National Health Service Corps Loan Repayment Program

Quick Facts

• Benefit type: Federal loan repayment program that reduces educational debt for health professionals working in shortage areas.
• Maximum award: $50,000 for an initial two-year full-time commitment; part-time clinicians receive up to $25,000. Additional continuation contracts can raise total awards to $100,000 or more.
• Who qualifies: Physicians, nurse practitioners, physician assistants, dentists, dental hygienists, certified nurse-midwives, health service psychologists, licensed clinical social workers, marriage and family therapists, licensed professional counselors, and SUD treatment providers.
• Tax status: Awards are tax-free under federal law.
• Service setting: NHSC-approved sites such as federally qualified health centers, rural health clinics, Indian Health Service facilities, correctional institutions, and community mental health centers.

Program Overview

The National Health Service Corps (NHSC) Loan Repayment Program incentivizes clinicians to practice in medically underserved communities. HRSA administers the program, offering substantial, tax-free loan repayment in exchange for service in Health Professional Shortage Areas (HPSAs). Participants commit to two years of service, with options to extend annually. Funding is competitive, so applicants with higher HPSA scores and greater debt-to-income ratios receive preference.

NHSC has distinct tracks for different professions, including the general Loan Repayment Program, the Substance Use Disorder Workforce Loan Repayment, and the Rural Community LRP. This guide focuses on the core program. Clinicians can work full time (minimum 40 hours/week) or part time (minimum 20 hours/week). Full-time participants receive the highest awards, but part-time commitments offer flexibility for those balancing family or academic responsibilities.

Eligibility Requirements

To qualify, applicants must:

1. Be U.S. citizens or nationals. Permanent residents are not eligible for the core program, though some NHSC initiatives accept them.
2. Hold a valid license or certification. Licensure must allow independent practice in the discipline and state of the NHSC-approved site.
3. Have qualifying educational debt. Loans must have been incurred to finance undergraduate or graduate education leading to the eligible health profession. Consolidated loans are allowed if they include only qualifying debt.
4. Work or have a job offer at an NHSC-approved site. Sites must have a current NHSC site agreement and a HPSA score. Clinicians must provide direct patient care.
5. Commit to service: Full-time participants must work at least 40 hours/week (with minimum clinical hours). Part-time participants must work at least 20 hours/week.
6. Have no conflicting service obligations. Applicants cannot have other service commitments (e.g., another LRP) that overlap.

Additional Considerations

• New graduates: You may apply before obtaining a license if you have a job offer and expect to be fully licensed before service begins.
• Telehealth: Limited telehealth is allowed if integrated with in-person care. The majority of hours must be on-site.
• Defaulted loans: Applicants with defaulted federal debt or judgment liens are ineligible until resolved.

Benefit Details

• Full-time award: $50,000 for an initial two-year contract. Additional one-year continuation contracts may provide $20,000–$50,000 each, depending on HPSA score.
• Part-time award: $25,000 for an initial two-year contract. Continuations offer $10,000–$25,000 per year.
• HPSA prioritization: Sites with higher HPSA scores (e.g., 18+) receive priority for awards. Clinicians at lower-scoring sites may still receive awards if funding allows.
• Tax treatment: Awards are exempt from federal income tax and FICA; HRSA issues a statement for your records but no W-2.
• Payment process: HRSA pays lump sums directly to the clinician, who must then apply funds to educational loans within three business days.

Application Process

1. Identify an NHSC-approved site: Use the NHSC Job Center to find openings, or confirm your employer’s site code.
2. Gather documentation: Collect proof of citizenship, licensure, education, and loan account statements (including account numbers and balances).
3. Create a BHW account: Register with HRSA’s Bureau of Health Workforce Customer Service Portal.
4. Complete the online application: Provide personal information, employment verification, loan documentation, and transcripts. Upload PDF copies of required documents.
5. Submit during the application window: Typically January to April. Late submissions are not accepted. Ensure the site administrator submits their portion verifying employment and site eligibility.
6. Monitor application status: HRSA reviews applications, verifying license status, site eligibility, and loan information. Respond promptly to requests for additional documentation.
7. Sign contract if awarded: Upon selection, sign the service contract. Service typically begins on a mutually agreed date shortly after award announcement.

