Healthcare is a basic necessity, and the Government of West Bengal understands this well. To ensure its employees and pensioners have access to quality medical treatment without financial stress, the state launched the West Bengal Health Scheme. This welfare initiative covers a wide range of medical expenses for eligible beneficiaries and has proved to be a major support system for thousands of families across the state.

In this article, we’ll explore everything you need to know about the West Bengal Health Scheme – including eligibility, benefits, how to apply, empanelled hospitals, and more.

What is the West Bengal Health Scheme?

The West Bengal Health Scheme (often abbreviated as WBHS) is a health insurance initiative started by the state government in 2008, initially for its employees and pensioners. Over time, it has evolved to offer cashless treatment facilities at both government and empanelled private hospitals.

In 2014, the scheme was upgraded to the West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme, which includes more extensive coverage and simplified processes.

Who is Eligible?

The scheme is primarily meant for:

  • State Government Employees

  • State Government Pensioners

  • Family members of employees and pensioners

  • AIS (All India Services) officers working with the West Bengal government

Departments and organizations under the state government that have opted for the scheme can extend the benefit to their staff as well.

Key Features and Benefits

Here are the major highlights of the West Bengal Health Scheme:

1. Cashless Medical Treatment

Beneficiaries can avail cashless indoor treatment up to ₹1,00,000 per year per indoor admission. This includes surgeries, hospital stays, diagnostic tests, etc.

2. Reimbursement Option

If treatment costs exceed the cashless limit, or if taken in a non-empanelled hospital, beneficiaries can claim reimbursement as per the WBHS approved rate list.

3. Wide Coverage

Covers major illnesses like:

  • Cancer

  • Cardiac surgeries

  • Neurological disorders

  • Orthopedic surgeries

  • Organ transplants

  • Dialysis

  • Maternity benefits

  • And many more…

4. Empanelled Hospitals

Includes top government and private hospitals across West Bengal and even outside the state in select cases (for specialized treatment).

5. OPD and Daycare

While the scheme mainly focuses on indoor treatment, certain OPD and daycare procedures are also covered under reimbursement.

How to Apply for the Scheme?

For Employees:

  1. Visit the official WBHS portal.

  2. Register using employee ID and department details.

  3. Fill in personal and dependent family member details.

  4. Upload necessary documents (photo, ID proof, etc.).

  5. Submit and print the application for record.

For Pensioners:

  1. Obtain a Digital Life Certificate (DLC).

  2. Apply via the official portal or contact your pension disbursing authority.

  3. Follow the same document and verification process.

Once verified, beneficiaries receive a WBHS card that can be used at empanelled hospitals.

List of Empanelled Hospitals

Some of the top empanelled hospitals under the scheme include:

  • Apollo Gleneagles Hospitals, Kolkata

  • AMRI Hospitals

  • Medica Superspecialty Hospital

  • Peerless Hospital

  • Tata Medical Center (for cancer treatment)

  • All major government hospitals in West Bengal

You can find the full updated list on the official website.

Important Guidelines

  • Always carry your WBHS card or ID proof during hospital visits.

  • Get the treatment approval from the Nodal Officer (for non-emergency admissions).

  • Submit reimbursement claims within 3 months of treatment.

  • Keep copies of all bills, prescriptions, and discharge summaries.

Final Thoughts

The West Bengal Health Scheme is a significant step toward ensuring healthcare security for state employees and pensioners. With rising medical costs, having such a scheme in place not only reduces the financial burden but also brings peace of mind to countless families.

Whether it's a sudden health emergency or planned surgery, the scheme ensures that you’re protected and supported through quality healthcare services. If you're eligible and haven’t enrolled yet, now is the perfect time to register and safeguard your health and that of your loved ones.

FAQs

Q1: What is the cashless treatment limit under the West Bengal Health Scheme?
You can avail cashless treatment up to ₹1,00,000 per indoor admission.

Q2: Can I get treatment outside West Bengal under this scheme?
Yes, if the treatment is not available in the state, select hospitals outside West Bengal are empanelled.

Q3: How can I claim reimbursement?
Submit all required documents and bills to the medical cell of your department or pension office within 3 months of treatment.

 

Q4: Are OPD expenses covered?
Some OPD and daycare procedures are eligible for reimbursement under specific conditions.