About

The WBHS is state-level medical coverage government assistance conspire. This plan started in the year 2008. Notwithstanding, in 2014, it went through a redo and came to be known as the West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme. The two plans have been blended. 

According to this plan, qualified individuals can benefit credit only treatment in the expressed rundown of clinics, otherwise called empaneled emergency clinics and Health Care Organizations (HCO). The individuals who are qualified can profit a credit only treatment of Rs. One lakh.

Features

1) Cashless Indoor Treatment: The recipient can benefit credit only indoor treatment up to Rs. One lakh in an empaneled clinic. On the off chance that the expense surpasses the cut off, the additional sum in the bill will be settled by the recipient. 

2) OPD Treatment: You can profit repayment for the OPD treatment according to the holding up period and different states of the plan. 

3) Hospital That is Non-empaneled: On the off chance that treatment is profited in a non-empaneled emergency clinic, a specific level of the sum can be repaid according to the terms and conditions. 

4) Out-of-state Hospitalization: Costs can be secured if the treatment is benefited in a clinic having a place with an alternate state, if it has been recorded as an empaneled medical clinic.

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

Diseases treated under health schemes

1.Rheumatoid Arthritis
8.Malignant diseases
2.Endodontic Treatment (Root Canal Treatment)
9.Tuberculosis
3.Systemic Lupus Erythematosus (LUPUS)
10.Hepatitis B/C and other liver diseases
4.Crohn’s Disease Heart disease
11.Insulin-dependent diabetes (Type-2 Diabetic Melitas is not considered as insulin-dependent diabetes)
5.Neurological disorder/Cerebrovascular disorders
12.Thalassaemia/Bleeding orders/Platelet disorders
6.Malignant Malaria
13.Renal failure
7.COPD (Chronic Obstructive Pulmonary Disease)
14.Injuries caused by accident (including animal bite)

Diseases not treated under the scheme

  • Cosmetic surgeries and non-medical treatments

Eligibility

1. This plan is coordinated towards state government workers, government representatives who profit annuity, and their families. 

2. Those who have picked this plan according to Medical Allowance are likewise qualified for it. 

3. This spread can be benefited by All India Services officials and beneficiaries. 

4. The spread referenced for the family incorporates that for the mate, guardians, youngsters who are dependent on the recipient and the kin who are dependent on the recipient.

Enrolling process

Stage 1 – Visit the West Bengal Health Scheme Portal 

Stage 2 – Click on Online Enrolment from the header area and select Government Employee. 

Stage 3 – in the event that you have a PRAN/GPF number, at that point check the Yes box and enter the subtleties. In the event that you don't have the subtleties, at that point check the NO container and select Non-GPF. 

Stage 4 – Mention subtleties like private region and birth date. Spare the data to enroll in the WB Health Portal and snap next for the remainder of the cycle. 

Stage 5 – Mention individual subtleties like name, address, portable number, worker number, and so forth. 

Stage 6 – Mention office subtleties. 

Stage 7 – Mention family subtleties. 

Stage 8 – Upload photo and mark. Make a point to hold fast to the predetermined principles with respect to the measurements. 

Stage 9 – Mention subtleties relating to the recipient. 

Stage 10 – Mention head office subtleties. 

Stage 11 – Save the subtleties and print the report for future reference.

Application form download procedure

Download Forms for State Government Employees 

Stage 1 – Visit the West Bengal Health Scheme Portal > Downloads area 

Stage 2 – Select 'Workers' from the "Select Category" drop-down menu 

Stage 3 – Download the applicable structure 

Download Forms for State Government Pensioners 

Stage 1 – Visit the West Bengal Health Scheme Portal > Downloads area 

Stage 2 – Select 'Retired person' from the "Select Category" drop-down menu 

Stage 3 – Download the significant structure

Health claim procedure

The plan takes a shot at a credit only premise. In this manner, if the treatment cost is under the expressed bundle, the recipient doesn't need to settle the clinic bill as the treatment will be secured according to the plan. In the event that the expense surpasses the breaking point referenced in the bundle designated for the treatment, the extra costs of the bill will be settled by the recipient and the medical clinic, and there will be no case for the surpassing sum. 

Stage 1 – Submit the credit only card while getting conceded for treatment at an empanelled emergency clinic. 

Stage 2 – Health Care Organization will send an authorisation solicitation to the Government Authorized Agency (GAA). 

Stage 3 – GAA will check the subtleties and endorse the solicitation. 

Stage 4 – Post the treatment, HCO or the clinic will send the bill to the GAA. The bill will be joined by required records like a clinical report, specialist's endorsement, release synopsis, and so forth. 

Stage 5 – GAA will confirm the sent archives. 

Stage 6 – GAA will move the sum to HCO.

Empaneled Hospitals Listed Under West Bengal Health Scheme

1.The Calcutta Medical Research Institute
6.Ruby General Hospital
2.Desun Hospitals and Heart Institute
7.BM Birla Heart Research Centre
3.Nightingale Hospitals
8.Medica Super-specialty Hospital
4.R N Tagore International Institute of Cardiac Sciences
9.Mission of Mercy Hospital
5.Apollo Gleneagles
10.Susrut Eye Foundation

FAQs

  1. Is it feasible for a worker to quit this plan? 

Indeed, a worker can quit the plan. Notwithstanding, the worker must meet certain necessities for doing as such. 

  1. Is it workable for the recipient or the recipient's relatives to profit by the plan's repayment office utilizing the Certificate of Enrolment? 

Indeed, representatives, beneficiaries and their relatives can profit with the assistance of a Certificate of Enrolment. 

  1. Is it workable for a representative who is an aspect of the West Bengal Health Scheme to profit by the West Bengal Services Rules offices? 

Indeed, it is conceivable to profit by West Bengal Services Rules offices for a representative who is an aspect of the West Bengal Health Scheme. 

  1. Is the plan part's life partner considered as a recipient? 

Truly, the part's mate can be considered as a recipient. 

  1. Will the cost of treatment for medical procedure be repaid if there is no bundle rate allocated to it? 

Truly, it very well may be repaid. The bundle cost of a comparative medical procedure will be mulled over. 

  1. What is the West Bengal (WB) Health Recruitment Board? 

The WB Health Recruitment Board is established by the State Government. It initiates applicants as a piece of direct enrollment. For instance, it initiates attendants and clinical officials. The official site of the board is www.wbhrb.in. 

  1. How might I access the West Bengal Health Department site? 

You can get to the Government of West Bengal's Health and Family Welfare Department by visiting www.wbhealth.gov.in.

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