West Bengal Health Scheme: Eligibility, Benefits and Hospital List

The West Bengal Health Scheme (WBHS), managed by the Medical Cell, Finance Department, Government of West Bengal, provides healthcare benefits to eligible State Government employees, pensioners and their family members. From 1 October 2026, the scheme offers cashless inpatient treatment of up to Rs. 5 lakh per admission at empanelled private hospitals. Eligible beneficiaries can enrol online through the official WBHS portal.

Introduction of West Bengal Health Scheme: A Brief Insight

Medical expenses can put a heavy burden on a family, even when it has a regular government salary or pension. To help its employees and pensioners manage these expenses, the Government of West Bengal runs the West Bengal Health Scheme (WBHS). The scheme also extends healthcare benefits to eligible family members.

Introduced in 2008, the scheme was later expanded as the West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme, 2014. The Medical Cell of the Finance Department, Government of West Bengal, manages the scheme. It provides cashless treatment, coverage for specified OPD treatments and reimbursement of eligible medical expenses.

From 1 October 2026, the cashless limit for inpatient treatment at empanelled private hospitals has increased from Rs. 2 lakh to Rs. 5 lakh per admission. The government has also added six new diseases to the OPD coverage list and revised treatment rates. The scheme covers over 10 lakh beneficiaries through 205 empanelled private hospitals and 30 diagnostic centres.

Eligible beneficiaries include serving State Government employees, pensioners, family pensioners, All India Services (AIS) officers of the West Bengal cadre, and employees and pensioners of Government aided colleges, universities and Panchayati Raj bodies. They can also enrol their eligible dependants. However, beneficiaries who join the scheme must give up their monthly Medical Allowance or Medical Relief, as applicable.

Eligible employees and pensioners can complete enrolment online through the WBHS portal. The Head of Office or Pension Sanctioning Authority verifies the submitted details before approval. For technical assistance, employees and pensioners can report issues through their portal login.

West Bengal residents who are not eligible for WBHS can explore other healthcare programmes, including the Mukhyamantri Swasthya Bima Yojana and the Central Government’s Ayushman Bharat PM Jan Arogya Yojana. Elderly residents aged 70 and above who are not covered as dependants can also check their eligibility for the Ayushman Bharat Vay Vandana Card Scheme.

Government employees, pensioners and other residents looking for welfare benefits can explore more programmes through our List of Welfare Schemes of the West Bengal Government page.

Latest Updates on West Bengal Health Scheme

• 17 September 2026: The Government of West Bengal increased the cashless treatment limit at empanelled private hospitals from Rs. 2 lakh to Rs. 5 lakh per admission through G.O. No. 81-F(MED)WB. The revised limit applies to patients admitted on or after 1 October 2026.
• 7 September 2026: The government added six new diseases to the outpatient department (OPD) treatment list under WBHS through G.O. No. 76-F(MED)WB.
• 14 August 2026: The government revised the approved treatment rates under the West Bengal Health Scheme through G.O. No. 70-F(MED)WB.

Benefits Provided to Eligible Beneficiaries

The West Bengal Health Scheme (WBHS) helps serving government employees, pensioners and their eligible family members manage medical expenses. From October 2026, the scheme provides a higher cashless treatment limit at empanelled private hospitals, along with outpatient treatment coverage, reimbursement facilities and access to a network of empanelled medical centres.

Cashless Indoor Treatment

• Cashless in-patient treatment of up to Rs. 5,00,000 per admission at empanelled private hospitals
• The cashless treatment limit increased from Rs. 2 lakh to Rs. 5 lakh under G.O. No. 81-F(MED)WB dated 17 September 2026
• The revised limit applies to patients admitted on or after 1 October 2026
• Treatment costs are covered at the approved rates under the scheme, revised through G.O. No. 70-F(MED)WB dated 14 August 2026

OPD Treatment

• Outpatient treatment coverage for diseases included in the scheme’s approved list
• The department added six new diseases to the OPD coverage list through G.O. No. 76-F(MED)WB dated 7 September 2026

Reimbursement Facility

• Eligible beneficiaries can claim reimbursement of medical expenses according to the scheme rules
• Beneficiaries can submit and track their reimbursement claims online through the WBHS portal

Wide Hospital Network

• Access to 205 empanelled private hospitals
• Access to 30 empanelled diagnostic centres

Scheme at a Glance (As per WBHS Portal)

Eligibility Conditions Required to be Fulfilled

The West Bengal Health Scheme (WBHS) is designed for serving and retired employees of the West Bengal Government and certain eligible government-aided institutions and bodies. Eligible dependent family members can also receive coverage under the scheme, subject to the applicable rules.

