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In 2014, the state government of West Bengal established a health insurance scheme to provide cashless medical treatment to state government and All India Service (AIS) officers and pensioners in enlisted hospitals.
This West Bengal cashless medical treatment scheme was officially known as West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme, 2014. Formerly, the state government’s health insurance scheme was called the West Bengal Health Scheme (2008) but was later merged with the new West Bengal cashless medical treatment scheme on September 15, 2014.
Under this scheme, beneficiaries can avail cashless medical treatment across empanelled hospitals or health care organisations (HCOs) across the state of West Bengal. However, the benefit available under approved package rates and up to a maximum amount of Rs. 1 lakh.
Let's understand the features of the West Bengal Cashless Medical Treatment Scheme:
With the WB Health Scheme, you can avail the benefits of cashless indoor treatment for up to ₹1,00,000 from hospitals included in the WBHS hospital list. If the bill amount exceeds ₹1,00,000, the additional amount must be settled by you.
As a beneficiary, you can claim reimbursement for OPD treatment according to the conditions provided by the scheme.
If you choose to avail any kind of treatment from a non-empanelled hospital, a certain amount of the bill can be reimbursed through West Bengal Health Scheme.
If you get a treatment done from an empanelled hospital belonging to a different state, you are eligible to claim reimbursement.
WB Health Scheme offers coverage for over 1000 medical procedures. The below table explains the extent of coverage for certain treatments.
Type of Treatment |
Number of Days Covered |
OPD and minor surgeries |
1 day |
Specialised surgeries |
Up to 12 days |
Normal deliveries and endoscopic or laparoscopic surgeries |
3 - 4 days |
Major surgeries |
7 - 8 days |
IAS officers can avail the benefits of West Bengal Health Scheme for themselves and their families as per the following conditions:
Enrolling for WBHS is optional
The concerned administrative department for IAS officers and their families would be the Personnel and Administrative Reforms Department
IAS officers and their families can avail facilities as per All India Services Rules, 1954
They shouldn’t receive healthcare benefits under the Central Government Health Scheme (CGHS)
IPS officers and their families can avail the benefits of WBHS as per the following conditions:
The WB health scheme is optional
Their administrative department would be The Home Department Police Service Cell
They can avail the facilities of All India Services Rules, 1954
They shouldn’t be availing the benefits of the Central Government Health Scheme (CGHS)
IFS officers and their families can benefit from WBHS as per the following conditions:
Then enrolment is optional
The concerned department for IFS officers would be the Department of Forests
They can avail All India Services Rules, 1954 facilities
Officers that receive healthcare benefits under the Central Government Health Scheme (CGHS) cannot be a part of the WB Health Scheme
The WB Health Scheme covers over 1000 medical treatments. Here's a list of a few OPD treatment diseases covered under the scheme:
Rheumatoid Arthritis
Endodontic Treatment (Root Canal Treatment)
Renal Failure
Systemic Lupus Erythematosus
Crohn's Disease
Neurological Disorder/Cerebrovascular Disorders
Malignant Malaria
Hepatitis B/C and other Liver Diseases
Chronic Obstructive Pulmonary Disease (COPD)
Insulin-Dependent Diabetes (Type-2 Diabetic Melitas does not fall under insulin-dependent diabetes)
Malignant Diseases
Thalassaemia/Bleeding Disorders/Platelet Disorders
Injuries caused by accidents
Tuberculosis
Treatments to Cure Animal Bites
The West Bengal Health Care Scheme only excludes cosmetic surgeries and non-medical treatments.
You are eligible for West Bengal Health Scheme if you fall under either of the categories:
State government employees, state government pensioners, and their families*
Individuals opting for this scheme according to their medical allowance
All India Services Officers and pensioners
The following refers to the dependent family member of the concerned government employee or pensioner:
Husband/Wife
Parents with income less than Rs. 3,500 per month
Minor siblings
Dependant, widowed, or divorced daughters
Children (including adopted kids, step-kids, and unmarried daughters)
Dependant, unmarried, divorced, or widowed sister
The process to enrol in the West Bengal Health Scheme is easy and can be done online through the West Bengal Health Department website. Here are steps you can follow to register in the West Bengal Health Scheme:
Step 1: Visit the West Bengal Health Scheme official portal: https://wbhealthscheme.gov.in/
Step 2: On the website, click on the option that says ‘Online Enrolment’ and then select the ‘Government Employee’ option.
Step 3: Click ‘Yes’ and enter your PRAN or GPF number if available. If not available, click on the ‘No’ option and select Non-GPF.
Step 4: Enter your personal details such as your residential address, birth date, district, contact number, employee number, etc. Save them and click ‘Continue’. Make sure that all information is correct.
Step 5: Upload your photograph and signature in the specified dimension.
Step 6: Enter the details of your beneficiary and save them.
Step 7: Take a printout of the online form for future reference.
Follow the given steps to download the WBHS application form from the official website:
Step 1: Go to the WBHS portal download section at: https://wbhealthscheme.gov.in/Home/wbhs_download.aspx
Step 2: On this page click on the ‘Select Category’ dropdown menu and choose your relevant category.
Step 3: From the list of forms that appear, download the WBHS application form.
Step 4: Make sure to save a soft copy on your computer and take a printout for future reference.
