NPS Swasthya Pension Scheme is a voluntary health-linked pension savings scheme introduced by the Pension Fund Regulatory and Development Authority (PFRDA) under its Regulatory Sandbox Framework. The scheme was launched through Circular No. PFRDA/2026/07/SUP-CRA/02 dated 27 January 2026 as a Proof of Concept (PoC). It allows eligible NPS subscribers to use a part of their accumulated corpus for outpatient and inpatient medical expenses while continuing to build retirement savings. The minimum initial contribution is Rs. 25,000. For official updates, visit pfrda.org.in.
NPS Swasthya Pension Scheme Highlights | |
|---|---|
| Scheme Name | NPS Swasthya Pension Scheme |
| Regulator | Pension Fund Regulatory and Development Authority (PFRDA) |
| Proof of Concept 1 Circular | PFRDA/2026/07/SUP-CRA/02 dated 27 January 2026 |
| Proof of Concept 2 Circular | PFRDA/2026/22/SUP-CRA/03 dated 7 April 2026 |
| Current Status | Proof of Concept under the Regulatory Sandbox Framework |
| Scheme Type | Voluntary self-funded health-linked pension savings scheme |
| Governing Law | Sections 12(1)(a) and 20 of the PFRDA Act, 2013 |
| Eligibility | Any Citizen of India meeting the prescribed conditions |
| Common Scheme Account | Mandatory if not already available |
| Minimum Initial Contribution | Rs. 25,000 |
| Corpus Transfer | Up to 30% from the Common Scheme Account for eligible Non-Government Sector subscribers above 40 years of age |
| Government Sector Subscribers | Corpus transfer not permitted |
| Medical Benefits | Outpatient and Inpatient medical expenses |
| Partial Withdrawal | Up to 25% of own contributions for each eligible withdrawal |
| Minimum Corpus for First Withdrawal | Rs. 50,000 |
| Premature Exit | 100% lump sum permitted if eligible inpatient expenses exceed 70% of the total corpus in a single instance |
| Health Insurance | Mandatory under Proof of Concept 2, with a premium deducted from the NPS Swasthya account |
| Current PoC Product | ICICI PF NPS Swasthya Equity Plus |
| Data Privacy | Explicit digital consent is required under the Digital Personal Data Protection Act, 2023 |
| PFRDA Office | E 500, Tower E, Fifth Floor, World Trade Centre, Nauroji Nagar, New Delhi 110029 |
| Phone | 011 40717900 |
| Official Website | pfrda.org.in |
Introduction of NPS Swasthya Pension Scheme: A Brief Insight
Medical expenses are one of the biggest financial challenges during retirement. A single hospitalisation can significantly reduce retirement savings, while health insurance may become expensive with age or may not cover every medical expense. To address this gap, the Pension Fund Regulatory and Development Authority (PFRDA) introduced the NPS Swasthya Pension Scheme through Circular No. PFRDA/2026/07/SUP-CRA/02 dated 27 January 2026 under its Regulatory Sandbox Framework.
The NPS Swasthya Pension Scheme is not a free health insurance scheme. It is a voluntary, self-funded pension savings product linked to healthcare needs. Subscribers invest their own money in a dedicated NPS Swasthya Account, which earns market-linked returns. The accumulated corpus can be used to meet eligible outpatient and inpatient medical expenses. If it is not used for healthcare, the amount continues to remain invested as part of the subscriber’s retirement savings.
Any Citizen of India can join the scheme voluntarily. Subscribers must also have a Common Scheme Account under the National Pension System. Those who do not already have one must open it before joining the scheme. Under the second Proof of Concept, the minimum initial contribution is Rs. 25,000.
Subscribers can withdraw up to 25% of their own contributions for eligible medical expenses after maintaining the prescribed minimum corpus. If eligible, inpatient medical expenses exceed 70% of the total corpus in a single instance, the subscriber may opt for a 100% lump sum premature exit as permitted under the scheme. The second Proof of Concept also requires subscribers to maintain health insurance, with the premium deducted directly from the NPS Swasthya Account.
