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West Bengal Cashless Medical Treatment Scheme

The Indian Central and State Government often introduce various health related plans for the citizens of the country, especially for the weaker or underprivileged sections of the society. With the soaring costs of healthcare in India, these government health insurance schemes and plans serve as great support for many Indian families. One such scheme is the West Bengal Cashless Medical Scheme. The West Bengal Health Scheme or WBHS is a Bengal State Government healthcare initiative that helps the eligible citizens and State Government Employees of West Bengal, All India Services (AIS) Officers, their families, and pensioners avail cashless health treatments. This scheme was launched in the year 2008 and was taken into action by the West Bengal Finance Department, Government of West Bengal. In 2009 and 2010, the Government also extended the facilities of this scheme to IAS, IPS, and IFS officers. [1]

The Government of West Bengal changed the name of “West Bengal Health Scheme” in the year 2014 and named it “West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme 2014.” Under this updated scheme, the Government also introduced a cashless medical facility of up to INR 2 lakh per indoor treatment. Under this scheme, there are a total of 177 empanelled private hospitals, 27 empanelled diagnostics centres, and 1234 ongoing treatments as of 15th November 2024. [2]

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Key Features of The West Bengal Health Insurance Scheme

The key features of the West Bengal Cashless Health Insurance Scheme are as follows:

  • Cashless Indoor Medical Treatment: This component is the key feature of the West Bengal Cashless Health Insurance Scheme. Under this feature, the insured can avail cashless indoor treatment at an accredited/ network hospital worth INR 1 lakh. This is done in order to reduce the burden on the insured and their family members. It is to be noted that if the treatment cost of the insured exceeds the amount of INR 1 lakh, then the remaining cost of the treatment is to be borne by the policyholder.
  • Out-of-State Hospitalisation Cover: With the WBHS, in case the insured has undergone a treatment in a hospital outside West Bengal, the cost of the treatments are covered. This is true only when the hospital is empanelled and listed by the West Bengal Government under the scheme.
  • Coverage for Treatment Done in A Non-empanelled Hospital: In case the treatment being done is not available in the empanelled hospitals, then the insured can choose to get their treatment done at a non-empanelled hospital. Under the West Bengal Cashless Health Insurance Scheme, a portion of this treatment will also be covered, and can be reimbursed. Please ensure you read the terms and conditions of the scheme carefully.
  • Major Treatments & Procedures Covered: Under WBHS, there are over 1000 treatments and procedures covered. There is also a coverage for specialised surgeries for up to 12 days, for major surgeries up to 7 to 8 days, laparoscopic and endoscopic surgeries, normal deliveries up to 3 to 4 days, and OPD and minor injury coverage of 1 day.

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