Who Can Enrol

• Serving Government Employees: Employees working under the Government of West Bengal
• Pensioners and Family Pensioners: Retired State Government employees and eligible family pensioners
• All India Services Officers: IAS, IPS and IFS officers of the West Bengal cadre, along with eligible AIS pensioners
• Government-Aided Colleges and Universities: Eligible employees and pensioners of these institutions
• Panchayati Raj Bodies: Eligible employees and pensioners of Panchayati Raj institutions
• Dependent Family Members: Eligible dependants of the above categories, as defined under the scheme rules

Conditions to Keep in Mind

• Enrolment is optional. However, enrolled employees and pensioners must give up the regular monthly Medical Allowance or Medical Relief, as applicable.
• Employees must complete enrolment through their Head of Office, while pensioners must follow the process through their Pension Sanctioning Authority.
• Employees enrolled under the scheme at the time of retirement continue their coverage as pensioners automatically, unless they choose to opt out.
• Aadhaar Card details, photographs, signatures and blood group information of all beneficiaries must be updated on the WBHS portal.

Who Is Not Covered

• Members of the general public who do not belong to an eligible employee or pensioner category
• Family members who do not meet the scheme’s definition of a dependent
• Employees or pensioners who have not completed the required enrolment on the WBHS portal

Note: West Bengal residents who are not eligible for the WBHS may explore the State’s public health coverage programme, known as the Mukhyamantri Swasthya Bima Yojana, which replaced Swasthya Sathi.

Documents Required to be Attached

The West Bengal Health Scheme (WBHS) involves two stages: enrolling yourself and your eligible family members, and using the scheme for medical treatment or reimbursement claims. Each stage requires specific documents. Keeping the necessary papers ready can help you complete enrolment, obtain your enrolment certificate and submit medical claims without unnecessary delays.

For Enrolment of Government Employees

• Service details, including HRMS or employee ID and office information
• Head of Office (HoO) code of the concerned office
• Recent photograph and signature of the employee
• Aadhaar Cards of the employee and each beneficiary
• Blood group details of the employee and eligible family members
• Proof of relationship and date of birth of dependent family members

For Enrolment of Pensioners and Family Pensioners

• Pension Payment Order (PPO) number and related details
• Details of the Pension Sanctioning Authority (PSA)
• Photographs, signatures, Aadhaar details and blood groups of the pensioner and beneficiaries
• Declaration opting out of the monthly Medical Relief

For Cashless Treatment at an Empanelled Hospital

• Digitally signed WBHS Enrolment Certificate containing the beneficiary’s photograph
• Photo identity proof of the patient
• Doctor’s prescription or referral for planned treatment

For Reimbursement Claims

• Original hospital bills and payment receipts
• Hospital discharge summary and medical prescriptions
• Investigation and diagnostic test reports
• Essentiality certificate signed by the treating doctor
• Bank account details of the employee or pensioner

How Beneficiaries Can Apply to Avail the Benefit of this Scheme

Government employees and pensioners can enrol in the West Bengal Health Scheme (WBHS) through the official website. The process is simple: fill out the online form, enter the required details, upload the necessary documents and submit the form for verification. Employees and pensioners must use their respective enrolment links. Follow the steps given below according to your category.

Enrolment for Government Employees

Step 1: Visit the WBHS Online Enrolment Page for Government Employees to start your registration.

Step 2: Keep your Head of Office (HoO) code ready. You will need this code while filling out the form. If you do not know your HoO code, visit the official WBHS portal and use the Search HoO Code option on the homepage.

Step 3: Enter your personal details and employment information in the online form. Check all the details carefully before moving to the next step.

Step 4: Add the details of your dependent family members whom you want to include under the scheme. Enter their Aadhaar numbers, dates of birth and blood groups as required.

Step 5: Upload your photograph and signature. You must also upload the photographs and signatures of your family members, wherever the form asks for them.

Step 6: Check the information you have entered and submit the enrolment form. After submission, inform your Head of Office (HoO) so that they can verify your details.

Step 7: Once your office approves the enrolment, you can receive your digitally signed Enrolment Certificate. Keep this certificate safe, as you may need it when you visit a hospital under the scheme.

Enrolment for Pensioners

Step 1: Open the WBHS Online Enrolment Page for Pensioners to begin your registration.

