The product allows reimbursement of medical costs without hospitalisation, a departure from insurance norms that generally tie a valid claim to a hospital stay.
New Delhi: The Pension Fund Regulatory and Development Authority (PFRDA) is set to launch NPS Swasthya this week, a product that links retirement savings with healthcare spending and carries a standard super top-up health insurance cover, according to a Business Standard report. Finance Minister Nirmala Sitharaman is to inaugurate the scheme, the report said.
According to the newspaper, NPS Swasthya brings together a set of products meant to ease access to healthcare services, so that subscribers can draw on their pension savings for medical needs while also holding insurance protection. The scheme has been running as a pilot since February 2026, the report said.
One feature sets it apart from conventional health policies. NPS Swasthya permits reimbursement even when the subscriber has not been admitted to hospital, the report said, whereas rules framed by the Insurance Regulatory and Development Authority of India (Irdai) generally require a hospital stay before a claim can be treated as valid.
The launch comes days after Irdai released a consultation paper on 23 September titled Recalibrating Economics of Insurance Distribution. In the paper, the regulator pointed to steep commissions, heavy concentration in policy porting and group business led by commissions in the health segment as signs that intermediary incentives now shape market behaviour more than customer value, underwriting quality or claims experience, according to the report.
Irdai has proposed linking the identity of the person who sold a policy to that policy so that mis-selling can be traced, along with tighter controls on commissions and expenses, the report said. The approach reverses the 2023 changes made under former chairman Debashis Panda, which had eased restrictions on insurers, it added.
The report set both moves against low insurance penetration in India, which stands at 3.7 per cent, made up of 2.7 per cent for life and 1 per cent for non-life, even as the country ranks tenth in the world by premium volume with a 1.8 per cent share. Expenses in general insurance rose from 30.3 per cent of premiums in FY15 to 32.1 per cent in FY26, the report said.
Source: Business Standard, 29 September 2026
