Loan repayment for nurses: how to manage student debt at every stage of your career

By Corey Buhay | Published on October 21, 2025

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A nursing degree can be the ticket to a fulfilling career—great benefits, and a job that’s always in demand—but for many students, it comes at a high cost. According to research by the Education Data Initiative, the median student takes out more than $17,000 in nursing school loans for an associate’s degree and more than $22,000 for a bachelor’s degree. That number can double for a master’s. And while RNs often make a decent salary, it can take a while to unlock that kind of income. So how do you start chipping away at your debt in the meantime?

The good news is that government agencies and nonprofit organizations offer tons of student loan repayment programs for healthcare professionals—including nurses. If you work in a rural community, are a nursing faculty member, or specialize in behavioral health or substance use disorders, you could have even more funding at your fingertips. Here’s a look at some loan repayment programs available to you at each stage of your nursing career.

In college: Managing your loans while you’re in school

If you’re currently a nursing student, you probably don’t need to worry about making payments just yet. Most education loans come with an in-school deferment period, i.e. a period of time during which your payments are put on pause. That means you don’t have to pay any student loan bills while you’re enrolled at least part-time at an accredited school. However, there are a few things you can do to get ahead of the curve.

1. Make interest-only payments. Making full loan payments while you’re in school can help you dramatically reduce the cost of your post-graduation bill. But even if you only pay the interest each month, that can still keep your debt from ballooning.

2. Start budgeting early. Start tracking your income and expenditures while you’re in college. Sticking to a budget is a great way to build good spending habits and start saving up for loan repayment.

3. Work a side hustle. If you have time between your studies, take on a side gig. Try freelancing, babysitting, or finding streams of passive income. A savings cushion will set you up to begin loan repayment later.

After graduation: How to begin loan repayment

Once you graduate, you’ll likely be granted a student loan grace period. This is a deferment period during which you don’t have to make payments. Most lenders, including the U.S. Department of Education, offer a six-month grace period. Earnest offers nine months¹.

If you can afford to start making payments during this period, it can help you get ahead of your debt and keep interest from accruing.

This is also a good time to choose a student loan repayment plan. If you have federal loans, it can be helpful to determine whether you want to pursue federal loan forgiveness. To qualify, you’ll typically have to make a certain number of payments under an eligible plan. So, the earlier you decide, the earlier you can get on the correct plan and start having your payments counted.

Paths to federal student loan forgiveness

There are a few different federal student loan forgiveness programs for nurses. Here are two of the most common.

• Income-Driven Repayment Plan (IDR): This describes a handful of federal student loan repayment programs that cap your monthly payment at a percentage of your income. It also takes into account your family size and any dependents you might have. The goal is to ensure your loan payments remain affordable. If you make 20 to 25 years’ worth of payments on an IDR plan, you could have the rest of your loans forgiven.

• Public Service Loan Forgiveness (PSLF): If you work at a nonprofit organization, not-for-profit hospital, public school, or state or federal hospital, you could qualify for PSLF. This is a federal program that will forgive the remainder of your education loans after you’ve made 10 years’ worth of qualifying payments. To get started, you’ll need to sign up for an income-driven repayment plan through your studentaid.gov account.

Early in your career: Finding a job that offers loan assistance

The average starting salary for nurses is anywhere from $45,000 to $89,000, depending on where you live. At the lower end of that range, student loan payments can feel extra heavy. So, if you’re hunting for your first job, keep in mind that some employers offer student loan repayment assistance as an employee benefit. You may have to work full-time or stick with that employer for a certain number of years to be eligible. But if you do, the payoff can be significant. Some employers will match your loan payments, while others will provide a regular stipend you can use toward pay-off.

If you’re interviewing for a new job, ask your hiring manager or the HR department whether they can offer you tuition reimbursement as part of your benefits package. If you already have a job, ask HR whether you can take advantage of any programs already in place.

National loan assistance programs

Even if you can’t find a specific employer to help pay off your loans, you may be able to increase your odds of loan assistance by choosing a particular service area or field within nursing. Some national organizations, like the National Health Service Corps and the Nurse Corps, offer loan repayment programs (LRPs) to nurses, nurse midwives, nurse practitioners, and other professionals. Priority typically goes to folks who work in rural health clinics or underserved areas with few healthcare facilities.

• National Health Service Corps (NHSC) Loan Repayment Program: This program is available to nurses, nurse practitioners, and other providers working in health professional shortage areas (HPSAs)—i.e., places that don’t have enough primary care or mental health care providers. You can see the full list of approved areas on the Health Resources and Services Administration website. Primary care providers can get up to $75,000 forgiven, and other providers can get up to $50,000 forgiven.

• Nurse Corps Loan Repayment Program: This program is typically reserved for registered nurses (RNs) and advanced practice registered nurses (APRNs) working in critical shortage facilities. It’s also available to nurse faculty members working in eligible nursing schools. The Nurse Corps Loan Repayment Program can pay off up to 85% of your loan balance.

State loan assistance programs

Some states also offer repayment assistance for nursing education loans. The California Department of Health Care Access and Information (HCAI) is a great example. The department offers seven different loan payoff programs for nurses.

The Michigan State Loan Repayment Program (MSLRP) is another good example, albeit more specific—only APRNs can apply, but if you qualify, you could get up to $300,000 of your loans forgiven.

Some of these state programs require participants to work in a hospital or behavioral health facility for a certain time period and/or to clock a certain number of hours of direct patient care. Search your state online to find out if there are programs available in your area. Then, read the fine print before you apply.

Later in your career: Repaying your loans down faster

The good news is that nursing salaries tend to rise steadily as your experience increases. Nurses with two to five years of experience make an average of $68,000 while nurses with more than a decade of experience can make around $89,000 on average.

Any time you get a promotion or raise, it’s a good idea to take a fresh look at your student loan repayment plan. If you’re on an income-driven repayment plan, a salary increase could result in a monthly payment increase. In that case, you might need to rebalance your budget accordingly. Regardless, if you’re making more money now than you used to, it might make sense to be proactive and start paying down your debt more aggressively.

If your income and credit score have increased since you took out your student loans, it may be time to consider refinancing². Refinancing allows you to exchange your old loans for a brand-new loan with a new lender. If you meet your lender’s eligibility requirements, you could also qualify for a lower interest rate. That could help you save money over the life of your loans³.

You can refinance your education debt as many times as you want. Just be aware that refinancing federal loans will turn them into private loans. That means you’ll lose access to loan forgiveness and other federal borrower protections. Once you’ve refinanced your federal debt, you can’t reverse the process and turn it back into private debt. So, if you think you might qualify for federal loan forgiveness, deferment, or other perks, think carefully before you refinance.

See how much you could save by refinancing

If you qualify for refinancing, it can be an incredible tool for reducing your monthly payment, saving money, or getting out of debt faster. That’s especially true if you refinance with Earnest. Earnest charges zero fees, offers flexible repayment plans, and provides some of the lowest rates to medical professionals, including nurses with graduate-level education. Even if you can reduce your interest rate by a single percentage point (and keep your loan term the same), refinancing could help you save some serious cash over time. Wondering just how much? Check your rate today. It’s fast, it’s free, and it won’t affect your credit score.

About the Author

Corey Buhay

Corey Buhay is a writer and editor based in Boulder, Colorado. She’s passionate about literature, the outdoors, and doing her taxes by hand. She has been writing about student loans and personal finance for Earnest since 2019. You’ll find her work in Outside Magazine, Backpacker Magazine, Smithsonian, and The Denver Post.