NPS Swasthya Pension Scheme

Scheme Introduction: A Brief Overview

he NPS Swasthya Pension Scheme is a healthcare-linked pension scheme regulated by the Pension Fund Regulatory and Development Authority (PFRDA) under the National Pension System (NPS). PFRDA issued the Operational Guidelines for NPS Swasthya on 18 September 2026 to establish the scheme's eligibility, investment account structure, mandatory health insurance, contribution requirements and healthcare withdrawal provisions. The scheme combines retirement savings with a separate super top-up health insurance policy to help eligible subscribers meet healthcare expenses while building a long-term investment corpus.

Any individual eligible to join the National Pension System can enrol in the NPS Swasthya Pension Scheme, subject to the applicable guidelines and insurance requirements. An existing NPS account is not mandatory. The minimum initial contribution covers the first-year health insurance premium, including applicable taxes, ₹200 in annual maintenance charges plus applicable taxes, and at least ₹1,000 towards investment. The minimum subsequent contribution is ₹10. Returns on the investment are market-linked and are not guaranteed.

NPS Swasthya includes a mandatory super top-up health insurance policy arranged by the participating Pension Fund through an insurer registered with the Insurance Regulatory and Development Authority of India (IRDAI). The health insurance under NPS Swasthya covers the subscriber, spouse and up to two dependent children as one family floater. Parents of the subscriber are not included in it. The entry age is 18 to 70 years, and the policy can be renewed up to age 85. Subscribers pick one of four options, ranging from a ₹10,000 deductible with ₹1 lakh cover to a ₹3 lakh deductible with ₹30 lakh cover. There is no co-payment and no disease-wise limit. The cover starts within one working day of enrolment. Because this is a super top-up policy, it pays only after the deductible is crossed, so a base health cover such as Ayushman Bharat PM-JAY or a personal policy still matters.

The NPS Swasthya Pension Scheme permits partial withdrawals of up to 25% of the subscriber's contributions to the Swasthya account for eligible healthcare expenses. Subscribers can make multiple withdrawals without a minimum waiting period, subject to the applicable conditions. Eligible withdrawal amounts are settled with the relevant hospital, healthcare provider or other eligible entity rather than paid directly to the subscriber. The scheme also provides specified premature-exit provisions for eligible inpatient medical treatment when the expense exceeds the permitted partial-withdrawal amount.

Before applying, individuals should check the official PFRDA website and the participating Pension Fund's current enrolment instructions. The dedicated registration route, available provider options, insurance premium and policy terms should be confirmed through official channels before completing enrolment. PFRDA also runs other specialised schemes under NPS, including NPS Sanchay for long-term retirement savings and NPS Vatsalya for parents building a corpus for their minor children.

Scheme Benefits

NPS Swasthya combines retirement savings with healthcare-related financial support and health insurance. The following benefits and facilities are specified in the final operational guidelines.

• Provides financial support for eligible outpatient (OPD) and inpatient (IPD) medical expenses.
• Includes a mandatory super top-up group health insurance policy covering the subscriber, spouse and up to two dependent children.
• Permits partial withdrawal of up to 25% of the subscriber's own contributions for eligible medical expenses.
• Allows an expense to be met from the corpus even if the insurer does not pay it.
• Permits premature exit with full use of the corpus for a large inpatient treatment.
• Lets subscribers fund the yearly renewal premium from the NPS Swasthya corpus.
• Builds a retirement corpus alongside the healthcare cover, invested as per the Central Government Scheme pattern.
• Keeps the NPS Swasthya account separate from any other NPS account the subscriber holds.

Health Insurance Coverage under NPS Swasthya

Every Pension Fund offering the scheme arranges a standard super top-up policy through an IRDAI-registered insurer. The policy terms are fixed by PFRDA and are the same across insurers.

• Covers the subscriber, spouse and up to two dependent children as one family floater. Parents are excluded.
• Entry age is 18 to 70 years, with renewal up to and including age 85.
• Cover begins no later than one working day (T+1) after successful enrolment and receipt of the minimum initial contribution.
• Applies the annual aggregate deductible to the family's combined admissible expenses for the policy year, not separately to each claim.
• Imposes no co-payment and no disease-specific sub-limits.
• Covers day-care procedures, inpatient and domiciliary hospitalisation, AYUSH treatment and organ-donor expenses, subject to the policy wording.
• Entitles the subscriber to a single private room, with ICU charges at actuals.
• Requires no fresh underwriting at renewal unless the sum insured is increased.

The standard policy offers four combinations of annual aggregate deductible and family floater sum insured.

Note: A super top-up policy starts paying only after the deductible is crossed. The deductible itself can be met from the subscriber's own funds, from another health insurance policy, from the NPS Swasthya account, or from a combination of these.

