NPS Health Scheme offers up to ₹30 Lakh Cover

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NPS Health Scheme offers retirement savings along with a health fund and super top-up health insurance, under operational guidelines issued by the Pension Fund Regulatory and Development Authority (PFRDA).

The scheme has a minimum initial contribution of ₹1,000.

The NPS Swasthya guidelines were issued by PFRDA on September 18, 2026.

The arrangement combines an NPS Health Investment Account with a separate Super Top-Up Health Insurance Policy.

 How NPS Health Scheme Works

The NPS Health Scheme has two separate components: the NPS Health Investment Account and the Super Top-Up Health Insurance Policy.

The health insurance component can cover the subscriber, spouse and up to two dependent children under a family floater policy, while parents are not included.

The initial contribution to the NPS Health account is at least ₹1,000.

The first contribution also includes the first-year insurance premium and applicable tax, along with a ₹200 annual maintenance charge.

After the initial contribution, the minimum contribution is ₹10.

The pension fund may also charge up to 0.08% annually on the NPS Health fund, apart from the ₹200 maintenance charge.

 Health Cover Can Go Up to ₹30 Lakh

The super top-up health insurance component offers different combinations of deductibles and coverage.

A ₹10,000 deductible comes with ₹1 lakh cover, while a ₹50,000 deductible offers ₹5 lakh cover.

For higher coverage, a ₹1 lakh deductible is linked to ₹10 lakh insurance cover, while a ₹3 lakh deductible provides up to ₹30 lakh cover.

The insurance policy is available to customers aged 18 to 70 years. Subject to the applicable rules and policy conditions, renewal can continue until the age of 85.

 Medical Expenses and Withdrawals

Subscribers can withdraw up to 25% of their contributions to the NPS Health account for eligible medical expenses.

This can include hospitalisation and eligible outpatient treatment, with the amount paid directly to the hospital or relevant healthcare provider rather than to the subscriber.

The insurance component covers hospitalisation, daycare procedures, home hospitalisation, AYUSH treatment and certain specified modern treatments, subject to the applicable policy terms.

PFRDA’s operational guidelines also provide for partial withdrawals from the NPS Swasthya account for outpatient or inpatient medical expenses.

The broader NPS Swasthya framework allows such withdrawals up to 25% of the subscriber’s own contributions, subject to applicable conditions.

What Subscribers Should Know

The health insurance and investment components remain legally and operationally separate.

This means the health cover operates alongside the retirement savings component rather than replacing the underlying NPS investment structure.

The NPS Health Scheme is designed to combine long-term retirement savings with a dedicated mechanism for eligible healthcare expenses and additional health insurance protection.

Subscribers should check the applicable policy terms, deductible and coverage conditions before choosing an option.

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