West Bengal Health Scheme (WBHS)

WBHS: Affordable Healthcare for West Bengal Government Employees

Over the years, medical costs risen significantly, making quality healthcare an expensive affair for most people. Therefore, to provide accessible healthcare for state employees and pensioners, the West Bengal government launched the West Bengal Health Scheme (WBHS) in 2008.    

In this guide, you will learn all the details of the WBHS scheme, such as eligibility criteria, WBHS hospital list, registration process, and more.  

What is the West Bengal Health Scheme (WBHS)?

WBHS is a healthcare scheme launched by the Government of West Bengal to provide low-cost medical services to state government employees and pensioners. It covers outpatient and inpatient treatments in government and private hospitals, thereby reducing financial burdens on the beneficiaries. It is a kind of West Bengal health insurance for the state government employees and pensioners, aiming to reduce financial burden during a health crisis.

The WBHS health plan is available with the benefits of medical consultation, diagnostic tests, surgical treatments, maternity benefits, and more. 

Also Read: Super Top-up health insurance

Eligibility Criteria for WBHS

The benefits under the WBHS scheme are available if an individual satisfies a set of conditions, such as:

1.State Government Employees: Government of West Bengal employees in service are covered under the WBHS health scheme. All the permanent and temporary employees are included in the list, but the only requirement is that they receive a salary from the state government. 

2.Pensioners: Retired employees of the Government of West Bengal are also eligible for the scheme. This includes both those receiving regular pensions and those availing of family pensions.

3.Eligible Family Members: The scheme is available to the family members of state employees and pensioners. These include the spouse, dependent children, dependent parents, and other eligible family members as defined by the government.

WBHS Scheme Coverage

The WBHS scheme offers wide-ranging health coverage for the beneficiaries. It can be broadly divided into the following:

Outpatient (OPD) Treatment

The WBHS OPD treatment list includes a wide array of services, like:

• Consultation: The beneficiaries can get medical consultations with general physicians or specialists, such as cardiologists and neurologists, among others.
• Diagnostic Services: The beneficiaries, being under OPD treatment under WBHS, can undergo diagnostic tests such as blood tests, X-rays, and other necessary examinations.
• Medicines: Prescription drugs are also included in the WBHS OPD treatment package. Also, medicines for all kinds of ailments will be available to the beneficiaries free of cost.

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Inpatient (IPD) Treatment

In cases where hospitalization is required, the WBHS scheme covers inpatient treatments, including surgeries, maternity care, and emergency services. This ensures that beneficiaries are not financially burdened by medical expenses during critical times.

Diagnostic Tests

Under the scheme, beneficiaries can access necessary diagnostic tests. These are mostly necessary for an accurate diagnosis and treatment plan. The test rates of WBHS are subsidized and include blood tests, CT scans, MRIs, and other essential medical examinations.
 

Surgical Procedures

The WBHS scheme covers a broad spectrum of surgeries, ranging from minor surgical procedures to major operations. Whether it is an emergency surgery or an elective procedure, the scheme ensures that beneficiaries receive the necessary treatment without worrying about finances.

WBHS Portal: Key Features

The WBHS portal is a crucial tool for beneficiaries, offering a centralized platform for accessing services, submitting claims, and obtaining information. The following are its key highlights:

• Hospital List: The portal provides beneficiaries with access to the complete list of WBHS hospitals, which includes a list of all the hospitals and clinics that areempanelledunder the scheme. These hospitals are both government and private, ensuring a variety of options for beneficiaries.
• Reimbursement Claims: The WBHS portal allows the beneficiary to file reimbursement claims for medical treatments already availed. This makes it easier for members to get their medical expenses reimbursed without much hassle.
• Service Details: The portal provides detailed information on various treatments and services covered under the scheme, including the list of diagnostic tests, surgeries, and outpatient services available.

The WBHS portal has become an essential tool for both the employees and pensioners of the West Bengal government, as it provides easy access to critical information and services.

WBHS Hospital List

The WBHS hospital list includes all hospitals and healthcare centres empanelled with the scheme. These hospitals provide medical services to the beneficiaries at reduced rates or even offer cashless treatment. The empanelled hospitals include:

• Government Hospitals: Many government hospitals in West Bengal are included in the WBHS network. They provide comprehensive medical services, including general consultations, emergency care, and specialized treatments.
• Private Hospitals: A few private hospitals and healthcare centres have been empanelled under the WBHS scheme. This enables beneficiaries to avail themselves of more specialized treatment options and shorter waiting times.

The list of WBHS hospitals is provided by WBHS through its portal, and beneficiaries can select a particular hospital based on their need, location, etc.

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WBHS Test Rates: Cost-Effective Diagnostic Facilities

One of the key benefits of the WBHS health scheme is that it guarantees affordable diagnostic tests. The WBHS test rates are set at subsidized prices, making essential diagnostic services like blood tests, X-rays, MRIs, and other imaging services more accessible to beneficiaries.

WBHS test rates are "capped" to prevent beneficiaries from experiencing severe financial distress while undergoing required medical tests. In this way, the entire process, from consultation to diagnosis and treatment, remains out of pocket under the scheme.

OPD Treatment Under WBHS

The OPD treatment provided by WBHS comprises consultation services, diagnostic tests, medicines, and minor treatments. Employees, pensioners, and dependents access such treatment through many empanelled hospitals. The WBHS list for OPD treatment encompasses several specialities, including:

• General medicine
• Cardiology
• Orthopedics
• Neurology
• Pediatrics
• Gynecology

Various treatment options provided by WBHS help beneficiaries avail themselves of appropriate health management and medical assistance without incurring exorbitant costs.

How to Register and Access WBHS Services

To access the benefits of the WBHS scheme, employees and pensioners must register on the WBHS portal. Once registered, they can:

• Download their WBHS Card: This card serves as proof of enrollment in the scheme and is essential for availing of medical services at empanelled hospitals.
• Find Empanelled Hospitals: The list of WBHS hospitals on the portal allows you to choose the right hospital for your health needs.
• File Claims: Beneficiaries can use the portal to file claims for reimbursement of medical expenses incurred.

Under the West Bengal Health Scheme, state government employees, pensioners, and their families can avail of affordable healthcare services in empanelled hospitals. This ensures seamless access to quality treatment during medical emergencies without extensive out-of-pocket expenses.

However, such benefits are not available to private-sector employees. For them, Star Health offers a wide range of individual and family health insurance plans.

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