West Bengal Government Health Scheme

  • Author :
  • TATA AIG Team
  • Published on :
  • 04/05/2023

Many welfare schemes are launched by the central and state governments to ensure that people who belong to the underprivileged sections of Indian society can lead a decent life and enjoy certain financial benefits. Some of the top schemes launched by various states are health insurance schemes. The West Bengal state government has also launched a health insurance coverage scheme for the underprivileged people of the state.

The WB health scheme is a great initiative by the West Bengal government to ensure people can better manage their healthcare expenses. The medical insurance plan scheme is designed to manage the medical expenses for emergencies that lead to hospitalisation.

Let us get into the West Bengal health insurance scheme details.

What is the West Bengal Government Health Scheme?

The WBHS is a West Bengal government health insurance scheme that was launched in the year 2008. In the year 2014, the scheme underwent a revamp and changed its name. The West Bengal Health Scheme changed to West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme.

Under the West Bengal Health Scheme benefits, the treatment can be undertaken at one of the empanelled hospitals or healthcare centres. The people eligible to be covered under the WB health scheme can avail of a cashless treatment of up to ₹1 lakh.

Eligibility of the West Bengal Government Health Scheme

Here is the eligibility criteria for the West Bengal Health Scheme benefits:

  • The scheme is launched to provide health insurance coverage to government pensioners, government employees, and their families.
  • People who have chosen the scheme as per the medical allowance can also avail of coverage under the scheme.
  • The coverage under the scheme can be availed of by All India pensioners and officers.
  • The coverage for family extends to the spouse, dependent children, dependent siblings, and parents.

Benefits of the WB Health Scheme

Here are the West Bengal Health Scheme benefits:

  • Cashless treatment

The eligible person can avail of cashless treatment of up to ₹1 lakh at one of the empanelled hospitals. If the amount of the bill is more than ₹1 lakh, then the excess amount will be settled by the beneficiary of the scheme.

  • OPD treatment

The reimbursement of the OPD treatment can also be availed depending on the West Bengal health scheme rules and regulations.

  • Non-empanelled hospitals

If you get treated at one of the non-empanelled hospitals, you can get reimbursement up to a certain amount as mentioned under the West Bengal health scheme rules.

  • Hospitalisation in a different state

The medical expenses can be covered if the treatment is undertaken at one of the empanelled hospitals in some other state.

  • Extent of coverage

There are over 1000 medical procedures covered under the scheme. The extent of the coverage provided is mentioned below.

List of Treatments and Diseases Covered Under the WB Health Scheme

The WB health insurance scheme covers over 1000 treatments and procedures. Here is the OPD treatment list for your reference:

  • Root Canal Treatment(Endodontic Treatment)
  • Rheumatoid Arthritis
  • Crohn’s Disease
  • Injuries due to an accident (includes animal bite)
  • Hepatitis B or Hepatitis C or any other liver disease
  • LUPUS (Systemic Lupus Erythematosus)
  • Malignant Malaria
  • Tuberculosis
  • Bleeding orders/Thalassaemia/Platelet disorders
  • Cerebrovascular disorders/Neurological disorder
  • Insulin-dependent diabetes (Type-2 Diabetic Melitas does not come into consideration as insulin-dependent diabetes)
  • Chronic Obstructive Pulmonary Disease(COPD)
  • Malignant diseases
  • Renal failure

Exclusions Under WB Govt Health Scheme

The coverage does not extend to non-medical treatments and cosmetic procedures. Except for these, almost all the treatments and diseases are covered under the scheme, and cashless treatment can be availed at the empanelled hospitals.

Steps for Enrolment Under the West Bengal Health Scheme

To get yourself enrolled under the scheme, you can go to the Health Department of the West Bengal Government website. On the website, you can select the option under which you wish to enrol on the scheme. You can enrol as a government pensioner, government employee, etc.

For your reference, here are the steps that you need to take if you are a government employee:

  1. Go to the WB Health Scheme website.
  2. Click on the tab for Online Enrolment. Choose Government Employee.
  3. If you have the GPF/PRAN number, tick the box for Yes and add all the details. If you do not have these details, tick for No and choose the non-GPF number option.
  4. Mention all the details like birth date and residential address. Save all this information for registration.
  5. Now click on Next to proceed ahead.
  6. Add in all the details like your name, mobile number, address, employee details, etc.
  7. Add all the office-related details.
  8. Add all the family details.
  9. Upload the signature and latest photograph. The dimensions for the photograph should be as per the rules.
  10. Add in the beneficiary details.
  11. Add the head office information.
  12. Save all the details and print them out for reference purposes.

Steps to Download the WB Health Scheme Application Form

Here are the various steps to download the application form for two different categories of beneficiaries of the policy:

State Government Employees

  1. Go to the WB Health Scheme website and go to the downloads section.
  2. From the select categories drop-down menu, select Employees.
  3. Download the form that is relevant to you.

State Government Pensioners

  1. Go to the WB Health Scheme website and go to the downloads section.
  2. From the select categories drop-down menu, select Pensioners.
  3. Download the form that is relevant to you.

Disclaimer / TnC

Your policy is subjected to terms and conditions & inclusions and exclusions mentioned in your policy wording. Please go through the documents carefully.

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