The West Bengal Health Scheme (WBHS) provides comprehensive healthcare benefits to WB State Government employees, Pensioners, and AIS serving/retired officers. In a recent order, issued by medical cell of Govt. of West Bengal made some significant updates regarding the WBHS enrollment process and reimbursement claim procedures under WBHS.
Extension of Last Date for Enrollment in WBHS and Claim Processing:
Fresh WBHS Enrollment Application:
- The last date for submission of online applications for fresh enrollment of State Government employees, Pensioners including AIS serving/retired officers is extended.
- The submission will remain open from 01.04.2024 until further notice.
Fresh WBHS Enrollment for Opt-Out Members:
- Employees who previously opted out of the WBHS scheme are permitted for fresh enrollment for a one-year period.
- This period is effective from 01.04.2024 till 31.03.2025.
Digitisation of Manual WBHS Cards:
- Enrolled members holding manual cards under WBHS must submit online applications for digitally signed enrollment certificates.
- This is in accordance with Order No. 4656-F(MED) dated 05/09/2014.
- The deadline for submission is before 31.03.2025.
Manual WBHS Enrollment Certificate Update:
- Enrolled members with manual enrollment certificates issued after the introduction of the Cashless Scheme must update their certificates.
- Information required includes individual photo, signature, blood group, and AADHAR Number of enrolled beneficiaries.
- The deadline for submission to the Certificate Issuing Authority for digitization is before 31.03.2025.
Aadhar Number Submission:
- Enrolled members with digitally signed enrollment certificates must submit their Aadhar Number.
- This is necessary if the Aadhar Number is not already incorporated into the enrollment certificate.
- The deadline for submission to the Certificate Issuing Authority is before 31/03/2025.
Extension of Claim Processing:
- The last date for processing and disbursement of manual claims, specifically those for treatment done before 01/07/2022, is extended.
- The new deadline is [provide the extended deadline here].
Also Read: WBHS Cashless Hospital List
Official Order
Government of West Bengal
Finance Department
Medical Cell
No. 37-F(MED)WB——————————————————————————- Dated:15.03.2024
Memorandum
In terms of F.D. Memo. No 57-F(MED) Dated 31/03/2023, last date of application for fresh enrollment of the State Government Employees and pensioners including AIS serving/retired officers under WBHS was 31/01/2024.
Secondly reimbursement claim cannot be processed in manual mode (not through WBHS Portal) after 31.03.2023 as per clause-25 of Appendix-I of Order No. 127-F(Med)WB dated 26.11.2021.
It has been found that a significant numbers of employees and pensioners are yet to enroll themselves through WBHS portal. Similarly there are still some unprocessed claim against treatment done before 01/07/2022 which are kept pending for disposal in manual mode at different levels of State Govt. Offices.
Extension of last date of fresh enrolment and processing of such claims in manual mode have been under active consideration from sometime past.
After careful observation, the Governor is now pleased to extend the last date for fresh enrollment, manual bill processing, digitisation of enrollment certificate etc. in the following manner: –
- Submission of online Application for fresh enrollment of the State Government employees, Pensioner including AIS serving/retired officers will remain open w.e.f. 01.04.2024 untill further order.
- Those who opted out of the scheme earlier are allowed for fresh enrollment for the period of one year only with effect from 01.04.2024 till 31.03.2025.
- Enrolled members having manual Card under WBHS must submit online application for digitally signed enrolment certificate as per Order No. 4656- F(MED) dated 05/09/2014 before 31.03.2025.
- Enrolled members having manual enrolment certificate issued after introduction of Cashless Scheme, must furnish individual photo, signature, blood group and AADHAR Number against enrolled beneficiaries before 31.03.2025 to the Certificate Issuing Authority for digitisation of the enrolment certificate.
- Enrolled members having digitally signed enrolment certificate must furnish Aadhar No. to the _ certificate Issuing Authority before 31/03/2025 if the Aadhar No. is not incorporated in the enrolment certificate.
- Last date of .processing and disbursement of manual claims where treatment done before 01/07/2022 is also extended up to 31/03/2025.
sd/-
K.A. Anwar, IAS
Senior Special Secretary to the
Government of West Bengal
Official Source: Click Here
Also Read: WBHS Cashless Hospital List