scheme: Eligibility, Benefits & Registration

The West Bengal Health Scheme (WBHS) provides financial relief to state government employees, pensioners, and their families by ensuring cashless treatment at recognised hospitals.

West Bengal Health Scheme (WBHS): Overview

It is a scheme for state government employees, pensioners, and their dependents. It covers medical expenses up to Rs 1.5 lakh (extendable in special cases) at recognised government and private hospitals across India for specified illnesses and treatments.

Features and benefits of West Bengal Health Scheme

Key features of the WB Health Scheme are:

• Cashless treatment: No need to pay upfront
• High coverage limit: Up to ₹1.5 lakh per family per year
• Extended coverage: In critical cases, treatments are covered beyond the limit
• Senior citizen health insurance: Covers pensioners and their dependents
• Reimbursement option: If treatment is done in a non-empanelled hospital, expenses can be reimbursed
• Wide network: Includes government and private hospitals across India

List of diseases covered under WB Health Scheme

The scheme covers a wide range of illnesses and treatments.

• Cardiac diseases
• Cancer treatments
• Neurological disorders
• Orthopaedic treatments
• Kidney-related diseases
• Liver diseases
• Accident and trauma care

Note: Routine OPD consultations, cosmetic surgeries, and experimental treatments are not covered.

Inclusions and exclusions of West Bengal Health Scheme

The scheme includes major treatments but has certain exclusions.

What’s included?

• Hospitalisation costs (room rent, doctor’s fees, and surgery costs)
• Pre and post-hospitalisation expenses (up to 30 days before and after hospitalisation)
• Critical illnesses
• Diagnostic tests (if linked to hospitalisation)

What’s excluded?

• OPD consultations (Unless part of hospitalisation)
• Cosmetic surgeries
• Non-essential medicines
• Fertility treatments

Eligibility criteria for West Bengal Health Scheme

To enrol in the scheme, applicants must meet specific requirements.

Who Can Apply?

• State government employees (Permanent or retired)
• Pensioners
• Family members of employees/pensioners
• Employees of government-aided institutions

Note: Private sector employees are not eligible.

How to apply online for WBHS?

The WB Health Scheme online registration process is simple.

• Visit the West Bengal Health Scheme website- https://healthscheme.wb.gov.in/
• Click on “Online Enrollment”
• Enter your date of entry into Govt services
• Fill out the application form
• Upload requested documents
• Submit form
• The respective government department will verify and approve the application.

Once approved, the applicant receives a West Bengal Health Scheme ID card, which must be used for cashless treatments.

How to download the application form for the West Bengal Health Scheme?

If you prefer the offline method, follow these steps:

• Go to the official website
• Click on “Forms”
• Download and print the form and fill it out
• Submit to the designated government office along with required documents

How to claim the West Bengal Health Scheme?

You can claim the benefits through two methods:

Cashless treatment:

• Show your WBHS ID card at a recognised hospital.
• The hospital verifies and initiates cashless treatment.
• The government settles the bill.

Reimbursement Claim:

• Pay the bills first if treatment is taken in a non-recognised hospital.
• Submit a reimbursement application with hospital bills.
• The government processes and reimburses the approved amount.

Hospitals empanelled under West Bengal Health Scheme

The scheme has a large network of recognised hospitals in West Bengal and across India.

• Government hospitals (state and central government)
• Private hospitals (Accredited private hospitals under WBHS)
• Super-specialty hospitals (for critical illnesses)

Check the full list on the official West Bengal Health Scheme website.

Helpline numbers for West Bengal Health Scheme

For queries or assistance, contact

• Number: (033) 2254-4123 / (033) 2254-4034
• Email:wbmedicalcell@nic.in
• Website: wbhealthscheme.gov.in

Regulation of the scheme

The scheme is regulated by:

• The West Bengal finance department
• State government health committees
• Hospitals recognised under the scheme

FAQs

• Who is eligible for the WB health scheme?

All state government employees, pensioners, and their dependents.

• Is the West Bengal Health Scheme applicable in private hospitals?

Yes, but only in recognised private hospitals.

• Can non-government employees apply?

The scheme doesn’t apply to people working in the private sector.

• What is the coverage limit?

Up to ₹1.5 lakh, extendable for critical cases.

Conclusion

The West Bengal Health Scheme is a vital health insurance scheme in West Bengal, ensuring cashless treatments and financial security for government employees and pensioners. The WB cashless health scheme simplifies medical access.

If you are eligible, complete the online registration to access quality healthcare without financial stress. You can also opt for health insurance plans that cover hospitalisation expenses, preventive care, outpatient treatments, and other related medical expenses.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It may contain outdated data and information regarding the Insurance industry and products. It is advised to verify the currency and relevance of the data and information before taking any major steps. ICICI Lombard is not liable for any inaccuracies or consequences resulting from the use of this outdated information.