Beneficiaries under West Bengal Health Scheme 2023 can avail cashless treatment in empanelled hospitals. They can avail the treatment up to Rs.1 lakh from but only from hospitals that are registered under this scheme. Read the important details about WBHS such as Eligibility Criteria, Benefits, Enrolment Process, Registration and Claim process for cashless facilities under the WB Health Scheme.
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What is WB Health Scheme?
West Bengal Health Scheme or the WBHS is a state-level health insurance scheme introduced in the year 2008. It was brought into force for better management of the health insurance welfare in the state of West Bengal. Helping people to manage their medical expenses in a better manner was one of the key objectives of the WB Health Scheme.
Thus the Scheme provides the beneficiaries the financial security during any medical emergency that requires patients to be hospitalized.
Also Read – WB Health Recruitment 2023.
Benefits Provided under WBHS
There are several perks of this scheme that the beneficiaries enjoy. They are:
- You can enjoy the facility of cashless indoor treatment up to Rs.1 lakh from any of the empaneled hospitals. However, you will be required to pay any amount that exceeds the stated amount which the scheme will cover.
- Beneficiaries can get a refund for the OPD treatment. But the amount will be refunded only according to the waiting period and other such conditions of the scheme.
- According to the terms and conditions, if treatment is done in any non-empaneled hospital then a certain part of the total expenditure can be reimbursed.
- Even if treatment is done from any out-of-state hospital it can be covered given the hospital is enrolled.
Eligibility Criteria of WB Health Scheme
There definitely are some criteria for eligibility. They are as follows –
- State government employees or government employees who avail pension are eligible for this scheme along with their family members.
- People who have chosen to avail the benefits of this scheme according to medical allowance are also eligible.
- Officers and pensioners of All India Services can avail of this cover.
- The family members mentioned earlier only include parents, spouse, children, and siblings of the beneficiary who are dependent on him/her.
West Bengal Health Scheme Hospital List
The beneficiaries can enjoy the facilities of the WBHS scheme only from the empaneled hospitals. To check the Hospitals Enlisted for the West Bengal Health Scheme, follow the steps:
- Go to the official website www.wbhealthscheme.gov.in.
- Now, click on “Empanelled Hospitals” or Click Here directly – https://wbhealthscheme.gov.in/Home/wbhs_empanelled_hco.aspx.
- You will find the detailed list of various government and private hospitals, nursing homes, and Health Care Organisations that are registered under this scheme.
West Bengal Health Scheme Cashless Hospital List Download:
| Private Hospitals, Nursing Homes etc within the State | Link |
| Class 1 Hospitals (Full Rate) | Download |
| Class 2 Hospitals (80% of Full Rate) | Download |
| Class 3 Hospitals (70% of Full Rate) | Download |
| Empanelled Diagnostic Centres within the State | Class 1, Class 2, Class 3 |
| State Aided Hospitals | Check Here |
Besides that, All hospitals (all systems of medicines), clinics, laboratories and diagnostic centres of WB and Other State Govt, Central Govt, Municipal Corporations/ Municipalities and the other Local Bodies within the State of West Bengal are listed under WB health scheme.
How to Register yourself online for WB Health Scheme?
Follow this procedure for enrollment if you are a government employee/pensioner –
- Go to the official website of the West Bengal Health Scheme i.e wbhealthscheme.gov.in.
- You will find the “Online Enrollment” tab on the homepage. Hover over it and a drop-down list will appear.
- From the drop-down list, click on “Government Employee” or ”Government Pensioner” respectively as per your category.
- Enter the date when you joined government services in the space provided. If you have a PRAN or GRPF number then click on “Yes” else click on “No”.
- Fill in all the details as asked for. Save the information and your registration under the scheme will be done. Then click on “next”.
- A page will appear asking you to provide some more details like your name, mobile number, address, etc. Fill in the details.
- Fill in the details about the office and family.
- You will now be required to upload your photograph and signature. Make sure to upload the files within the dimensions mentioned.
- Mention any other details required. Save the report and get it printed for your convenience.
How to Claim Benefits of the WBHS Cashless Scheme?
- During admission to the hospital submit the cashless card.
- An authorization request will be sent to the Government Authorised Agency (GAA) by the healthcare institution.
- The details will be checked and then approved by the GAA.
- Once the treatment is done, the bill will be sent by the healthcare center to the GAA. The bill will include reports like medical certificates, discharge summary, etc.
- The documents submitted will be verified by the GAA and the amount will the sent to the concerned healthcare center.
After that, you can login your details to the WB Health Scheme Portal in this link to track your claim status.
For latest updates and information related to the West Bengal Health Scheme 2023, keep checking our website www.pscwb.org.in.