Treatment in Private Nursing Home (80% reimbursement)
Cost up to 80% of the West Bengal Health Scheme approved rates may be reimbursed for the indoor medical treatment, if availed in a non-empanelled private hospital.GOVERNMENT OF WEST BENGAL
Finance Department
Audit Branch
Medical Cell
No. 10539-F(MED), Dt. 21-11-2011
Notification
At present the State Government employees/ Government pensioners who are enrolled under the West Bengal Health Scheme, 2008 are entitled to the reimbursement of the cost of medical attendance and treatment including their family members in recognised hospitals/ nursing homes under the Health Scheme. The Government has been considering from some times past to allow such Government employees/ Government pensioners to avail medical treatment facilities in non-empanelled private hospitals/ nursing homes also.
Accordingly, the Governor is pleased to order that the State Government employees and Government pensioners who are enrolled under the West Bengal Health Scheme, 2008 may avail the indoor medical treatment facilities in any non-empanelled private hospital/ nursing home.
Reimbursement of the cost of such indoor medical treatment will be made under the Health Scheme in the following manner:-
1.(a) Cost up to 80% of the West Bengal Health Scheme approved rates may be reimbursed for the indoor medical treatment, if availed in a non-empanelled private hospital/ nursing home with bed capacity more than 80 (eighty).(b) For indoor medical treatment in a non-empanelled private hospital/ nursing home with bed capacity 80 (eighty) or less, costs up to 60% of the West Bengal Health Scheme approved rates may be reimbursed.
2. No O.P.D. treatment cost will be reimbursed.
3. No advance will be sanctioned for medical treatment in non-empanelled private hospital/ nursing home.
4. The Sanctioning Authorities under Clause-13 of the West Bengal Health Scheme will settle the claims.
5.(a) The State Government employees will furnish Essentiality Certificate in Form-D3 and apply for reimbursement of the costs following Clause-12 of the Health Scheme.
(b) The Government pensioners will furnish Essentiality Certificate in Form-IV3 and apply for reimbursement of the costs following Para-11 of the Memo No. 3475-F, dt. 11-05-2009.
By order of the Governor
Sd/- (C.M. Bachhawat)
Principal Secretary to the
Government of West Bengal