West Bengal Health Scheme (WBHS) 2008

Why Was West Bengal Health Scheme (WBHS) Introduced

Prior to WBHS, most of the hospitalisation expenses were paid by the Government officers and pensioners of West Bengal, who were confined to the traditional way of reimbursement, which was time-consuming and limited in scope. This put a strain on finances, particularly for pensioners on fixed incomes who suddenly find they need medical care.

The West Bengal government introduced WBHS in 2008 to give state employees and pensioners a structured, cashless treatment option at empanelled hospitals, similar in concept to the Central Government Health Scheme (CGHS) available to central government employees. provided they are not already covered under CGHS, and periodically updating the cashless treatment limit and process through the WBHS online portal.

West Bengal Health Scheme – Key Highlights

Who is Eligible to Enroll in West Bengal Health Scheme (WBHS)

• West Bengal Government Employees: All serving West Bengal government employees are eligible for enrollment, including their eligible dependents.
• Superannuated Government Employees and Family Pensioners: all West Bengal state government pensioners and family pensioners.
• Employees or pensioners who have opted for the scheme via the Medical Allowance route.
• Serving All India Service (AIS) Officers: All India Service (IAS, IPS, IFS) officers posted in West Bengal, and their family members, are eligible for enrollment in WBHS, provided they are not simultaneously enrolled in CGHS. Simultaneous enrollment in both CGHS and WBHS is not permissible.
• All India Service (IAS, IPS, IFS) officers serving in West Bengal will be eligible for enrollment in the West Bengal Health Scheme, with the concurrence of CGHS. Enrollment in the CGHS and WBHS at the same time is not permissible.
• Panchayati Raj (PR) Bodies Employees: Employees of Panchayati Raj (PR) bodies in West Bengal are eligible for enrollment.
• Grant-in-Aid (GIA) Colleges and Universities Employees: Beneficiaries of Grant-in-Aid (GIA) colleges, universities,
• Eligible dependent family: generally consist of spouse, dependent parents, children, dependent siblings, and widowed, divorced, or unmarried daughters/sisters are eligible to apply.

What West Bengal Health Scheme (WBHS) Covers

The West Bengal Health Scheme (WBHS) provides coverage for medical expenses through reimbursement and cashless facilities across several categories:

• Cashless Indoor Hospitalisation Treatment: Eligible beneficiaries will receive reimbursement of the the cost of all indoor treatments performed at empanelled hospitals in West Bengal. Any treatment received in non-empanelled hospitals within the state is also covered for reimbursement, but the claim must comply with the scheme's specific guidelines.
• Cashless Medical Facilities – Scheme has been in force since 2014 to provide cashless treatment up to ₹2,00,000 per indoor treatment.
• OPD Treatment: The scheme provides treatment at the cost of the Outpatient Department (OPD) for 18 identified diseases.
• Treatment outside West Bengal: 11 hospitals are enlisted outside West Bengal, which can provide treatment to beneficiaries.

What West Bengal Health Scheme (WBHS) does not cover

• Treatment costs beyond the prescribed cashless limit are not covered unless covered under a specific extension provision.
• AIS officers already covered under CGHS cannot simultaneously claim WBHS benefits.
• Only currently empanelled hospitals and diagnostic centres are eligible for cashless treatment; the network changes periodically (currently 204 hospitals and 30 diagnostic centres), so beneficiaries should verify a facility's current empanelment status before availing treatment.
• Specific items/treatments listed as "inadmissible" under the scheme are not covered.

How to Apply for West Bengal Health (WBHS) – Step by Step

Fresh enrolment for employees and pensioners is currently open until 31 July 2026, per the official portal notice.

Step 1: Visit the WBHS Portal

Visit the official West Bengal Health Scheme website at https://healthscheme.wb.gov.in/

Step 2: Select to Online Enrolment

On the home page, locate the "Online Enrolment" dropdown menu.

Step 3: Select Your Category

Choose the link that corresponds to your specific status to begin the registration process:

• Government Employees: Select "Govt. Employee" to start or continue registration.
• Government Pensioners: Select "Govt. Pensioner".
• GIA College Beneficiaries: Select "Beneficiaries of Grant-in-Aid College".
• GIA University Beneficiaries: Select "Beneficiaries of Grant-in-Aid University".

Step 4: Check Eligibility Requirements

Before proceeding with the application, ensure you meet the following conditions:

• Medical Allowance: Employees must stop receiving the Medical Allowance, while pensioners must stop receiving the Medical Relief.
• All India Service Officers: Retired AIS officers must pay a one-time contribution of ₹40,000 and stop receiving CGHS benefits.

Step 5: Complete the Registration Form

Follow the prompts on the specific registration page for your category to input your details and submit your application.

Once enrolled, you can manage your benefits and file for online claims through the "Online Claim" section of the portal, which requires a separate sign-up for Government or GIA beneficiaries.

Documents Required for West Bengal Health Scheme (WBHS)

• Duly filled out the online enrolment form.
• Proof of employment or pension status (Employee ID, PPO number, GPF/PRAN, HRMS ID, or equivalent).
• Aadhaar card and identity proof.
• Photograph of the applicant.
• Details and proof of eligible dependents to be added.

How to Check Your WBHS Application, Card, or Claim Status

To check the status of your application, health card, or medical claim under the West Bengal Health Scheme (WBHS), you can use the various modules available on the official portal (healthscheme.wb.gov.in).

1. Checking Beneficiary or Card Status

To verify if your beneficiary profile is active or to check your card details, you can use the authentication tool provided for hospitals and beneficiaries:

• Navigate to the Hospital menu on the home page.
• Select the Authenticate beneficiary.
• You may also check View permission under the same menu to see the status of any authorised treatments.

2. Checking Claim Status

Monitoring the status of a medical reimbursement or cashless claim requires you to access the dedicated claim portal:

• Go to the Online Claim dropdown menu.
• Select the category that applies to you: Government Beneficiary or GIA Beneficiary.
• You will need to log in or sign up if you haven't already to view your specific claim history and current status.

3. Checking Application/Enrollment Status

If you have recently applied and want to check if your registration is complete:

• Go to the Online Enrolment menu.
• Select your category (e.g., Govt. Employee or Govt. Pensioner).
• The portal provides options to continue registration, which typically allows you to see the progress of your application or complete a pending one.

Helpline and Support for WBHS

WBHS and Other Health Schemes

• Central Government Health Scheme (CGHS): A central government healthcare scheme providing medical services to Central Government employees, pensioners and their eligible dependents.
• Ayushman Bharat PM-JAY: A central government health scheme providing health coverage of up to ₹5 lakh per family per year to eligible economically weaker families.
• Telangana New Employees Health Scheme (NEHS): A state government healthcare scheme providing cashless treatment to Telangana Government employees, pensioners and their eligible dependents.