The National Pension System (NPS) is set to get a new healthcare-linked option that combines retirement savings with health insurance benefits. The new scheme, called NPS Swasthya, is expected to be formally launched by Union Finance Minister Nirmala Sitharaman on October 1, 2026, on the occasion of NPS Diwas. The Pension Fund Regulatory and Development Authority (PFRDA) issued the operational guidelines for the scheme on September 18.
NPS Swasthya will have two separate components: a dedicated investment account and a mandatory super top-up health insurance policy. The scheme also allows subscribers to make partial withdrawals from their NPS Swasthya corpus for eligible healthcare expenses, subject to the prescribed rules.
What Is NPS Swasthya?
Under NPS Swasthya, subscribers will build a dedicated corpus while also receiving access to healthcare-related benefits and a standard super top-up insurance policy.
The health insurance component is mandatory for those enrolling in the scheme. The policy is separate from the NPS Swasthya investment account, meaning the investment corpus and insurance coverage operate under their respective rules.
Individuals eligible to join NPS can enrol in NPS Swasthya, subject to the scheme’s conditions. The age range for enrolment is 18 to 70 years, while renewal can continue up to the age of 85, subject to the applicable terms. The standard family-floater coverage includes the subscriber, spouse and up to two dependent children. Parents are not covered under this family floater.
How Much Is the Initial Contribution?
The initial contribution to NPS Swasthya includes the applicable first-year health insurance premium, annual maintenance charges of Rs 200 plus applicable taxes, and a minimum investment of Rs 1,000 in the NPS Swasthya account. Subsequent contributions can be as low as Rs 10.
The insurance premium is not a fixed amount. It is determined by the insurer according to the subscriber’s age and applicable insurance guidelines.
How Much Health Insurance Cover Is Available?
The standard super top-up health insurance policy offers different combinations of annual deductibles and family-floater coverage.
The available options include:
- Rs 10,000 deductible – Rs 1 lakh cover
- Rs 50,000 deductible – Rs 5 lakh cover
- Rs 1 lakh deductible – Rs 10 lakh cover
- Rs 3 lakh deductible – Rs 30 lakh cover
A deductible is the amount of eligible medical expenses that has to be borne before the super top-up insurance coverage starts applying. The scheme’s final framework provides family-floater coverage ranging from Rs 1 lakh to Rs 30 lakh.
Can NPS Swasthya Funds Be Used for Medical Expenses?
Yes. Subscribers can make partial withdrawals from their NPS Swasthya account for eligible healthcare expenses, including outpatient and inpatient treatment.
The withdrawal limit is up to 25% of the subscriber’s contributions to the NPS Swasthya account. The guidelines do not impose a minimum waiting period or a fixed limit on the number of such withdrawals, subject to the applicable conditions.
The amount is not paid directly to the subscriber. Instead, eligible healthcare-related payments are settled with the hospital, healthcare provider or other qualified healthcare entity as prescribed under the scheme.
Disclaimer: This article is based on the NPS Swasthya operational guidelines and information available at the time of writing. The scheme’s insurance terms, premiums, eligibility conditions, withdrawal rules and other provisions are subject to applicable regulations and official updates. Readers should check the latest PFRDA and insurer guidelines before making any financial or healthcare-related decision.