Is Eye Treatment Covered Under WBHS?

WBHS Eye Care Coverage: What You Need to Know

Eye health is a vital part of a person’s overall well-being. The West Bengal Health Scheme (WBHS) provides medical coverage for different treatments. However, when it comes to eye care, most of the beneficiaries have questions regarding the coverage offered.

Whether you require cataract surgery or specialized eye treatments, being aware of what WBHS covers for eye care can assist you in planning your healthcare costs. Let's analyze the types of eye treatment included under WBHS and the information you should be aware of.

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WBHS and Eye Care: What is Covered?

Beneficiaries under the WBHS are covered for cashless treatment of a variety of medical procedures, including eye-related treatments. The scheme covers a number of eye treatments, including cataract removal, glaucoma treatment, corneal transplant, dry eye treatment, and other routine ophthalmologic procedures.

Some of the most common eye treatments covered under WBHS are:

● Cataract Surgery: A very common procedure in which the cloudy lens of the eye is replaced with an artificial one. This is among the most prevalent surgeries under WBHS.

● Glaucoma Management: Glaucoma is an umbrella term for eye diseases that can cause optic nerve damage, usually as a result of high intraocular pressure. This type of treatment is covered under the scheme.

● Corneal Transplantation: Surgical intervention in which a cornea that has been damaged is transplanted with a donor cornea. Such treatment is required for patients with corneal diseases, and WBHS covers the related expenditures.

● Treatment for Dry Eyes: WBHS also offers coverage for the treatment of chronic dry eye, which could involve particular remedies such as prescribed eye drops or specialized therapies.

Procedure to Benefit from Eye Treatment under WBHS

To avail of the benefit of eye care services from an empanelled hospital under WBHS, the beneficiaries are required to follow a simple process:

● Obtain Enrollment Certificate

Before getting treated, government employees or pensioners must have a valid WBHS enrollment certificate. It should be presented when visiting any empanelled hospital, including those providing eye care services.

● Hospital Visit

After the enrollment certificate is prepared, beneficiaries can go to a network eye hospital. They need to furnish the certificate, along with a valid photo ID such as an Aadhaar card, voter ID card, etc.

● Consultation and Investigations

On their visit to the hospital, beneficiaries will need to undergo an eye test and might require further investigations, like imaging or blood work. These investigations are billed at reduced rates, according to the WBHS rate chart.

● Surgery and Treatment

If surgery or other specialized treatment is needed, the beneficiary can arrange for the procedure. During surgery, all documents, such as medical reports, prescriptions, and the enrollment certificate, must be provided.

The expense of surgeries such as cataract surgery or corneal transplant will be borne under the WBHS limit, with the option of a cashless treatment facility.

Eligibility Criteria for WBHS Eye Treatment

The West Bengal Health Scheme provides coverage to a large category of people so that employees, pensioners, and their dependents are covered for medical costs. The following individuals are entitled to receive treatment under WBHS:

● State Government Employees: All regular employees serving under the West Bengal Government have been covered under WBHS.

● Pensioners: Retired government employees drawing a pension are also eligible to receive medical care under the scheme.

● Dependents: Coverage is extended to the dependents of the employees and pensioners, such as spouses, children below 25 years of age, and dependent parents.

It is necessary for the beneficiaries to register their dependents under the scheme in order to take advantage of the benefits for eye treatment or other medical care.

List of Empaneled Eye Hospitals Under West Bengal Health Scheme

Here is a list of empanelled eye hospitals under WBHS:

● Spectra Eye Foundation

● The Calcutta Medical Research Institute

● Disha Eye Hospitals

● Dr. Nihar Munshi Eye Foundation

● Eye Care and Research Centre

● Silverline Eye Hospital

● Susrut Eye Foundation

Steps to Download the West Bengal Health Scheme Certificate

Mentioned below is the simple step-by-step process to download the WBHS certificate:

Step 1: Navigate to the West Bengal Health Scheme official portal.

Step 2: After this, tap on the ‘Login’ option.

Step 3: Provide the user ID, password, and CAPTCHA code and click on ‘OK’.

Step 4: Select the ‘Download Enrolment Certificate’ option once the pensioner or employee account page opens.

Step 5: Select the ‘Enrolment ID Number link’ in order to download the WBHS enrolment certificate.

To conclude, WBHS provides vital coverage for common to major eye problems that require hospitalization or surgery, such as cataract operations and the treatment of glaucoma. As a result, beneficiaries can focus on their recovery without worrying about the pressure of expensive medical charges.

However, as a beneficiary, you need to consider the inclusions and exclusions of WBHS when it comes to eye care. This will help avoid surprises when filing claims.