This scheme is part of the National Pension System (NPS). It aims to provide financial support for medical expenses, including both outpatient (OPD) and inpatient treatments.
The scheme is currently being implemented in an advanced/second PoC phase (as per industry updates), expanding features and partnerships to test real-world implementation.
NPS Swasthya Pension Scheme - Key Highlights
| Features | Details |
| Scheme Name | NPS Swasthya Pension Scheme |
| Launched by | PFRDA |
| Scheme Type | Contributory Pension + Health Benefit Scheme |
| Availability | Voluntary for all Indian citizens |
| Purpose | Cover medical expenses (OPD & hospitalization) |
| Framework | Regulatory Sandbox (Pilot Phase) |
| Withdrawal Limit | Up to 25% of own contributions |
| Minimum Corpus for Withdrawal | ₹50,000 |
| Special Benefit | 100% withdrawal in critical illness |
| Transfer Option | Up to 30% from NPS account (age 40+) |
| Official Notification | Circular PDF Download |
What is NPS Swasthya Pension Scheme?
The NPS Swasthya Pension Scheme is a special sector scheme under NPS that allows subscribers to use their pension savings for health-related expenses. It is designed as a multi-partner ecosystem, combining pension funds, healthcare providers, and digital platforms to deliver seamless medical financing.
The scheme is being launched with a restricted number of subscribers under a controlled environment as part of the Regulatory Sandbox. Unlike traditional pension plans, this scheme adds a health security layer, enabling users to withdraw funds when medical needs arise.
NPS Swasthya Pension Scheme is a pilot scheme that allows subscribers to use part of their pension savings for medical expenses like OPD and hospitalization. It operates under the Multiple Scheme Framework (MSF) and is currently being tested on a limited scale.
NPS Swasthya Pension Scheme is a pilot scheme that allows subscribers to use part of their pension savings for medical expenses like OPD and hospitalization. It operates under the Multiple Scheme Framework (MSF) and is currently being tested on a limited scale.
Objective of the Scheme
The main goal is to:- Integrate health benefits with retirement savings
- Reduce financial burden during medical emergencies
- Promote subscriber-centric innovation in NPS
- Test feasibility before full-scale launch
- Address rising healthcare costs in India (expected to grow 11.5%–14% in 2026)
Key Partners & Implementation Model
As per PoC implementation updates, the scheme is being tested with partners such as:
- Medi Assist Healthcare Services - Digital infrastructure & hospital network
- CAMS KRA - KYC & onboarding support
- Tata Pension Fund Management - Fund management
- Axis Pension Fund - Fund management
- Aditya Birla Health Insurance - Group health super top-up cover
- Medi Assist TPA - Claims processing
Eligibility Criteria
- Any Indian citizen can join the scheme
- Age range: 18 to 85 years (as per PoC implementation details)
- Must have an NPS Common Account
- Health declaration required at the time of enrolment
Contribution Rules
- Subscribers can contribute any amount
- Contributions follow standard NPS guidelines (Non-Government sector)
- Funds are invested by Pension Funds as per official rules
Transfer from NPS Account
- Applicable only for non-government subscribers
- Age must be 40 years or above
- Can transfer up to 30% of contributions to this scheme
Medical Withdrawal Benefits
Partial Withdrawal- Allowed for both OPD and hospitalization
- Maximum withdrawal: 25% of your own contributions
- No limit on number of withdrawals (as per Regulatory Sandbox relaxation)
- No waiting period
Withdrawals may be enabled through digital platforms integrated with CRA (such as MAven app in PoC stage).
Critical Illness Benefit
If medical expenses exceed 70% of total corpus:- You can exit the scheme completely
- Withdraw 100% of funds as lump sum
- No restriction on corpus size
How Claim Settlement Works
- Payments are made directly to:
- Health Benefit Administrator (HBA)
- Third Party Administrator (TPA)
- Based on valid medical bills and invoices
- Any unused amount goes back to your NPS account
Hospital Network & Coverage
The PoC integrates with a large hospital network (reported to include 15,500+ hospitals)- Coverage across 1,200+ cities
- Cashless inpatient services
- Tech-enabled outpatient services
Exit Rules
- In normal cases:
- Funds are transferred back to your NPS main account
- Standard NPS exit rules apply
- If scheme fails (PoC stage):
- You can shift funds to your Common Scheme Account
- Then exit as per existing rules
Grievance Redressal System
- Managed by Pension Funds
- Supported by CRA and HBA/TPA
- Ensures quick resolution of complaints
Data Privacy & Consent
- Follows Digital Personal Data Protection Act, 2023
- Subscriber data shared only with consent
- Required for claim processing
Market Context & Growth
- As per recent data, the combined subscriber base of NPS and Atal Pension Yojana is 9.64 crore
- Total AUM: ₹16.55 lakh crore (as of March 2026)
- Rising healthcare inflation driving need for such schemes
Important Note (Pilot Phase)
Currently, the scheme is:- In second Proof of Concept (PoC) phase
- Available to limited subscribers only
- Expanded from earlier pilot (Jan 2026)
FAQs on NPS Swasthya Pension Scheme
Q1. Is NPS Swasthya Pension Scheme available to everyone?Yes, but currently limited due to pilot phase.
Q2. Can I withdraw money anytime?
Yes, for medical purposes after ₹50,000 corpus.
Q3. Is this a replacement for health insurance?
No, it complements health insurance.
Q4. What is new in the second PoC?
It now includes hospitalization and expanded healthcare services.
Q5. How are claims processed?
Through digital platforms and TPA with hospital integration.
Along with schemes like NPS Vatsalya, this initiative shows how the NPS ecosystem is evolving to meet different financial needs across age groups.
If successfully implemented nationwide, this scheme could significantly reduce out-of-pocket healthcare costs and strengthen the NPS ecosystem.
Through digital platforms and TPA with hospital integration.
Conclusion
The NPS Swasthya Pension Scheme is a game-changing initiative that combines retirement planning with healthcare security. While still in its testing phase, it has the potential to become a powerful financial tool for managing medical expenses in India.Along with schemes like NPS Vatsalya, this initiative shows how the NPS ecosystem is evolving to meet different financial needs across age groups.
If successfully implemented nationwide, this scheme could significantly reduce out-of-pocket healthcare costs and strengthen the NPS ecosystem.
Note: Some implementation details such as partners, app integration, and hospital network are based on Proof of Concept (PoC) stage updates and may change after full rollout.
Source / Reference Link: Official circular by Pension Fund Regulatory and Development Authority (Introduction of NPS Swasthya Pension Scheme as a Proof of Concept ) + industry PoC updates.
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