Subscribers in the Non-Government Sector who are above 40 years of age can transfer up to 30% of their accumulated corpus from the Common Scheme Account to the NPS Swasthya Account, subject to the conditions specified by PFRDA. This transfer facility is not available to Government Sector or Government-owned Corporate Sector subscribers. At present, ICICI PF NPS Swasthya Equity Plus is the only product operating under the first Proof of Concept.
Subscribers who want to build retirement savings for their children can also explore NPS Vatsalya, which allows parents and guardians to open NPS accounts for minors. Those looking for another long-term pension savings option can also check NPS Sanchay, another initiative introduced under the National Pension System.
For more pension, retirement, and social security initiatives launched by the Government of India, visit our Central Government Welfare Schemes page.
Benefits Provided to Eligible Beneficiaries
The NPS Swasthya Pension Scheme offers the following health-related benefits to eligible subscribers under the National Pension System:
Medical Expense Support
- Use the accumulated corpus to pay eligible outpatient (OPD) medical expenses such as doctor consultations, medicines, and diagnostic tests.
- Use the accumulated corpus for eligible inpatient or hospitalisation expenses.
- Payments are made to the authorised Health Benefit Administrator (HBA), Third Party Administrator (TPA), or Health Tech Company (HTC) after claim verification.
- If any amount remains after settling the medical claim, it is transferred back to the subscriber’s Common Scheme Account.
Partial Withdrawal Facility
- Withdraw up to 25% of your own contributions for eligible medical expenses.
- There is no limit on the number of eligible withdrawals, subject to the scheme conditions.
- No minimum waiting period is prescribed after the first withdrawal.
- The first withdrawal is allowed only after the NPS Swasthya Account accumulates a minimum corpus of Rs. 50,000.
Premature Exit for Major Medical Expenses
- If eligible, inpatient medical expenses exceed 70% of the total corpus in a single instance, the subscriber can opt for a 100% lump sum premature exit as permitted under the scheme.
- After settling the medical expenses, any remaining balance is transferred to the subscriber’s Common Scheme Account.
Health Insurance Facility
- Under the second Proof of Concept, health insurance is mandatory for subscribers.
- The insurance premium is deducted directly from the NPS Swasthya Account as per the scheme provisions.
- Subscribers receive complete information about the insurance coverage, exclusions, claim process, and grievance redressal mechanism.
Investment of Contributions
- Contributions are invested by Pension Funds according to the investment guidelines prescribed under the Multiple Scheme Framework.
- At present, ICICI PF NPS Swasthya Equity Plus is the only product operating under the first Proof of Concept.
- If the corpus is not used for medical expenses, it continues to remain invested and forms part of the subscriber’s retirement savings.
Eligibility Conditions Required to be Fulfilled
To join the NPS Swasthya Pension Scheme, subscribers must fulfil the following eligibility conditions prescribed by the Pension Fund Regulatory and Development Authority (PFRDA):
- Must be a Citizen of India.
- Joining the scheme is voluntary.
- Must have a Common Scheme Account under the National Pension System. New subscribers must open one before enrolling in the scheme.
- A minimum initial contribution of Rs. 25,000 is required under the second Proof of Concept.
Corpus Transfer from an Existing NPS Account
- Non-Government Sector subscribers above 40 years of age can transfer up to 30% of their eligible corpus from the Common Scheme Account to the NPS Swasthya Account, subject to the scheme conditions.
- This facility is available only to Non-Government Sector subscribers.
- Government Sector and Government-owned Corporate Sector subscribers cannot transfer their existing corpus to the NPS Swasthya Account.
Who Is Not Eligible for Corpus Transfer
- Government Sector subscribers.
- Government-owned Corporate Sector, subscribers.
- Subscribers who are 40 years of age or below. However, they can still join the scheme through a fresh contribution if they meet the prescribed conditions.
Documents Required to be Attached
Subscribers should keep the following documents ready while opening or activating an NPS Swasthya Pension Scheme account:
- Aadhaar Card for identity and KYC verification.