To avail the benefits of the West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme, state government employees must fill and submit a designated form for availing a particular type of service. These forms include:
1. Form A: This is the application form for enrolment to the West Bengal health scheme.
2. Form D1: This form represents an essentiality certificate and a statement of expenditure for outpatient (OPD) treatment. It has to be certified by a treating specialist.
3. Form D2: Includes an essentiality certificate and a statement of expenditure for both IPD and OPD treatment, certified by a medical specialist.
4. Form D3: Includes an essentiality certificate and a statement of expenditure for medical treatment in non-empanelled hospitals.
5. Form C: A state government can claim reimbursement for medical expenses incurred by using these forms:
Form C1: Reimbursement for the cost of OPD treatment in empanelled hospital
Form C2: Reimbursement of inpatient department (IPD) treatment in a non-network hospital
Form C3: Cashless IPD treatment in a hospital that is in the West Bengal health scheme hospital list
Form C4: Non-cashless IPD treatment in non-empanelled hospital
6. Form E: Includes a checklist for reimbursement of medical claims.
State government pensioners have to fill and submit a different set of forms. They include the following:
Type of Forms |
Particulars |
Form I |
Application form for enrolment to the West Bengal cashless medical treatment scheme. |
Form II |
Reimbursement claim settlement form |
Form III |
Certificate of enrolment |
Form IV 1 |
Essentiality certificate-cum-statement of expenditure (OPD) |
Form IV 2 |
Essentiality certificate-cum-statement of expenditure (IPD & OPD) |
Form IV 3 |
Essentiality certificate-cum-statement of expenditure for non-empanelled hospitals |
Form V |
Checklist for reimbursement of medical claims |
Form VI |
Temporary family permit |
The WBHS scheme is completely cashless, meaning the beneficiaries do not have to pay any money out of pocket. The hospital bills are directly settled by the insurers. However, if the bill amount exceeds the maximum coverage, the beneficiary would have to pay for the extra expenses. Here are the steps to claim the WBHS:
Step 1: Submit your WBHS cashless card at the empanelled hospital where you are getting treated.
Step 2: The hospital will send a verification request to the GAA (Government Authorised Agency).
Step 3: The GAA will verify the details and send their approval.
Step 4: After the treatment, the hospital will send the bills to the GAA.
Step 5: Upon verifying the details, the GAA will settle the bill with the hospital.
The Calcutta Medical Research Institute |
Desun Hospitals and Heart Institute |
Nightingale Hospitals |
R N Tagore International Institute of Cardiac Sciences |
Apollo Gleneagles |
Ruby General Hospital |
BM Birla Heart Research Centre |
Medica Superspecialty Hospital |
Mission of Mercy Hospital |
Susrut Eye Foundation |
Institute of Neuroscience |
Belle Vue Clinic |
Fortis Hospital |
Kothari Medical Centre |
Peerless Hospitex Hospital |
Rotary Narayana Nethralaya |
Silverline Eye Hospital |
B.P Poddar Hospital |
Dr.Nihar Munshi Eye Foundation |
Eye Care and Research Centre |
D.M Hospital Pvt. Ltd |
Bhattacharya Orthopedics |
R.G Stone Urology and Laproscopy Hospital |
Dafodil Hospitals |
Kothari Medical Centre |
KPC Medical College |
Disha Eye Hospitals |
Amri Hospitals |
Barrackpore Medicare |
Ekbalpur Nursing Home |
Nabajiban Hospital |
Implants Better Sight Centre |
Eskag Sanjeevani |
Divine Nursing Home |
Email address of WBHS website: support.wbmedicalcell@nic.in
Contact number: (033)2254-4123/(033)2254-4034
For Technical Help:
Email address: support.hshed-wb@nic.in
Contact number: 18001028014
Yes, you can opt-out of the scheme if you have adequate private health insurance to take care of yourself and your family. However, if any of your family members have availed the WBHS benefit, then you won’t be able to opt-out until 5 years of availing the benefit.
If you are eligible for WBHS, then you should take full advantage of the scheme to get medical coverage for yourself and your family. However, a cover of only ₹1 lakh may not be enough as medical costs have risen swiftly in the past few years. Ensure that you and your family members (including dependents) are well protected with adequate health insurance cover as deadly infectious diseases like the coronavirus (COVID-19) spread rapidly across the world. If you think your family health cover is not adequate, consider buying comprehensive family health insurance on Bajaj MARKETS, starting at just ₹292 per month.
It is a health care scheme offered by the government of West Bengal for State Government employees/pensioners and their families.
If you are an employee of the West Bengal State Government, all your family members are eligible for benefits of WBHS, provided they meet a few conditions:
Employee’s spouse
Children (Step-children, adopted children, including unmarried, widowed, and divorced daughters)
Siblings below 18 years of age
Dependent parents with an income of less than ₹3,500 per month
Dependent sister (Unmarried, widowed, or divorced)
He can be considered a beneficiary until he reaches 25 years of age or until he earns a minimum of ₹1500 per month.
The WBHS full form is West Bengal Health Scheme.
Here are a few hospital names mentioned under the West Bengal cashless medical treatment scheme hospital list 2021:
The Calcutta Medical Research Institute
BP. Poddar Hospital
DM Hospital Pvt. Ltd
BM. Birla Heart Research Centre
Susrut Eye Foundation
Rotary Narayana Nethralaya
Silverline Eye Hospital
Fortis Hospital
Daffodil Hospitals
Kothari Medical Centre
Yes, the scheme member’s wife and husband, both are considered as beneficiaries.
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