NPS Health Scheme combines retirement savings with health insurance, giving eligible subscribers an option to build an NPS corpus while also receiving medical coverage.
The plan includes a family floater health policy along with the NPS account.
The facility is available for individuals aged 18 to 70 years. Depending on the policy terms and premium payments, the health policy can continue until the age of 85.
NPS Health Scheme Covers Family Members
Under the plan, the account holder can include their spouse and a maximum of two children under the family floater health insurance cover.
Parents are not included in the general family coverage under this plan. The coverage applies to the eligible family members included in the policy, subject to its terms and conditions.
Health Cover Available Up to ₹30 Lakh
The health insurance component follows a super top-up model. This means the policy starts paying eligible medical expenses after the applicable deductible has been reached.
Subscribers can choose coverage options of up to ₹1 lakh with a ₹10,000 deductible, ₹5 lakh with a ₹50,000 deductible, ₹10 lakh with a ₹1 lakh deductible, or ₹30 lakh with a ₹3 lakh deductible.
The deductible is calculated by combining eligible medical expenses incurred by all covered family members.
Premium Depends on Age
When opening an NPS Health account, subscribers have to pay the first-year health insurance premium along with applicable taxes. An annual maintenance charge of ₹200 plus taxes is also applicable.
A minimum investment of ₹1,000 is required in the NPS account. After the initial contribution, additional investments can be made from as little as ₹10, while the health insurance premium depends on the subscriber’s age.
Up to 25% Can Be Withdrawn for Treatment
Account holders can withdraw up to 25% of their NPS Health account contributions for eligible medical expenses. The withdrawal facility covers hospitalisation as well as eligible outpatient treatment.
For eligible treatment expenses, the amount is settled with the relevant hospital or healthcare provider.
If the cost of treatment during a single hospitalisation exceeds the permitted 25% withdrawal limit, the account holder can choose premature exit, subject to applicable conditions.
When Can the Account Be Closed?
The NPS Health account can be closed in cases such as normal exit, premature exit, insufficient funds for renewing the health insurance policy, or the death of the account holder.
Closing the NPS Health account does not affect any other NPS accounts held by the same individual.
Overall, the plan combines pension savings with a health insurance component, while the available cover, premium, withdrawal facility and exit conditions remain subject to the applicable terms.
