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West Bengal Cashless Medical Treatment Scheme

The West Bengal Cashless Medical Treatment Scheme provides cashless healthcare services up to Rs.1 lakh to pensioners, officers, and employees of the West Bengal state government. AIS officers and their families are also covered under this scheme.
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The West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme, notified in 2014 is a comprehensive health scheme which aims to provide cashless medical facilities to employees, officers and pensioners of state government (not excepting family pensioners) All India Service (AIS) officers and their family members across empanelled hospitals in West Bengal. The WBHS 2008 has been merged with the Health for All Employees and Pensioners Cashless Medical Treatment Scheme, 2014 from September 15th, 2014.

It is important to note that the cashless facility is available on the approved package rates under this scheme. Beneficiaries under this scheme can avail of cashless medical treatment for up to Rs.1 lakh. In case the treatment costs exceed the ceiling amount, the beneficiary has to pay the remaining balance amount to the HCO (Health Care Organisation). Furthermore, cardholders of West Bengal Health Scheme (2008) should apply for online enrollment at http://wbfin.nic.in by using their GPF account number as login id. Post registration, the print outs of the registration forms should be taken which along with stamp size photographs should be submitted to DDOs. State government pensioners should also follow the same procedures.

In other words, a beneficiary under this scheme has to submit an enrolment certificate before a HCO for availing cashless medical treatment. However, no prior authorization is required for availing cashless indoor medical facilities. At the time of discharge of a beneficiary, his or her bill will consist of details regarding treatment charges and code number.

Forms for State Government Employees:

The table below shows the different types of forms for State Government Employees

Type of forms Particulars
Form-A Enrolment application
Form-D1 Essentiality Certificate (OPD treatment)
Form-C Claim settlement for reimbursement
Form-E Checklist
Form-D2 Essentiality Certificate (Indoor treatment and OPD treatment
Form-D3 Essentiality Certificate (non-recognised HCOs)

Forms for State Government Pensioners:

The table below shows the different types of forms for State Government Pensioners

Type of forms Particulars
Form-I Enrolment application (West Bengal Health Scheme, 2008)
Form-III Claim settlement for reimbursement
Form-II Enrolment certificate
FORM IV2 Essentiality certificate-cum-statement of expenditure (duly certified by a specialist for Indoor and OPD treatment)
FORM IV1 Essentiality certificate-cum-statement of expenditure (duly certified by any OPD Treatment specialist)
Form-V Checklist for medical claims reimbursement
FORM IV3 Essentiality certificate-cum-statement of expenditure (duly certified by a specialist from any non-recognised private nursing home under WB Health Scheme)
Form-VI Family Permit (Temporary)
West Bengal Health Scheme

Implementation of West Bengal Health Scheme 2008:

The finance department of the government of West Bengal along with the department of health and family welfare issue guidelines for operations and clarifications for the smooth functioning of the scheme. The West Bengal Health Scheme 2008 is implemented in the following ways:

  • The finance department prepares the respective policy, rules and regulations which need to be applied under the West Bengal Health Scheme 2008
  • The rates for various medical treatment procedures are fixed by the finance department
  • Various private HCOs along with diagnostic centres are empanelled in consultation with the health and family welfare department
  • Various regulations are laid down for government departments to approve reimbursement proposals
  • Ensure proper monitoring of HCOs for proper treatment of beneficiaries under this scheme
  • Grant permission for the following:
    • Treatment in specialty hospitals out of West Bengal which are recognized under WBHS
    • Implantation of medical implants
    • Organ transplantation
    • Cochlear surgery

Benefits of West Bengal Health Scheme 2008 extended to IAS, IFS and IPS officers:

IAS officers:

The benefits of the West Bengal Health Scheme, 2008 was extended to the members of Indian Administrative Service (IAS) and their family members, subject to the following conditions:

  • Enrolment under the WBHS 2008 scheme is optional for IAS officers
  • The Personnel and Administrative Reforms Department is the concerned administrative department for IAS officers under the West Bengal Health Scheme, 2008
  • IAS officers and their families can avail of facilities under the West Bengal Health Scheme, 2008 besides facilities under the All India Services (Medical Attendance) Rules, 1954
  • IAS Officers enrolled under the central government health scheme cannot avail of the West Bengal Health Scheme, 2008

