Indian Health Service Loan Repayment Program

Quick Facts

• Benefit type: Federal loan repayment program for licensed health professionals serving American Indian and Alaska Native communities.
• Maximum award: Up to $50,000 over an initial two-year service commitment ($25,000 per year), with potential extensions until qualifying loans are paid.
• Who can apply: U.S. citizens and nationals with health professional degrees (physicians, dentists, nurses, pharmacists, behavioral health providers, and more) who hold an active license and have eligible education loans.
• Service sites: Indian Health Service (IHS) hospitals and clinics, tribally operated programs, and Urban Indian organizations with approved staffing needs.
• Application cycle: Rolling applications with priority consideration for submissions received by mid-February each year.

Program Overview

The Indian Health Service (IHS) Loan Repayment Program (LRP) helps address chronic shortages of health professionals in tribal communities. In exchange for a two-year service commitment at a qualifying facility, the program repays up to $25,000 per year of eligible student loans and covers federal tax liabilities through an additional tax payment. Participants may extend contracts annually until their loans are paid in full, subject to continued site need and funding availability.

The program is open to a broad range of clinical disciplines, including primary care physicians, nurse practitioners, physician assistants, dentists, pharmacists, registered nurses, mental health counselors, psychologists, social workers, and public health professionals. Priority funding is given to applicants who select high-need sites with a Health Professional Shortage Area (HPSA) score of 14 or higher.

Eligibility Requirements

1. Citizenship: Must be a U.S. citizen or national.
2. Professional qualifications: Possess a degree in an eligible health profession and hold (or be eligible to obtain) an unrestricted license in a U.S. state. New graduates may apply if they will secure licensure before starting service.
3. Educational loans: Have qualifying government or commercial loans for undergraduate and graduate health professional education. Consolidated loans must be solely for qualifying education.
4. Service commitment: Agree to serve full-time (minimum 40 hours per week) at an approved IHS, tribal, or Urban Indian organization site for at least two years.
5. Site placement: Work at a facility with staffing priorities documented by the IHS Area office. Applicants already employed at an IHS site can apply if their facility is eligible.
6. Exclusions: Individuals with federal judgment liens, delinquent federal debt, or existing service obligations conflicting with IHS service cannot participate.

Application Process

1. Research eligible sites: Review the IHS Loan Repayment Site List for facilities with staffing priorities. Contact site recruiters to discuss openings and service needs.
2. Create an online account: Submit the application via the IHS LRP portal. Provide personal information, education history, licensure, loan details, and site preferences.
3. Upload documentation: Include professional licenses, transcripts, loan statements, proof of citizenship, and employer verification if already working at an IHS facility.
4. Obtain site evaluation: The proposed service site completes a Site Information Form confirming vacancy priority and ability to employ the applicant.
5. Submit by priority deadline: While applications are accepted year-round, submit by February (Cycle 1 deadline) for best funding chances. A second review occurs in August if funds remain.
6. Selection and award: IHS evaluates applications using site priority, discipline, and applicant characteristics. Awardees sign a contract specifying service dates and payment schedule.
7. Begin service: Service typically starts within 90 days of award approval. Payments are disbursed quarterly directly to loan servicers or to the participant.

Funding and Payments

• Loan repayment: Up to $25,000 per year, paid in quarterly installments. Participants must continue making minimum loan payments to avoid delinquency.
• Tax benefit: IHS makes an additional 20% payment to cover federal income taxes arising from loan repayment benefits. State tax responsibility varies.
• Extensions: After the initial two-year contract, participants may extend for one-year increments. Each renewal can provide up to $25,000, subject to loan balance and funding.
• Loan types: Qualifying loans include federal Direct, FFEL, Perkins, and certain private loans used for health professional education. Parent PLUS loans and personal loans are ineligible.

Service Expectations

• Full-time clinical service: Minimum of 80 hours per pay period, with at least 32 hours in direct patient care (for clinical disciplines). Administrative or teaching duties may count if integral to the role.
• Practice settings: Rural and reservation clinics, critical access hospitals, behavioral health centers, and urban Indian health programs.
• Community engagement: Participants often engage in cultural competency training, community outreach, and interdisciplinary care coordination.

Coordination with Other Programs

• National Health Service Corps (NHSC): You cannot hold concurrent service obligations with NHSC. However, former NHSC participants who completed obligations may apply to IHS LRP.
• Public Service Loan Forgiveness (PSLF): Payments made by IHS count toward PSLF qualifying payments if the employer is a qualifying public service organization. Coordinate with loan servicers to ensure payments are counted.
• State loan repayment: Some states offer additional incentives for practicing in tribal areas. Verify if state obligations conflict with IHS requirements.

Strategies for Applicants

1. Choose high-need sites: Facilities with high HPSA scores receive priority funding. Engage with site administrators early to ensure your application aligns with staffing needs.
2. Prepare complete documentation: Missing transcripts or loan statements delay review. Organize documents before submitting.
3. Highlight tribal experience: Emphasize cultural competence, prior service in Native communities, or language skills in your personal statement.
4. Maintain licensure: Ensure licenses and certifications remain active throughout the application and service period.
5. Budget for taxes: Although IHS provides a federal tax payment, set aside funds for potential state tax liabilities.

Common Challenges and Solutions

• Delayed site placement: Start conversations with multiple sites to secure a position quickly. Consider temporary assignments within the same Area to begin service.
• Loan servicing issues: Coordinate with loan servicers to correctly apply payments and avoid capitalization of interest.
• Housing and relocation: Many rural sites offer housing assistance or relocation bonuses. Ask recruiters about available support.
• Family considerations: Some sites provide flexible schedules, childcare resources, or community integration programs for spouses.

Example Participant Stories

• Primary care physician: Dr. Yazzie, a Navajo physician, returns to serve at a reservation clinic. IHS LRP pays $50,000 over two years, allowing her to reduce $180,000 in medical school debt while pursuing PSLF.
• Behavioral health counselor: Maria, a licensed professional counselor, addresses trauma-informed care at an urban Indian center in Minneapolis. After her initial contract, she renews for an additional year to continue providing culturally grounded therapy.
• Pharmacist: Ethan joins an IHS hospital in Alaska, where access to pharmacy services is limited. The program covers his student loans while he gains experience in telepharmacy and collaborative care.

Frequently Asked Questions

• Can I switch sites during my contract? Transfers require approval from the IHS Area office and the Loan Repayment Program. You must move to another eligible site with equal or higher priority.
• What happens if I breach the contract? You must repay all funds received plus interest and liquidated damages, often exceeding the original award. Avoid breach by communicating with program officers if issues arise.
• Are part-time positions eligible? The standard program requires full-time service. Part-time options are limited to special hardship cases and must be approved.
• How do I track payments? Participants receive quarterly statements detailing loan repayment and tax payments. Maintain records for tax filing and PSLF purposes.
• Is malpractice insurance covered? Coverage depends on the employing facility. Many IHS and tribal sites provide federal tort claims coverage or reimburse premiums.

Additional Resources

• IHS Loan Repayment Program
• Eligible Site List
• Application Checklist
• IHS Career Opportunities
• Cultural Competency Training Resources