State govt lifts Rs 2 lakh ceiling on cashless treatment for pensioners

Kolkata: The West Bengal government has announced that pensioners and family pensioners will now be eligible for cashless treatment in private hospitals even when the hospital bill exceeds Rs 2 lakh.

According to a notification issued by the state Finance Department, in several critical and complex indoor patient (IPD) cases the cost of treatment often exceeds the stipulated cashless limit, imposing an additional financial burden on employees and pensioners.

Under the earlier rule, pensioners and employees were entitled to cashless treatment only up to Rs 2 lakh. If the hospital bill exceeded that amount, the patient or family had to initially bear the additional cost and later seek reimbursement.

The system often caused hardship for elderly patients and their families, as arranging large sums at short notice was difficult for many middle-class households. The problem was particularly acute in cases involving ICU treatment or major surgeries, where medical bills could run into several lakh rupees. The new directive from the state government aims to address this issue.

According to fresh guidelines issued by the Finance Department, a procedure has been laid down to avail cashless treatment beyond Rs 2 lakh. If a pensioner is admitted to a private hospital and the treatment cost is expected to exceed the ceiling, the Finance Department must be informed immediately by the pensioner or an authorised representative.

The hospital authorities or the patient’s family will need to submit an estimated cost of treatment for the next ten days along with a prognosis report detailing the patient’s medical condition and treatment plan. The Finance Department will examine these documents to assess the necessity and estimated cost of treatment.

The department has also set a timeline for approval. Once the application is submitted following the prescribed procedure, it will be processed within 24 hours, ensuring treatment is not delayed due to financial constraints.

According to administrative sources, the decision is expected to benefit several lakh retired government employees and their dependent family members across the state.