IPS officers:

The benefits of the West Bengal Health Scheme, 2008, have been extended to members of the Indian Police Service (IPS) and their families, subject to the following conditions:

  • Enrolment under the West Bengal Health Scheme, 2008 scheme is optional for IPS officers
  • The Home Department, Police Service Cell, is the concerned administrative department for IPS officers under the West Bengal Health Scheme, 2008
  • IPS officers and their families can avail of facilities as per the All India Services (Medical Attendance) Rules, 1954 in addition to those under West Bengal Health Scheme, 2008
  • IPS officers enrolled under the health scheme of the central government cannot avail West Bengal Health Scheme, 2008

IFS officers:

The benefits of the West Bengal Health Scheme, 2008, have been extended to members of Indian Forest Service (IFS) and their families, subject to the following conditions:

  • Enrolment for IFS officers under the West Bengal Health Scheme, 2008 is optional
  • The Department of Forests is the concerned administrative Department for IFS officers under the West Bengal Health Scheme, 2008
  • IFS officers and their families can avail of facilities under All India Services (Medical Attendance) Rules, 1954 in addition to those under West Bengal Health Scheme, 2008
  • IFS officers enrolled under the health scheme of the central government cannot avail of West Bengal Health Scheme, 2008

Empanelled Hospitals in Kolkata, West Bengal:

The following is the list of empanelled hospitals in the state of West Bengal and NCR

  1. The Calcutta Medical Research Institute
  2. Desun Hospitals and Heart Institute
  3. Nightingale Hospitals
  4. R N Tagore International Institute of Cardiac Sciences
  5. Apollo Gelneagles
  6. Ruby general hospital
  7. BM Birla Heart research centre
  8. Medica Superspecialty Hospital
  9. Rotary Narayana Nethralaya
  10. Silverline Eye Hospital
  11. B.P Poddar Hospital
  12. Mission of Mercy Hospital
  13. Dr.Nihar Munshi Eye Foundation
  14. Eye care and Research Centre
  15. D.M Hospital Pvt. Ltd
  16. Susrut Eye Foundation
  17. Bhattacharya Orthopedics
  18. Institute of Neuroscience
  19. Amri Hospitals
  20. Barrackpore Medicare
  21. Disha Eye Hospitals
  22. Belle Vue Clinic
  23. Fortis Hospital
  24. Kothari Medical Centre
  25. Peerless Hospitax Hospital
  26. Apex Institute of Medical Sciences
  27. Dafodil Hospitals
  28. Kothari Medical Centre
  29. Ekbalpur Nursing Home
  30. R.G Stone Urology and Laproscopy Hospital
  31. Nabajiban Hospital
  32. KPC Medical College
  33. Implant’s Better Sight Centre
  34. Eskag Sanjeevani
  35. Divine Nursing Home

Revised Rate list:

The following table shows some rates* under the West Bengal Health for all Employees and Pensioners Cashless Medical Treatment Scheme, 2014, Finance Department, Government of West Bengal

Description Rate Package or non-package
Consultation by super specialists (indoor) (two visits per day) Rs.250 Non-package
Consultation by specialists (Indoor - two visits) Rs.200 Non-package
Consultation by super specialists (OPD) Rs.250 Non-package
Consultation by Medical Officer (OPD) Rs.150 Non-package
Excision of moles Rs.600 Package
Excision of Corns Rs.550 Package
Excision of Molluscum Contagiosum Rs.600 Package
Excision of Warts Rs.600 Package
Excision of Venerel Warts Rs.600 Package
Cyst under LA Rs.300 Non-package
Flap operation per tooth Rs.500 Non-package
Extraction of Tooth including LA Rs.120 Non-package
Gingivectomy per tooth Rs.300 Non-package
Complicated extraction per tooth including LA Rs.250 Non-package
Retrobular Injection (both eyes) Rs.300 Non-package
Lacrimal sac for one eye Rs.200 Non-package
Subconjunctival Injection -one eye Rs.200 Non-package
Subconjunctival Injection -both eyes Rs.300 Non-package

*List is not exhaustive. Rates vary according to the medical procedure

GST rate of 18% applicable for all financial services effective July 1, 2017.

Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

West Bengal Health Scheme Reviews

Page 1 of 50 1 2 3 4 5
  • Religare Health Insurance
    "Better"
    0.5 4.5/5 "Excellent!"
    I do have a health insurance with Religare and have purchased via online. I never tried this policy till now but as per the market value its good. IVR option is simple to reach the customer care. I have taken medical coverage of 5L and it included 5 members of my family.They have good network of hospitals for cashless. The premium was 13K -14K paid through online.
    Was this review helpful? 0
    , faridabad
    Reviewed on Feb 21, 2019
  • National Insurance Health Insurance
    "Good health insurance policy"
    0.5 4.5/5 "Excellent!"
    My employer has provided me a health insurance policy from National Insurance. I have applied for the loan and they have sanctioned the claim in 1 months. The response is very good in their customer and i have submitted the all the required documents. They have given me a 100% cover.
    Was this review helpful? 0
    , hyderabad
    Reviewed on Feb 21, 2019
  • Star Health Health Insurance
    "Best Policy"
    0.5 5.0/5 "Blown Away!"
    I purchased my health insurance policy from Star Health. I have been renewing the policy for last 5 years. I had a claim experience with them and they have given me 100% claim. Since the service and claim process is good hence i have bought the policy from them. I got the policy for my entire family.
    Was this review helpful? 0
    , hyderabad
    Reviewed on Feb 20, 2019
  • Star Health Health Insurance
    "Really good policy in health insurance industry. "
    0.5 5.0/5 "Blown Away!"
    Star health insurance company is the one of the best health insurance in India. Since i have been working as a star agent, i have chosen the policy with them. My claim experience is really good. They have given me a coverage of 95%. They have given me the claim in 15 days. My entire family has been covered in this policy. I have got the coverage amount of Rs. 5 lakhs.
    Was this review helpful? 0
    , thane
    Reviewed on Feb 20, 2019
  • Star Health Health Insurance
    "Excellent service"
    0.5 5.0/5 "Blown Away!"
    I have been holding my health insurance with STAR HEALTH .They are providing good service there customer support team is very good they are co-operating well and there responsiveness is good they have been charging nominal premium per year ,and i am paying my premium through on line. They have tie up with many hospital , and till now i have no claim experience with them.
    Was this review helpful? 0
    , hyderabad
    Reviewed on Feb 20, 2019
  • Star Health Health Insurance
    "GOOD"
    0.5 5.0/5 "Blown Away!"
    I am holding an health insurance policy with the STAR HEALTH & ALLIED INSURANCE policy since from last one years and it is the second year. The premium i paid is 14K for the medical coverage of 5L for family. I had no claim experience with this policy.
    Was this review helpful? 0
    , coimbatore
    Reviewed on Feb 20, 2019
  • Reliance General Health Insurance
    "Need to improve the services"
    0.5 2.0/5 "Expected more"
    I'm not satisfied with the reliance health insurance. Some of my colleagues are facing the issues in their claim process. They have offered me a health insurance for my family too. I got the coverage value of Rs. 1.5 lakhs. Till now i have not claimed anything.
    Was this review helpful? 0
    , hyderabad
    Reviewed on Feb 20, 2019
  • Max Bupa Health Insurance
    "Good Policy"
    0.5 4.0/5 "Great!"
    I have a health insurance with Health insurance with MAX BUPA from last 2 years. I am not aware of the premium amount as my company pays it. This policy has a coverage value of Rs 5 lacs and i have not claimed so far with this insurance.
    Was this review helpful? 0
    , bangalore
    Reviewed on Feb 20, 2019
  • HDFC Ergo Health Insurance
    "More than satisfactory"
    0.5 4.0/5 "Great!"
    It was a easy process to buy my health insurance with HDFC Ergo. It was a online process. The premium cost is normal. I have taken a family floater. Though I have not used the policy, there are cash less facilities. They have a medical coverage around 11 lakhs.
    Was this review helpful? 0
    , new delhi
    Reviewed on Feb 20, 2019
  • Apollo Munich Health Insurance
    "GOOD"
    0.5 5.0/5 "Blown Away!"
    APOLLO MUNICH is the insurance provider where i am using the health insurance policy since from last one years, i have not faced with any issues so far with this insurance. The premium is good, they are providing the medical coverage of 10L for self.
    Was this review helpful? 0
