This scheme is also known as WBHS. Through this scheme, policy holder can avail cashless facility in network hospitals. Those who are eligible for west bengal health scheme can take medical coverage of rs.1lakh. Apart from this, the scheme also provides OPD coverage on 15 different diseases. Under this scheme treatment can also be done in 9 other hospitals outside the state.
Benefits of West Bengal Health scheme(WBHS)
WBHS is a government scheme that provides the following benefits:-
- Cashless indoor treatment:- special benefits of West Bengal Health Scheme include indoor treatment which covers up to rs.1 lakh in network hospitals. If the total cost of the treatment exceeds the specified limit, then the insured person has to pay the remaining amount at his own expense.
- Off state hospitalization facility:-This scheme is also provides coverage in out of state hospitals. But the hospital should be in network list.
- OPD Treatment:-The insured person can also get the coverage on OPD treatment after completing a certain period of time. However other conditions are applicable for OPD treatment should be kept into mind .
- Treatment in non network hospital:– The holders of WBHS scheme also get a lot of benefits in non network hospitals. if you are undergoing treatment at an out of network hospital, you may receive a reimbursement of a percentage of the total cost of the treatment.
Eligiblity criteria of West Bengal Health Scheme
- If you are a state government employee, then you and your family can avail the benefits of this health plan.
- If you have been a state government employee earlier and you are currently on pension, then you and your dependents can take the advantage of this scheme.
- Those who have opted for medical allowance can a part of West Bengal Health Scheme policy.
- All India Service Pensioners can also avail the benefit of the West Bengal Health Scheme.
Features of West Bengal Health scheme
- This scheme provides coverage to the employee as well as his family which also includes parents and real sibilings.
- An employee who has been registered for West Bengal Health Scheme can avail the policy and they will be eligible to get benefits under the West Bengal Services (Medical Assistance) rules 1964.
- The insured person has a cashless card,which can be used to get treatment in hospitals.
- Claim for reversal of indoor treatment should be made 3 months before the discharge.
- Expenses for treatment at certain out of state hospitals (including travel and searches conducted on an attendant) reimbursement will be made.
what is covered in WBHS?
West Bengal Health Scheme provides coverage to the insurer on more than 1000 medical treatments 3 including 12 days special services 7 to 8 days laparoscopic surgery 2 to 4 days normal delivery, OPD and 1day on minor surgeries till you get the amount.