- PAN Card.
- Bank account details for contributions and settlement of eligible claims.
- Recent passport-size photograph.
- Mobile number linked with Aadhaar Card for OTP based authentication and digital consent.
Subscribers must also provide digital consent for sharing the required information with the authorised Health Benefit Administrator (HBA), Third Party Administrator (TPA), or Health Tech Company (HTC) in accordance with the Digital Personal Data Protection Act, 2023.
When claiming eligible medical expenses, subscribers must submit the medical records, bills, invoices, and other supporting documents required by the concerned HBA, TPA, or HTC for claim verification.
How Beneficiaries Can Apply to Avail the Benefit of this Scheme
The NPS Swasthya Pension Scheme is currently being implemented as a Proof of Concept (PoC) under the PFRDA Regulatory Sandbox Framework. Interested subscribers can join the scheme only through Pension Funds approved by PFRDA. Before enrolling, ensure you meet the prescribed eligibility conditions and have an active NPS Common Scheme Account.
Step 1: Check whether you already have an active National Pension System (NPS) Common Scheme Account with a valid PRAN. If you do not have one, open an account through the eNPS Portal or by visiting a registered NPS Point of Presence (POP).
Step 2: Visit the PFRDA official website to check the list of approved Pension Funds offering the NPS Swasthya Pension Scheme under the Regulatory Sandbox. At present, ICICI PF NPS Swasthya Equity Plus is available under the first Proof of Concept.
Step 3: Contact the approved Pension Fund or your NPS Point of Presence and request enrolment in the NPS Swasthya Pension Scheme. Complete the required formalities and open an NPS Swasthya Account linked to your Common Scheme Account.
Step 4: Make the minimum initial contribution of Rs. 25,000 to activate your NPS Swasthya Account. Future contributions can be made according to the applicable scheme provisions.
Step 5: Provide the required digital consent for sharing information with the authorised Health Benefit Administrator (HBA), Third Party Administrator (TPA), or Health Tech Company (HTC) for processing eligible medical claims.
Step 6: If you are a Non-Government Sector subscriber above 40 years of age, you may also transfer up to 30% of the eligible corpus from your Common Scheme Account to your NPS Swasthya Account, subject to the conditions prescribed by PFRDA.
Step 7: After meeting the withdrawal conditions, submit your medical claim along with the required supporting documents through the prescribed claim process. Eligible claim amounts are settled according to the scheme provisions.
For the latest circulars, approved Pension Funds, and operational updates, visit the PFRDA official website or contact PFRDA at 011 40717900.
Difference Between NPS Swasthya Pension Scheme and Regular Health Insurance
| Particulars | NPS Swasthya Pension Scheme | Regular Health Insurance |
|---|---|---|
| Nature | Self-funded health-linked pension savings product | Insurance risk protection product |
| Medical Expenses | Paid from the subscriber’s accumulated corpus | Paid by the insurer as per the policy terms and sum insured |
| Contribution | The subscriber contributes to the NPS Swasthya Account | The policyholder pays an insurance premium |
| Available Amount | Depends on the accumulated corpus | Depends on the insured amount under the policy |
| Investment Value | Unused corpus continues to remain invested for retirement | Premium does not create a retirement corpus |
| Outpatient (OPD) Expenses | Eligible as per the scheme provisions | Depends on the health insurance policy |
| Hospitalisation | Eligible as per the scheme provisions | Covered according to the policy terms |
| Purpose | Supports healthcare expenses while building retirement savings | Provides financial protection against medical risks |
The NPS Swasthya Pension Scheme is designed as a health-linked retirement savings product, while regular health insurance provides insurance coverage against medical risks. Depending on individual financial needs, both can complement each other as part of long-term financial planning.