    , chennai
    Reviewed on Feb 20, 2019
  • review Health Insurance
    "Good insurance service provider"
    0.5 4.5/5 "Excellent!"
    As of now i never had a word with them regarding the services. I had a good experience because they have not asked for much documents. They have sanctioned the loan within a fraction of second. There will be a terms and condition changes in every years. I have bought the policy for my entire family.
    Was this review helpful? 0
    , bangalore
    Reviewed on Feb 20, 2019
  • HDFC Ergo Health Insurance
    "Good health insurance"
    0.5 5.0/5 "Blown Away!"
    Purchased my health insurance policy from HDFC Ergo. They have approached me and explained me about the plan benefits. Of course, i don;t have any health insurance earlier hence i have accepted the policy and i have been continuing with them for last 4 years. I have been paying the premium amount of Rs. 24000 for my entire family. My claim experience was good and they have given me a 100% coverage.
    Was this review helpful? 0
    , hyderabad
    Reviewed on Feb 20, 2019
  • New India Health Insurance
    "Need an improvement on cashless"
    0.5 4.0/5 "Great!"
    I have a health insurance which was offered my company from United India Assurance. The medical coverage is sufficient. I have contacted the customer service and it was fine. I have utilized the policy and have gone for cashless and reimbursement but its average.
    Was this review helpful? 0
    , new delhi
    Reviewed on Feb 19, 2019
  • Oriental Insurance Health Insurance
    "Good Policy"
    0.5 4.0/5 "Great!"
    I have a health insurance policy with Oriental insurance from more than 2 years. A premium of Rs 24000 has to be paid for this insurance. I had a claim experience last year and they covered 90% of the billed amount and it was a cashless treatment.
    Was this review helpful? 0
    , bangalore
    Reviewed on Feb 19, 2019
  • Apollo Munich Health Insurance
    "Good sum assured health policy"
    0.5 4.0/5 "Great!"
    I have taken Apollo munich by myself because of the feature is better than others, every year they increase the sum assured upto 50% it has no claim bonus. I got the medical cover of Rs. 15 lakhs its for me. The premium is around Rs. 12700. They have all hospitals tied up in kolkata.
    Was this review helpful? 0
    , kolkata
    Reviewed on Feb 19, 2019
  • Star Health Health Insurance
    "Very good policy"
    0.5 4.5/5 "Excellent!"
    I recently got a health insurance from STAR HEALTH 2 months back, a premium of Rs 12500 has to be paid for this insurance. I did not claim anything so far with this insurance. Coverage value is Rs 10 lacs and it can be covered up to Rs 30 lacs in a year.
    Was this review helpful? 0
    , ghaziabad
    Reviewed on Feb 19, 2019
  • HDFC Ergo Health Insurance
    "Average Policy"
    0.5 3.5/5 "Pretty good"
    It was not a good experience with HDFC ERGO health insurance, the reason was they work for third party and the coverage value of Rs 4lacs is less and it can be covered up to Rs 20 lacs for this insurance. There was no claim experience so far with this insurance.
    Was this review helpful? 0
    , ghaziabad
    Reviewed on Feb 19, 2019
  • ICICI Lombard Health Insurance
    "Excellent"
    0.5 5.0/5 "Blown Away!"
    Actually I have a health insurance with ICICI Lombard and also company has offered me another health policy with them. The claim procedure was excellent. The medical coverage is for 5L for total family in a year. I have recently got a reimbursement and the amount was refunded within two weeks.
    Was this review helpful? 0
    , mumbai
    Reviewed on Feb 19, 2019
  • review Health Insurance
    "Good service"
    0.5 4.0/5 "Great!"
    I have been holding my health insurance with Kotak mahindra general insurance, They have a tie up with many hospitals, and they have shared the location as well. I have no claim experience with them, I was told that they provide cash less treatment. I used to pay the premium online on a yearly basis.
    Was this review helpful? 0
    , pune
    Reviewed on Feb 18, 2019
  • United India Health Insurance
    "Very Good Policy"
    0.5 4.0/5 "Great!"
    I have taken this insurance policy almost two years back through the company which i am working. The premium has been paying annually and the amount is not too high. There is cash less treatment available and there is many hospitals covered in the locality. There was claims made for me and my spouse as well where the claiming method was easy.
    Was this review helpful? 0
    , pune
    Reviewed on Feb 18, 2019
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