Eligibility Requirements

An individual must be eligible to join the National Pension System to enrol in NPS Swasthya. Enrolment also requires the mandatory super top-up health insurance policy and payment of the applicable initial contribution.

• Any citizen of India who is eligible to join NPS is eligible to join the NPS Swasthya Pension Scheme.
• The scheme is available voluntarily under the National Pension System (NPS).
• An existing NPS account is not required to enrol.
• Applicants who do not already have an NPS account get one opened along with their NPS Swasthya account.
• Taking the super top-up health insurance policy is mandatory for enrolment.
• The insurance entry age is 18 to 70 years, with renewal permitted up to and including age 85 years.
• The family floater covers the subscriber, spouse and up to two dependent children. Parents cannot be included.
• Subscribers with an existing NPS account under the All Citizen Model may transfer funds into their NPS Swasthya account, limited to the amount needed to meet the applicable deductible under the Insurance Policy.

Required Documents

• Aadhaar Card
• PAN Card
• Proof of Identity
• Proof of Address
• Recent Passport-size Photograph
• Bank Account Details
• Mobile Number
• Email ID
• PRAN (Permanent Retirement Account Number), if already enrolled in NPS
• Good Health Declaration, covering the subscriber, spouse and dependent children
• Additional documents, if required by the participating Pension Fund or insurance company

Note: PFRDA has not notified any scheme-specific document list for the NPS Swasthya Pension Scheme.

Steps to Apply

Applicants can apply for the NPS Swasthya Pension Scheme online. PFRDA has specified npscentral.in as the enrolment platform. Here is how to apply for NPS Swasthya online.

• To apply for the NPS Swasthya Pension Scheme, visit the official NPS Central portal at npscentral.in.
• To onboard for the scheme applicants needs to first complete the Sign Up. Applicants who are already registered can click on the Sign in button instead and proceed.
• Enter your mobile number and date of birth to get started.
• Enter the one-time verification code received on your mobile number.
• Start the NPS Swasthya onboarding process once the verification is complete.
• Choose a Pension Fund that currently offers NPS Swasthya.
• Complete your KYC. An existing NPS account is not required. If you do not have a PRAN, one is generated along with your NPS Swasthya account.
• Select your insurance option from the four standard deductible and sum insured combinations.
• Review the disclosures. The Pension Fund must show you the sum insured, deductible, exclusions, waiting periods, premium, renewal conditions, claim process and all applicable charges before you enrol.
• Submit the Good Health Declaration for yourself and your covered family members.
• Pay the minimum initial contribution, covering the first-year premium with taxes, ₹200 annual maintenance charges plus taxes, and ₹1,000 towards investment.
• Receive your PRAN card, Certificate of Insurance, Customer Information Sheet and the details of your Health Benefit Administrator, insurer and TPA.

Note: Your insurance cover starts no later than one working day (T+1) from the date your enrolment succeeds and your minimum initial contribution is received.

Waiting Periods under the Insurance Policy

• Initial waiting period of 30 days, except for accidents.
• Pre-existing disease waiting period of 12 months.
• Specified disease or procedure waiting period of 12 months.
• Controlled Type 2 diabetes, hypertension, hyperlipidaemia and asthma are covered after 12 months, where the health declaration does not trigger enhanced underwriting.

Partial Withdrawal Rules

• The limit is 25% of the contributions made by the subscriber, not 25% of the current market value of the corpus.
• There is no restriction on the number of partial withdrawals.
• No minimum waiting period applies to the first or any later withdrawal.
• The amount is settled directly with the hospital or healthcare provider. It is never paid to the subscriber.
• Withdrawals can be made for both outpatient and inpatient expenses, not only for hospitalisation.
• A fraudulent or fabricated request is not payable from the corpus.

Premature Exit and Account Closure

• Premature exit is available where a single instance of eligible inpatient expenditure exceeds the permissible partial withdrawal amount.
• The corpus is first used towards that treatment. Any remaining balance moves into an NPS scheme under the All Citizen Model.
• An insurance policy already in force continues for the rest of its policy period.
• The account also closes on normal exit, on death of the subscriber, or where funds are not available to renew the insurance.
• Closure of the NPS Swasthya account does not affect any other NPS account held by the subscriber.

Relevant Links

• NPS Swasthya Pension Scheme Online Registration
• NPS Swasthya Pension Scheme Login
• NPS Swasthya Pension Calculator
• NPS Swasthya Pension Scheme Operation Guidelines
• NPS Swasthya Pension Scheme FAQs
• PFRDA Official Website
• NPS Swasthya Pension Scheme Complaint

Contact Information

• NPS Swasthya Pension Scheme Helpline Number:
  • Protean (NSDL) CRA: 18002100080
  • KFin Technologies CRA: 18002081516
  • CAMS CRA: 18005726557
• NPS Toll Free Number: 1800110708
• SMS NPS 56677