West Bengal Health Scheme: Facilities Available

Last Updated on January 25, 2022 by WBPAY

The following Facilities available for the employee enrolled in West Bengal Health Scheme 2008 and Cashless Scheme 2014.

Cashless indoor treatment facilities upto Rs 1,00,000/-Cashless indoor treatment facilities upto Rs 1,00,000/-per indoor is available provided treatment done in Private Empanelled Hospitals. Reimbursement of indoor treatment cost beyond Rs 1,00,000/-is also available subject to submission of claim to DDO/PSA.
Reimbursement of related OPD treatment costCost of OPD treatment,relating to the Indoor treatment, incurred during the period of thirty days prior to admission as well as during the period of thirty days after discahrge is available for reimbursement.
Reimbursement of OPD treatment costOPD treatment cost is reimbursable in case of certain specified diseases provided treatment done in recognised hospitals. For detailed list of specified disease Click Here
Reimbursement of indoor treatment cost in Non Empanelled Hospitals60% (80% where number of bed is more than 80) of approved Cost or actual amount paid whichever is less is reimbursable when treatment is done in non empanelled hospitals within the State provided the hospital, on the date of treatment, had a valid license under West Bengal Clinical Establishment Act and Rules.
Reimbursement of cost of certain investigations as mentioned in point 10 of Memo No 797-F(Med)/WB Dt 31/01/2011Cost of certain investigations as mentioned in point 10 of Memo No 797-F(Med)/WB Dt 31/01/2011 are reimbursable on the basis of OPD prescriptions of doctors, consulted in a recognised hospitals, in case of any disease provided the investigations are done in empanelled hospital/diagnostic centre. For detailed list of investigations Click Here
Reimbursement of cost of treatment in certain Speciality Hospitals outside the StateActual cost of treatment including cost of journey with one attendent is reimbursable provided treatment is done in certain specified Speciality Hospitals outside the State. For detailed list of speciality hospitals Click Here

Official Web Site of West Bengal Health Scheme

View: How to Enroll Under West Bengal Health scheme

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