Step 2: Enter your Pension Payment Order (PPO) number and the pension details requested in the form. Keep these details ready before you start.

Step 3: Add the details of your eligible family members. Enter their Aadhaar numbers, dates of birth and blood groups wherever required.

Step 4: Upload your photograph and signature, along with those of your eligible family members, as requested in the form.

Step 5: Review the information and submit the form. Your Pension Sanctioning Authority will verify the details you have provided.

Step 6: After the authority approves your enrolment, download your Enrolment Certificate and keep it safe for future use.

Important: If you were already enrolled in WBHS as a government employee before retirement, your coverage continues automatically after retirement. You do not need to enrol again unless you want to opt out of the scheme.

How to Avail Cashless Treatment and Submit Claims

After enrolment, eligible beneficiaries can use the West Bengal Health Scheme in two ways. They can receive cashless treatment at an empanelled hospital or apply for reimbursement of eligible medical expenses. The steps for both options are explained below.

Getting Cashless Treatment

Step 1: First, open the official list of WBHS empanelled hospitals. Choose a hospital that provides the treatment you need and is convenient for you to visit.

Step 2: Visit the selected hospital with your WBHS Enrolment Certificate and a valid photo ID. These documents help the hospital confirm your identity and scheme enrolment.

Step 3: At the time of admission, show your Enrolment Certificate at the hospital’s WBHS desk. The hospital staff can guide you through the formalities required for cashless treatment.

Step 4: Receive your treatment under the scheme’s cashless facility. The scheme provides cashless indoor treatment of up to Rs. 5 lakh per admission at approved rates, subject to the applicable scheme rules and approval requirements.

Step 5: If the hospital bill exceeds the amount approved under WBHS, you may have to pay the extra amount yourself. Before treatment, ask the hospital about the approved package rate and any expenses that the scheme does not cover.

Submitting a Reimbursement Claim Online

Step 1: Visit the WBHS Online Claim Login Page to access the claim facility.

Step 2: If you are using the portal for the first time, sign up for an account. If you have already registered, log in with your existing account details.

Step 3: After logging in, select the option to submit a new reimbursement claim. Enter the required information about the patient, hospital and treatment. Make sure the details match your medical records and bills.

Step 4: Upload clear scanned copies of the required documents, such as hospital bills, the discharge summary, prescriptions, test reports and the essentiality certificate, as applicable to your claim.

Step 5: Review the claim form and uploaded documents before submitting it. After submission, save the claim number or reference details so you can check the progress later.

Step 6: Log in to the portal whenever you want to check your claim status. If the claim is approved, the reimbursable amount will be paid into your bank account, subject to the scheme’s rules.

Important: Before planning treatment, check the Official WBHS Rate List. It shows the approved rates for treatment under the scheme and helps you understand the charges that may be covered.

West Bengal Health Scheme vs Mukhyamantri Swasthya Bima Yojana

The West Bengal Government offers different healthcare schemes for different groups of residents. The West Bengal Health Scheme (WBHS) mainly serves eligible government employees and pensioners, while the Mukhyamantri Swasthya Bima Yojana caters to other eligible residents. The table below highlights their key differences.

Eligible government employees and pensioners can explore the West Bengal Health Scheme for healthcare benefits. Other residents can check the eligibility conditions and benefits of the Mukhyamantri Swasthya Bima Yojana to find out whether they qualify for health coverage.

Important Links Available of the Scheme

• West Bengal Health Scheme Official Portal
• Online Enrolment for Government Employees
• Online Enrolment for Pensioners
• WBHS Online Claim Login and Registration
• List of Empanelled Hospitals Under WBHS
• WBHS Approved Treatment Rate List

Contact Details in Case of Help Needed

• Nodal Office: Medical Cell, Finance Department, Government of West Bengal
• Government Employees and Pensioners: Raise technical issues through your WBHS portal login
• Empanelled Hospitals: wbhshospitalassist@gmail.com
• Grant-in-Aid Colleges and Universities: 1800-102-8014, support.hshed-wb@nic.in
• Panchayati Raj Bodies: 1800-572-6506, wbhspri@gmail.com
• Medical Cell Email: as1med.fd-wb@bangla.gov.in

Frequently Asked Questions (FAQs)

Tabassum

Tabassum is a government schemes researcher and writer with 5 years of experience tracking Central and State welfare scheme programmes across India. She has covered 500+ schemes spanning agriculture, women welfare, education, and housing, helping lakhs of beneficiaries understand their entitlements in simple language.