Bihar Government Health Scheme

Why the Bihar Government Health Scheme (BGHS) was Introduced

Previously, the employees and pensioners of the Bihar Government had to bear the costs of treatment themselves during any emergency and there were no Health Insurance that provides safety net. Afterwards, they used to get reimbursements, but again faced complications with the process of reimbursement.

Now, in order to simplify things for the employees and pensioners of the Bihar Government, the government launched a health scheme, which is known as the Bihar Government Health Scheme. Under the scheme, instead of first paying and then getting reimbursement, the eligible individuals and their families get a card that makes their visit to the approved hospitals free and hassle-free.

Key Highlights - Bihar Government Health Scheme

Who is Eligible for the Bihar Government Health Scheme

• State Legislature Members: Current and retired Members of the Legislative Assembly (MLAs) and Members of Legislative Council (MLCs).
• Officers of All India Services (AIS): Currently serving and retired AIS officers (IAS, IPS, IFS) in the Bihar Cadre.
• State Government Employees: Regular employees, staff, and officers in all departments of the Bihar Government.
• Retired Pensions and Family Pensions: Retired employees of the Bihar State government receiving pensions and family pensions (spouses).
• Family Members: Legal dependents (spouse, dependent children, and dependent parents) of all eligible primary members mentioned above.

What the Bihar Government Health Scheme Covers

• Inpatient Hospitalisation (IPD): The scope of treatment shall include cashless inpatient medical treatment of eligible beneficiaries.
• Hospitals in Network: Cashless medical facilities shall be valid within:
  • Government Hospitals
  • Private Hospitals Panelled With Health Department
  • Panelled CGHS Hospitals
• Limits and Caps on Rates: Expenses shall be reimbursed up to the maximum limit of the CGHS admissible rate.
• Extra Cost: The amount exceeding the total billing of the hospital over and above the maximum CGHS rate shall be borne by the beneficiary directly.
• Treatment in Non-Empanelled Hospitals: Treatment at Non-empanelled/non-CGHS Hospitals is not Cashless; expenses will be refunded as per existing norms after treatment.

What the Bihar Government Health Scheme does not cover

• OPD Treatment: OPD Treatment is not covered under Cashless scheme; serving employees keep 10% of their monthly medical allowance for daily expenses.
• Expenditure in Excess of CGHS Admissible Rates: Any expenditure incurred in excess of the ceiling rate of CGHS admissible rates will not be covered by the scheme and needs to be paid out of pocket by the beneficiary.
• No Direct Cashless Services from Non-Empanelled Hospitals: If any treatment is taken from non-empanelled hospitals, which could be private or non-CGHS hospitals, then it will not be processed for cashless services under this scheme.

Documents Required to Apply for the Bihar Government Health Scheme

• Aadhar Card (Needed for identification & e-KYC).
• Government Service ID / Government Employee ID Card (Issued to regular employees/teachers).
• Pension Payment Order (PPO/Pension Slip) (Issued to state government pensioners/family pensioners).
• PAN Card (For tax/Payroll purposes).
• Marriage Certificate (If adding a spouse whose details have not been updated in the service record).
• Birth Certificate/Age Proof (If the dependent is a minor child)

How to Apply Step by Step for the Bihar Government Scheme

Step 1: User Verification

• Serving Personnel: Log in to the official Bihar Health Department website using your HRMS/Employee ID and OTP received on your registered mobile number.
• Pensioners and Family Pensioners: Login using your Pension Payment Order (PPO) number and your registered mobile number.

Step 2: Submit Voluntary Consent and Contribution

As the scheme is voluntary, you can choose the terms under which you want to join the scheme online:

• Serving Employees: Submit an online application where you give your consent for the diversion of 90% of your monthly medical allowance of ₹900 out of the total ₹1,000 to the BGHS Corpus Fund (you can keep ₹100/month for OPD expenses).
• Pensioners: You need to provide a one-time contribution equal to one month's basic pension.

Step 3: Dependent Mapping (e-KYC)

• Add your dependents who fall under the eligible age bracket (spouse, children, parents).
• Perform identity authentication through Aadhaar e-KYC with the government services' database for each dependent.

Step 4: Approval and Download Digital Card

• Once approved by your DDO/Treasury office, your Digital BGHS Cashless Health Card will be issued to you.
• Download your e-card (unique QR code) for cashless inpatient treatment from empanelled hospitals.

Helpline and Support Contact Information

Other Government Health Insurance Schemes

State Government Schemes

• AB-PMJAY Bihar: Agovernment health insurance scheme that offers coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalisation.
• Mukhyamantri Jan Arogya Yojana: A state health insurance scheme that offers coverage of up to ₹5 lakh per family per year to those who are not covered under the PM-JAY Scheme.

Central Government Schemes

• Central Government Health Scheme (CGHS): This is a central health insurance scheme which covers government employees and pensioners.
• Ayushman Bharat Scheme (PM-JAY): This is a central health insurance scheme which insures the individual up to ₹5 lakh per year per family.
• Employees' State Insurance Scheme (ESIC): This scheme consists of the provision of health care, including medical, maternity, and disability benefits to the employees.
• Ex-Servicemen Contributory Health Scheme (ECHS): a health insurance scheme that offers medical coverage to retired Armed Forces personnel (Army, Navy, Air Force) and their dependents.