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NPS Swasthya Pension Scheme

Kartavya Desk Staff

Source: TOI

Subject: Economy

Context: The Pension Fund Regulatory and Development Authority (PFRDA) has launched the NPS Swasthya Pension Scheme as a pilot project under its Regulatory Sandbox Framework to integrate healthcare expense coverage with pension savings.

About NPS Swasthya Pension Scheme:

What is the NPS Swasthya Pension Scheme?

• The NPS Swasthya Pension Scheme is a sector-specific scheme under the National Pension System (NPS) designed to provide financial support for medical expenses—both outpatient (OPD) and inpatient (IPD)—using pension-linked savings.

• It is being introduced as a Proof of Concept (PoC) on a limited scale under PFRDA’s Regulatory Sandbox, allowing controlled experimentation before any full-scale rollout.

Nodal Authority: The Pension Fund Regulatory and Development Authority (PFRDA).

Aim of the scheme:

• Integrate healthcare financing with long-term retirement planning

• Reduce out-of-pocket expenditure (OOPE) on medical care

• Test the operational, technological, and regulatory feasibility of health-linked pension products

• Enhance subscriber-centric innovation within the NPS ecosystem

Key features of the NPS Swasthya Pension Scheme:

Voluntary & contributory: Open to all Indian citizens on a voluntary basis, with flexible contribution amounts.

Multiple Scheme Framework (MSF): Contributions are invested as per MSF guidelines, ensuring regulated asset allocation.

Medical expense withdrawals: Partial withdrawals allowed for OPD and IPD expenses Up to 25% of subscriber’s own contributions can be withdrawn No cap on the number of withdrawals First withdrawal allowed after a minimum corpus of ₹50,000

• Partial withdrawals allowed for OPD and IPD expenses

• Up to 25% of subscriber’s own contributions can be withdrawn

• No cap on the number of withdrawals

• First withdrawal allowed after a minimum corpus of ₹50,000

Critical illness protection: If a single inpatient treatment exceeds 70% of total corpus, Subscriber can exit prematurely with 100% lump-sum withdrawal exclusively for medical treatment

• If a single inpatient treatment exceeds 70% of total corpus,

Transfer from Common Scheme Account: Subscribers above 40 years (excluding government sector) can transfer up to 30% of their contributions into the Swasthya Scheme.

Claim settlement mechanism: Medical claims are paid directly to HBA/TPA or hospitals Any surplus after settlement is credited back to the subscriber’s NPS account.

• Medical claims are paid directly to HBA/TPA or hospitals

• Any surplus after settlement is credited back to the subscriber’s NPS account.

Strong governance safeguards: Mandatory disclosures on benefits, fees, claims, exits Robust grievance redressal mechanism Explicit digital consent as per the Digital Personal Data Protection Act, 2023

• Mandatory disclosures on benefits, fees, claims, exits

• Robust grievance redressal mechanism

Explicit digital consent as per the Digital Personal Data Protection Act, 2023

Significance of the scheme:

Health–Pension convergence: First structured attempt to link retirement savings with healthcare financing in India.

Reduced medical impoverishment: Helps households manage health shocks without liquidating assets.

AI-assisted content, editorially reviewed by Kartavya Desk Staff.

About Kartavya Desk Staff

Articles in our archive published before our editorial team was expanded. Legacy content is periodically reviewed and updated by our current editors.

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