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WBHS
West Bengal Health Scheme is to provide Medical Benefits to the State Government Employees and their dependent family members, State Government Pensioners.
An amount of Rs. 8500/- for parent and Rs. 5000/- for other members of the family has been fixed as the maximum ceiling of gross income/ earning for becoming the dependent beneficiary under the Scheme.
If patient has a history of cardiac surgery like of Bypass Surgery, AICD, Valve Replacement or Implantation of Stent through Angioplasty or Implantation of Pacemaker, will get lifelong reimbursement of the cost.
Governor is now pleased to enhance the ceiling of cashless limit of each IPD treatment in private empanelled hospital up to Rs. 1,50,000/- only from the existing ceiling of Rs. 1,00,000/-.
Governor is pleased to introduce the online processing of medical advance claim through WBHS Portal with the following guidelines, new set of Forms and Pro-forma Estimate from the Hospital for processing and settlement of the claim:
Revision of guidelines for seeking permission by the state empanelled private hospitals from West Bengal Health Scheme Authority for providing treatment under West Bengal Health Scheme.
Considering the gravity of the disease/illness named ‘Covid-19’ the West Bengal Health Scheme Authority (WBHSA) has agreed to include the same as 17th (seventeenth) disease/ illness in the OPD List of WBHS.
Last date of incorporation of Aadhar Number of existing beneficiaries above the age five years is 30.06.2022 failing of which they may face inconvenience to avail uninterrupted benefit under this scheme.
All Head of the offices under Govt. of West Bengal have the financial power for sanctioning the reimbursement cost of medical attendance and treatment under West Bengal Health Scheme (WBHS).
Introduction of online functionality for seeking prior permission of availing treatment in Enlisted Hospitals outside the State through West Bengal Health Scheme Portal.
Training on processing & disbursement of reimbursement claim under West Bengal Health Scheme on ONLINE platform through WBHS and WBIFMS Portal.
Governor is pleased to prescribe the entitlement of accommodation for indoor treatment in different Hospitals including the Government Hospitals and Tata Medical Centre, Rajarhat to the beneficiaries under WBHS after ROPA-2019
Governor is pleased to implement ONLINE functionality for discontinuation of Medical Allowance/ Relief from the Salary/Pension of the enrolled employee and pensioner with the following directives:
The facility shall be restricted only for the treatment of one or more diseases/ illness mentioned in the Enrolment Certificate out of the above mentioned critical diseases/ illness.
Introduction of online functionality for Opt-out and Termination of enrolment from West Bengal Health Scheme through WBHS Portal.
Online processing of reimbursement claims through WBHS Portal and making payments thereof under WBIFMS in integrated web mode was under active consideration for some time past. And, in order to make the ONLINE processing of these claim more comprehensively, the existing claim Forms also modified.