Required Documentation Checklist

• Proof of citizenship (U.S. passport, birth certificate, certificate of naturalization).
• Current professional license or documentation that you will be licensed by the service start date.
• Employment verification from the NHSC site, including start date, hours, and site code.
• Loan documentation: statements, payoff letters, promissory notes, consolidation breakdowns.
• Academic transcripts demonstrating completion of qualifying degrees.
• Current resume or CV.
• For substance use disorder providers, proof of DATA 2000 waiver or other specialty certifications if relevant.

Deadlines and Timing

• Application period: Typically opens in January and closes in April. HRSA announces exact dates annually.
• Award notifications: Usually released in late summer. Applicants receive emails and portal updates.
• Service start: Begins upon contract execution, often in September or October. Participants must begin service within six months of award.
• Continuation contracts: Participants nearing completion can apply for additional contracts in subsequent application cycles.

Interaction with Other Programs

• Public Service Loan Forgiveness: NHSC payments count as lump-sum payments toward loan principal but not as qualifying PSLF payments. However, clinicians can continue making PSLF-qualifying payments on remaining balances while serving at nonprofit sites.
• State loan repayment programs: Many states allow stacking NHSC funds with state awards if service requirements align. Ensure the combined hours meet both obligations.
• Other NHSC initiatives: You cannot receive funds from multiple NHSC repayment programs simultaneously, but you may transition to another program after completing the initial contract.
• Military service: Active duty service obligations generally preclude participation unless service can be completed concurrently at an eligible site.

Maximizing Your Benefit

1. Target high HPSA scores: Working in sites with higher scores increases award likelihood. Use the HPSA finder to compare locations.
2. Maintain complete documentation: Incomplete applications are common reasons for rejection. Double-check that all uploads are legible and signed.
3. Plan for loan payments: Since funds are sent to you, set up immediate payments to servicers to comply with the three-day requirement. Keep proof of payment for audits.
4. Consider continuation contracts: Start planning early if you want to extend service. Maintaining good performance and staying in high-need sites improves approval chances.
5. Leverage employer support: Many NHSC sites provide relocation bonuses or housing stipends. Combine these with loan repayment to maximize financial benefit.

Common Mistakes to Avoid

• Applying without site approval: Ensure your employer is NHSC-approved. Without a site agreement, the application will be denied.
• Incomplete loan information: Missing account numbers or mixing ineligible debt can delay or disqualify applications.
• License gaps: Keep licenses active and unencumbered. Suspensions or disciplinary actions can terminate awards.
• Missing deadlines: HRSA does not accept late documents. Submit early to account for technical issues.
• Not applying funds promptly: You must send award funds to loan servicers within three business days and provide proof. Failure may trigger default and penalties.

Example Scenarios

• Rural family physician: Dr. Patel practices in a rural clinic with an HPSA score of 20 and $200,000 in loans. She receives $50,000 for the first two years and a continuation contract for $30,000, helping her pay down debt rapidly.
• Behavioral health provider: Jordan, a licensed clinical social worker, works at a community mental health center in a high-need urban area. He secures a part-time award of $25,000 while maintaining a flexible schedule.
• Dentist in tribal clinic: Dr. Yazzie serves at an Indian Health Service facility. With large dental school debt, she receives $50,000 initially and later a $40,000 continuation contract, significantly reducing her balance.

Frequently Asked Questions

• Are awards guaranteed each year? No. Funding depends on congressional appropriations and the number of applicants.
• Can residents apply? Residents generally do not qualify until they can provide independent patient care. Some postgraduate-year positions at NHSC sites may count if you are fully licensed.
• Is the program portable? Changing sites requires HRSA approval. The new site must be NHSC-approved with an equal or higher HPSA score.
• How does part-time service work? Part-time participants must work at least 20 hours per week, with 45 weeks per service year. Awards are prorated accordingly.
• What happens if I fail to complete service? You must repay the full amount with interest and penalties. NHSC rarely grants waivers, except for extreme hardship.

Additional Resources

• NHSC Loan Repayment Program overview
• NHSC Site and Job Search
• HPSA Find tool
• NHSC Customer Care Center: 800-221-9393
• Comparison of NHSC loan programs