With the rising healthcare costs, programs such as the West Bengal Health Scheme (WBHS) have become a boon for government servants and pensioners. Even though the scheme covers a vast array of medicines and treatments, it is crucial to understand that not every medicine is covered.
The government has categorically specified exclusions to ensure rational use and to avoid misuse of public funds. Let's discuss the types of medicines beyond the reimbursable list under WBHS.
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Under the provisions made by the Finance Department (Audit Branch), Medical Cell of the Government of West Bengal, some medicines—though manufactured with a drug license—are not reimbursed under the West Bengal Health Scheme, 2008.
Under Finance Department Memorandum No. 6586-F(MED), dated 29.06.2011, these are the medicines not reimbursed under WBHS:
Serial Number | Category |
1 | Invalid Foods |
2 | Baby Foods |
3 | Weaning Foods |
4 | Glucose Preparations |
5 | Liquid Foods and Wines |
6 | Meat Extracts and Juices |
7 | Carbonated Beverages |
8 | Protein Biscuits |
9 | Miscellaneous Foods |
Serial Number | Sub-Category | Examples and Brand Names |
1 | Tonics | Ferradol, Glycerophosphate with Vit. B Complex, Minadex, B.G. Phos, Deyplex, Renovan, Hemiphos, Rakto Phospho Malt, Univine, Opimalt, Maltomin, Vitale-Cithin, etc. |
2 | Inadmissible Medicines | Gripe Water, Caladryl Lotion, Cremaffin, Milk of Magnesia, Calcium Sandoz, Lacto-Calamine, Vicks Vaporub, Ringworm Ointments, Livo-B Complex, Madhu Tab, Taka Combex, etc. |
3 | Vitamins | Becadexamin, Beniplex, Polyvitamins (various), Vitazyme, Vitamalt, Vitaphosmin, Vitabion, Vitapepsin, Poly-B Complex, Vitadex, Vitronal, Viterra, etc. |
Serial Number | Item Type | Examples |
1 | Toiletries & Cosmetics | Cold Creams, Face Powders, Shaving Creams/Soaps, Talcum Powders, Vanishing Creams, Toothpaste/Powder, Bath Salts |
2 | Skin & Hair Preparations | Hair Tonics, Astringent Lotions, Skin Lotions, Lanoline Toilets, Hand Creams |
3 | Miscellaneous | Soaps (of all types), J.B. Powders |
Serial Number | Chemical Group | Examples / Chemicals |
1 | Phenol & Derivatives | Phenol, Phenyl, Cresol, Lysol, Chlorosol, Clearsol |
2 | Alcohols | Ethyl Alcohol, Isopropyl Alcohol, Rectified Spirit |
3 | Glycols | Triethyl Glycol, Propylene Glycol |
4 | Aldehydes | Formaldehyde Solution, Formalin |
5 | Acids | Acetic Acid, Picric Acid |
6 | Iodine Compounds | Tincture Iodine, Weal Solution of Iodine, Iodoform Powder |
7 | Chlorine Compounds | Hypochlorite Solution, Chlorinated Lime (Bleaching Powder), Liquid Chloramine Eusol |
8 | Oxidizing Agents | Hydrogen Peroxide, Potassium Permanganate, Zinc Sulphate, Zinc Chloride |
9 | Dyes | Methylene Blue, Crystal Violet, Scarlet Red, Brilliant Green, Malachite Green, Methyl Violet |
10 | Cationic Surfactants | Cetrimide, Savlon, Cetavlex, Cetavlon |
11 | Miscellaneous Disinfectants | Listerine, Tetmosol, K-Liquid, Fairgenol, Hibitane Cream, Zylol, Thymol Glycerine, Klofen Liquid, Liso Liquid |
Now that you know the types of medicines excluded under WBHS, let’s take a look at the types of diseases and treatments covered within this scheme:
● Accident-related injuries (including animal bites)
● Crohn’s disease
● Cerebrovascular and neurological disorders
● Chronic obstructive pulmonary disease (COPD)
● Endodontic procedures (root canal therapy)
● Hepatitis B/C and other liver conditions
● Heart problems
● Insulin-dependent diabetes (excluding type 2 diabetes mellitus)
● Malignant conditions
● Renal failure
● Rheumatoid arthritis
● Severe malaria
● Systemic lupus erythematosus (lupus)
● Thalassemia (platelet or bleeding disorders)
● Tuberculosis
● Ankylosing spondylitis
Medical follow-up treatments are reimbursable for the following specified ailments:
● Neurosurgery
● Surgeries, chemotherapy, or radiotherapy related to cancer
● Cardiac surgeries (including coronary angioplasty and implants)
● Renal transplantation
● Replacement surgery of hip or knee
● Accident cases
The expenses for the following specific diagnostic tests will be reimbursed when they are prescribed by authorized hospitals in an outpatient department (OPD):
● Computed Tomography (CT) scan
● Ultrasonography
● Sigmoidoscopy
● Colonoscopy
● Endoscopy
● Endoscopic Retrograde Cholangiopancreatography (ERCP)
● Magnetic Resonance Imaging (MRI)
Eligibility for the West Bengal Health Scheme (WBHS) comprises the following categories:
● All government pensioners and their families
● All India Services (AIS) officers and pensioners residing in West Bengal
● All government employees and their dependents
● Indian Administrative Service (IAS) officers and their families who have registered themselves voluntarily with the WBHS and do not avail of any healthcare benefits under the Central Government Health Scheme (CGHS).
● Members of the Indian Police Service (IPS) and their families who have opted to join the WBHS and do not receive such benefits under the Central Government Health Scheme (CGHS).
● Members of the Indian Forest Service (IFS) and their families who have registered themselves voluntarily for the WBHS and do not get benefits under the Central Government Health Scheme (CGHS).
Having a thorough understanding of what medicines are not covered under WBHS is important for beneficiaries. This will help them abide by the scheme, prevent unnecessary rejections, and facilitate the rational use of drugs. Individuals should also cross-check prescriptions against current West Bengal Health Scheme (WBHS) guidelines to avoid surprises when settling claims.