Programs for Loan Repayment and Forgiveness: A List for Rural Providers

by Laura Grangaard, MPH
(Minor updates to program requirements by Jana Reese, May 14, 2024)

Loan repayment/forgiveness programs can be an optimal way to attract needed healthcare professionals.  In exchange for varying levels of loan repayment/forgiveness from the federal and/or state government, providers work at an approved site in an underserved area for a certain amount of time (often subject to increase, if desired). Rural areas that are underserved are often host to sites that are approved or are able to become approved.

Options to Consider

Before considering these recruitment programs and options, it is useful to understand if your site is in a Health Professional Shortage Area (HPSA), which is required to participate in most programs, and if your site is an approved site type.

The Health Resources and Services Administration (HRSA) offers a searchable online database of HPSAs by state and county, with the corresponding HPSA score.

Depending on the program, the federal HPSA designation may not be a requirement, and the program may also be open in locations that are designated as a Medically Underserved Area (MUA) or provide healthcare services to Medically Underserved Populations (MUP). HRSA provides an online search tool to determine if a location is in an MUA/P.

The National Health Service Corps has an online list of approved site types. Some programs have slightly different criteria (noted below), when applicable.

Types of repayment/forgiveness programs

The following information is framed for a potential site seeking to recruit a new provider.  Note that most of these programs offer a yearly application cycle, although this may be dependent upon funding streams.

National Health Service Corps (NHSC) loan repayment Licensed health care providers are offered loan repayment assistance in exchange for working in facilities in HPSAs.
Funding: Federal
Approved site types: NHSC Types of Sites
NHSC site information: Become an NHSC Site
Professions: Licensed primary care medical, dental, and mental/behavioral health providers
Length of time for service: 2 years of full-time service, or 4 years of half-time service
For more information: NHSC Loan Repayment Program Fact sheet
Money available per applicant: Award amounts are based on profession. Funds are not taxable.

• Up to $75,000 for 2 years of full-time or 4 years of half-time
• Up to $37,500 for 2 years of half-time

National Health Service Corps (NHSC) Students to Service Loan Repayment Program (S2S LRP) Physician, nursing, physician assistant, dental, and maternity care treatment students in their last year of school are given loan repayment assistance in exchange for a commitment to provide primary care services in eligible HPSAs.
Funding: Federal
Approved site types: NHSC-approved sites
NHSC site information: Become an NHSC Site
Professions: Students pursuing programs in medicine (MD and DO), dentistry (DMD and DDS), nurse practitioner, certified nurse midwife, and physician assistant.
Length of time for service: 3 years of full-time service. Participants may request a waiver to complete the commitment through half-time service, if needed.
For more information: Students to Service Loan Repayment Program fact sheet
Money available per applicant: Up to $120,000 in 4 equal installments. Funds are not taxable.

HRSA Nurse Corps Loan Repayment Program
Loan repayment to registered nurses and advanced practice registered nurses working in a public or private nonprofit Critical Shortage Facility and nurse faculty in an accredited school of nursing.
Funding: Federal
Approved site types: Public or private nonprofit Critical Shortage Facilities and eligible accredited schools of nursing
Professions: Licensed registered nurses, advanced practice nurses, nursing faculty, or nurse practitioners
Length of time for service: 2-year minimum (optional third year)
For more information: Nurse Corps Loan Repayment Program fact sheet
Money available per applicant: Repays 60% of a qualifying educational loan balance in exchange for 2 years of service at a critical shortage facility. Participants may be eligible to work a third year and receive an additional 25% of the qualifying loan balance. Funds are taxable.

HRSA NURSE Corps Scholarship Program
Nursing students (accepted or enrolled) receive scholarships for education in exchange for working at an eligible Critical Shortage Facility after completion of education.
Funding: Federal
Approved site types: Public or private nonprofit Critical Shortage Facilities
Professions: Students accepted or enrolled in a diploma, associate, baccalaureate or graduate nursing programs (including Nursing Bridge Programs: RN to BSN; RN to MSN-NP and non-nursing Bachelor's to NSN-NP)
Length of time for service: 2-year minimum (4-year maximum conditional support)
For more information: Nurse Corps Scholarship Program fact sheet
Money available per applicant: Scholarships include tuition, fees, reasonable educational costs, and a monthly living stipend while in school. Scholarships are taxable.

Indian Health Service Loan Repayment Program
A wide range of health care providers are offered loan repayment assistance in exchange for serving at least 2 years full-time at an Indian health program site.
Funding: Federal/IHS
Approved site types: Indian Health Programs
Professions: See Eligibility Criteria
Length of time for service: 2-year minimum. Extension possible on a year-to-year basis.
Application cycle: Applications are accepted October 1 through August 15 and are evaluated monthly beginning in January (or as soon as funds become available).
Money available per applicant: Up to $25,000 per year.

State-based Loan Repayment Programs (SLRP) Federally funded grant program that provides cost-sharing grants to states help them operate their own state loan repayment programs for primary care providers in HPSAs.
Funding: State and federal
Who to contact: Not all states host a State-based Loan Repayment Program, but a list of State Loan Repayment Program contacts is available on the National Health Service Corps website.
Approved site types: Varies, but site must be in a Health Professional Shortage Area (HPSA). Contact state office for specifics.
Professions: Vary by state. May include physicians (MD or DO), Nurse Practitioners, and Physician Assistants in primary care or mental health capacities; dental professionals; mental health professionals; Registered Nurses; and/or pharmacists. Contact state office for specifics.
Length of time for service: In most cases, 2 or 3 years. Extension usually possible on a year-to-year basis
Money available per applicant: Variable. Some examples follow:

• Colorado: $120,000 for 3-years of full-time for physicians, $90,000 for 3 years of full-time for physician assistants, advanced practice nurses, clinical pharmacists, licensed mental health providers, licensed addiction counselors, dental hygienists and certified addiction counselors.
• Louisiana: $90,000 for 3 years of full-time for physicians, psychiatrists, and dentists. $60,000 for 3 years of full-time for other eligible professions
• Minnesota: Up to $40,000 for 2 years of full-time, or $20,000 for 2 years of half-time for eligible professions including physicians, dentists, dental hygienists, certified nurse midwives, nurse practitioners, physician assistants, and certain behavioral health providers
• Ohio: For full-time physicians, up to $25,000 annually for 2 years of service and up to $35,000 annually for a third and fourth year of service.

Other State-based programs
Many states offer additional state-appropriated funds for health professions loan repayment or forgiveness programs. To find more information about these programs, contacting the State Office of Rural Health, Primary Care, Workforce, or related offices (the location of these programs varies by state) would be a good first step. The Rural Health Information Hub (RHIhub) offers a state-by-state listing of State Offices of Rural Health.

RHIhub also offers lists of Loan Repayment Programs currently accepting applications and Loan Repayment programs which may offer funding in the future.

Laura Grangaard is a Research Analyst for Stratis Health. This guide was compiled as part of a team project for Rural Health System Analysis and Technical Assistance (RHSATA), a cooperative agreement between the Federal Office of Rural Health Policy, the RUPRI Center for Rural Health Policy Analysis (RUPRI Center) and Stratis Health. Grangaard can be reached at: LGRANGAARD@stratishealth.org.

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