Important Links Available
- Pension Fund Regulatory and Development Authority (PFRDA)
- NPS Swasthya Pension Scheme Proof of Concept 1 Circular
- NPS Swasthya Pension Scheme Proof of Concept 2 Circular
- eNPS Portal
- Protean CRA Portal
Contact Details in Case of Help Needed
- Authority: Pension Fund Regulatory and Development Authority (PFRDA)
- Address: E 500, Tower E, Fifth Floor, World Trade Center, Nauroji Nagar, New Delhi 110029
- Phone: +91 11 40717900
- Email: grievance@pfrda.org.in
- Website: www.pfrda.org.in
Frequently Asked Questions (FAQs)
Q. What is the NPS Swasthya Pension Scheme?
Ans. The NPS Swasthya Pension Scheme is a voluntary health-linked pension savings product introduced by the Pension Fund Regulatory and Development Authority (PFRDA) under the Regulatory Sandbox Framework. It allows eligible subscribers to use a dedicated NPS Swasthya Account to meet eligible outpatient and inpatient medical expenses using their accumulated corpus.
Q. Is the NPS Swasthya Pension Scheme a free health insurance scheme?
Ans. No. It is not a free health insurance scheme. Subscribers contribute their own money to an NPS Swasthya Account, which is invested and can be used for eligible medical expenses. The available amount depends on the accumulated corpus.
Q. Who can join the NPS Swasthya Pension Scheme?
Ans. Any Citizen of India can join the scheme voluntarily. Subscribers must also have an active National Pension System Common Scheme Account.
Q. What is the minimum contribution required?
Ans. Under the second Proof of Concept, the minimum initial contribution is Rs. 25,000.
Q. Can Government employees join this scheme?
Ans. Yes. Government Sector subscribers can join the scheme by making fresh contributions. However, the facility to transfer an existing corpus from the Common Scheme Account is available only to eligible Non-Government Sector subscribers above 40 years of age.
Q. How much can I withdraw for medical expenses?
Ans. Subscribers can withdraw up to 25% of their own contributions for eligible medical expenses. The first withdrawal is allowed only after accumulating the prescribed minimum corpus of Rs. 50,000.
Q. What happens if my medical expenses are very high?
Ans. If eligible inpatient medical expenses in a single instance exceed 70% of the total corpus, the subscriber may opt for a 100% lump sum premature exit in accordance with the scheme provisions.
Q. Can I transfer money from my existing NPS account?
Ans. Yes. Eligible Non-Government Sector subscribers above 40 years of age can transfer up to 30% of the permitted corpus from their Common Scheme Account to the NPS Swasthya Account. This facility is not available to Government Sector or Government-owned Corporate Sector subscribers.
Q. What medical expenses are covered?
Ans. The scheme supports eligible outpatient and inpatient medical expenses in accordance with the applicable scheme provisions.
Q. How are medical claims settled?
Ans. Eligible medical claims are processed through the authorised Health Benefit Administrator (HBA), Third Party Administrator (TPA), or Health Tech Company (HTC) as per the scheme guidelines.
Q. Is health insurance mandatory?
Ans. Yes. Under the second Proof of Concept, subscribers are required to maintain health insurance, and the premium is deducted from the NPS Swasthya Account as prescribed under the scheme.
Q. What happens after the Proof of Concept period ends?
Ans. PFRDA will review the outcome of the Proof of Concept before deciding the future course of the scheme. Subscribers will be governed by the directions issued by PFRDA at that time.
Q. Which Pension Fund currently offers this scheme?
Ans. At present, ICICI PF NPS Swasthya Equity Plus is operational under the first Proof of Concept. Subscribers should visit pfrda.org.in for the latest list of approved Pension Funds.
Q. How is the NPS Swasthya Pension Scheme different from regular health insurance?
Ans. The NPS Swasthya Pension Scheme allows subscribers to use their own accumulated retirement corpus for eligible medical expenses, whereas a regular health insurance policy provides insurance coverage subject to the policy terms and conditions.
Q. How can I join the NPS Swasthya Pension Scheme?
Ans. Eligible subscribers can approach an approved Pension Fund or a registered NPS Point of Presence for enrolment. The latest operational details and approved Pension Funds are available on the PFRDA official website.
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.