One PRAN, Two Promises
NPS Swasthya
Save for retirement and keep your family's health covered, from the same NPS account.
One Vision,
2,00,000+ Stories
2,00,000+ Stories
Every time we hear a new story, it inspires us.
Hope they inspires you as well.
Hope they inspires you as well.
Over 1.8 crore users have already created
their NPS stories for a golden retirement.
their NPS stories for a golden retirement.
News & Articles
FAQs
Who can join NPS Swasthya?
Anyone eligible to join NPS can enrol, and the subscriber entry age for the health policy is 18 to 70. The policy can be renewed up to and including age 85, subject to premium, policy terms and applicable law.
Who is covered by the insurance?
One family floater covering the subscriber, spouse and up to two dependent children. Parents are not included in the standard cover — this is the detail people most often assume the other way round.
What does the annual aggregate deductible mean?
It is the amount of insurance-admissible medical expense that has to be reached before the insurance starts paying. It is calculated on the cumulative admissible expenses of all covered family members across the policy year, not separately for each claim.
So a ₹30 lakh sum insured does not pay from the first rupee of a bill — the applicable deductible comes first.
So a ₹30 lakh sum insured does not pay from the first rupee of a bill — the applicable deductible comes first.
What are the cover options?
Four standardised pairs of annual aggregate deductible and family floater sum insured:
- ₹10,000 deductible — ₹1 lakh sum insured
- ₹50,000 deductible — ₹5 lakh sum insured
- ₹1 lakh deductible — ₹10 lakh sum insured
- ₹3 lakh deductible — ₹30 lakh sum insured
How much can I withdraw for medical expenses, and how often?
Up to 25% of the contributions you have made to the NPS Swasthya account, towards eligible out-patient and in-patient healthcare expenses. There is no limit on the number of withdrawals and no minimum waiting period before the first or any later one.
The amount is not paid to you. It is settled directly with the hospital, healthcare provider or other eligible entity against the expense.
The amount is not paid to you. It is settled directly with the hospital, healthcare provider or other eligible entity against the expense.
What does it cost to open and run?
The minimum initial contribution is three things together:
- The first-year insurance premium, including applicable taxes
- ₹200 plus taxes as the annual maintenance charge for the Health Benefit Administrator
- At least ₹1,000 towards investment in the NPS Swasthya account
After that, the minimum subsequent contribution is ₹10. The standard All Citizen Model NPS charges apply, and the pension fund may levy up to 0.08% a year of the NPS Swasthya corpus plus taxes. Every charge has to be disclosed to you before you enrol and whenever it changes. The premium itself is set by the insurer under the IRDAI framework and depends on your entry-age band, so we are not quoting a figure until there is a real one.
Are there waiting periods?
Yes. A 30-day initial waiting period (except for accidents, as set out in the final policy wording), a 12-month waiting period for pre-existing diseases, and 12 months for specified diseases or procedures, subject to the final policy wording.
Controlled type 2 diabetes, hypertension, hyperlipidaemia and asthma that do not trigger enhanced underwriting are covered after a waiting period of 12 months. Fresh underwriting is not imposed at renewal unless the sum insured is increased.
Controlled type 2 diabetes, hypertension, hyperlipidaemia and asthma that do not trigger enhanced underwriting are covered after a waiting period of 12 months. Fresh underwriting is not imposed at renewal unless the sum insured is increased.
Will I need a medical test?
Enrolment is ordinarily based on a Good Health Declaration — a set of questions you answer for yourself, your spouse and your dependent children about specified conditions.
Where a declaration triggers enhanced underwriting, the insurer applies a premium loading based on the declaration, without requiring formal medical reports. If a proposal is declined you must be told the specific reason, and a decline for one family member does not by itself disqualify the others.
Where a declaration triggers enhanced underwriting, the insurer applies a premium loading based on the declaration, without requiring formal medical reports. If a proposal is declined you must be told the specific reason, and a decline for one family member does not by itself disqualify the others.
What does the cover actually include?
Subject to the final policy wording:
- Single private room for normal hospitalisation; ICU charges at actuals
- Pre-hospitalisation 30 days, post-hospitalisation 60 days
- Day-care procedures, in-patient and domiciliary hospitalisation
- AYUSH treatment, prescribed modern treatments, organ-donor medical expenses
- Road ambulance up to ₹2,500 per emergency hospitalisation
There are no co-payments and no disease-specific sub-limits.
Can I move money from my existing NPS account into it?
Partly. You can transfer from an existing NPS scheme under the All Citizen Model into the NPS Swasthya account, but the transfer is limited to the amount needed to meet the applicable deductible under the policy. Anything beyond that stays where it is.
When does the account close, and what happens to my money?
There are four situations: normal exit, premature exit, insufficient funds to renew the insurance, and death of the subscriber.
On a premature exit — available when a single eligible in-patient expense exceeds what the 25% withdrawal allows — the corpus goes to that expense first, and any remaining balance moves into an All Citizen Model NPS scheme. If the renewal premium goes unpaid past the grace period the cover lapses and the account is treated as closed, again merging into an All Citizen Model scheme.
On a premature exit — available when a single eligible in-patient expense exceeds what the 25% withdrawal allows — the corpus goes to that expense first, and any remaining balance moves into an All Citizen Model NPS scheme. If the renewal premium goes unpaid past the grace period the cover lapses and the account is treated as closed, again merging into an All Citizen Model scheme.
Closing the NPS Swasthya account does not affect any other NPS account you hold.
Can I open an NPS Swasthya account through PensionBox today?
Not yet, and we would rather say so plainly. PFRDA's guidelines have been in force since 18 September 2026, but they leave the functions of a Point of Presence under NPS Swasthya to be specified by PFRDA later. Until that happens, we cannot onboard you.
Joining the waiting list is not an application and does not create any account or policy. We will write to you when we can actually open one.
Joining the waiting list is not an application and does not create any account or policy. We will write to you when we can actually open one.
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