Managing Student Loans During Residency

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FIRST for Medical Education Financial Information, Resources, Services, and Tools Managing Student Loans During Residency Nicole Knight Spring 2010 NOTE: All information and estimates are based on AAMC interpretation of federal regulations as of February 2010 and are subject to change. Borrowers should always contact their lender/servicer(s) to discuss loan balances and repayment options. Class of 2009 Indebted Graduates Median Education Debt % with Education Debt Private $177,500 84 Public $150,000 89 All $160,000 87 Source: AAMC 2009 Graduation Questionnaire 1

Class of 10 Indebtedness UC Irvine, School of Medicine 87% with educational debt Average medical indebtedness $116,689 Average pre-medical indebtedness $17,250 Non-education loans average $11,500 Source: UCI Financial Aid Office and 2009 Graduate Questionnaire (GQ) data Agenda 1) Know Your Loan Portfolio 2) How to Postpone Payments 3) Payments During Residency 4) Forgiveness Options 5) Other Considerations 2

Know Your Loan Portfolio Finding Your Federal Loans www.nslds.ed.gov To access you provide: - SS# - Date of Birth - First 2 letters (last name) - PIN # (www.pin.ed.gov) 3

To Find Other Loans www.annualcreditreport.com Grace Periods 4

Interest Rates In school, Grace and Deferment Forbearance, Repayment Stafford Loans 6.8% 6.8% (disbursed on or after 7/1/06) Stafford Loans* (disbursed between 7/1/98 and 6/30/06) 6.8% Fixed 1.88% Variable Grad PLUS Loans** 8.5% Fixed Perkins Loans / PCL / LDS 5.0% Fixed Private Loans 6.8% Fixed 2.48% Variable 8.5% Fixed 5.0% Fixed Typically Variable Check the Promissory Note Institutional Loans Consolidation Loans Varies by Loan Check the Promissory Note Fixed rate based on weighted average interest rate of underlying loans rounded up to nearest one-eighth of a percent (capped at 8.25%) * Variable rates change every July 1 based on the 91-day treasury bill ** Interest rate for Direct Grad PLUS Loans 7.9% Repayment Strategy Prioritize repayment efforts pay the most expensive debt FIRST! 5

Subsidized vs. Unsubsidized Sub si dy [suhb-si-dee] noun - Financial assistance granted by the government to cover accruing interest while in-school school, in grace, or in a qualifying deferment. Source: www.dictionary.com Subsidized vs. Unsubsidized Subsidized Subsidized Stafford Perkins* Primary Care Loans LDS Loans* Institutional Loans (some) Consolidation Loans (underlying eligible subsidized loans) Unsubsidized Unsubsidized Stafford Grad PLUS Private Loans Institutional Loans (some) Consolidation Loans (underlying unsubsidized loans) *subsidy and deferment rights lost during consolidation 6

Capitalization Addition of unpaid interest to the principal Increases the total amount due The less frequent the better Identify your lenders policy PRINCIPAL + INTEREST = LARGER PRINCIPAL Repayment Strategy Pay the interest on unsubsidized loans PRIOR to capitalization 7

Master Promissory Note A contract with the lender Has a multi-loan feature Details borrower s Rights and Responsibilities Defines Terms and Conditions of the loans Rights and Responsibilities Rights include the ability to: Prepay any federal loan without penalty Request a shorter repayment schedule Change repayment plans Request a deferment or forbearance Review your promissory note for all rights 8

Rights and Responsibilities Responsibilities include: Make on time loan payments Make payments despite receipt of bill Notify the lender of changes in contact info Attend an Exit Counseling session Review promissory note for all responsibilities A serious obligation Student loans must be repaid whether or not: Program was completed Program completed in normal amount of time Satisfied with your experience Employment is obtained 9

Consequences of Delinquency Reported to credit bureaus, affects your credit Default Negatively affects your credit Wages and tax returns can be garnished Lawsuit leveled against you (responsible for costs) Other federal debt collection methods Terms and Conditions Discharge may be available in cases of: Death or Total/Permanent Disability Closed school / False certification Certain public school service professions Identity Theft Bankruptcy (rarely) Review your promissory note for all terms 10

Introducing Dr. Median Dr. Median s student loan portfolio: Undergraduate debt: $10K ** Median Medical School debt: $150K * Graduates in 09 with $160k total education debt * Subsidized and Unsubsidized Stafford ** Unsubsidized Stafford The Effects of Capitalization Loan Type* Interest Rate Balance Consolidation (Undergrad + M1): 4.375% $56k Stafford (M2 thru M4): 6.8% $125k TOTAL $181,000 *Both loan types include subsidized and unsubsidized portions. 11

Dr Median s Options Most likely options during residency Pay Later (using Forbearance) Pay Now (using Income-Based Repayment) Seek Forgiveness (using PSLF) How to Postpone Payments 12

Postponement Options Deferment Economic Hardship (up to 3 years) Graduate Fellowship (unlimited) Unemployment (up to 3 years) Military For a complete list and more details on types of deferment, contact your lender(s) or servicer(s) Postponement Options Forbearance Administrative Discretionary Mandatory For a complete list and more details on types of forbearance, contact your lender(s) or servicer(s) 13

Forbearance Medical Residency/Internship Forbearance Used to postpone payments Requested annually from lender(s) Continuous periods may avoid capitalization Interest accumulates on sub and unsub loans *Other forbearance and deferments options may be available Borrowers should contact their lender/servicer(s) for more details. Forbearance Dr. Median s situation after a 4-year residency Balance after Grace Residency Interest Post- Residency Balance Consolidation (Undergrad. + M1): $56K + $10K = $66K Stafford (M2 to M4): $125K + $34K = $159K TOTAL $181K + $44K = $225K *Both loan types include subsidized and unsubsidized portions. 14

Forbearance Dr. Median s repayment of $225K after residency: Plan Yrs. Monthly Payment Total Interest Total Repayment Standard 10 $2,500 $141K $301K Extended 25 $1,500 $280K $440K *Other repayment plans Graduated, Income-Based, Income- Contingent or Income-Sensitive are likely not as practical Debt Management Strategy Utilize forbearance on federal debt and focus payments towards high rate debt. 15

Payments During Residency Repayment Plans Determines payment amount and interest cost Standard (Level) Extended Graduated = $2,000/mo = $1,200/mo = $900/mo Income Sensitive (FFEL) Income Contingent (Direct Loans) Income Based Repayment (IBR) = $900/mo = $600/mo = $380/mo 16

Repayment Plans Effects of each Repayment Plan on Cost Debt Manager Booklet: Page 17-18 Debt Fact The lower the monthly payment the higher the interest cost 17

Repayment Plans Estimated Monthly Payment Amounts Debt Manager Booklet: Page 19-20 Income-Based Repayment Loans eligible for IBR FFELP Loans (sub, unsub and consolidation) DL Loans (sub, unsub and consolidation) Perkins and LDS loans are NOT eligible* Private loans are NOT eligible * unless included in a federal consolidation loan 18

Income-Based Repayment New plan made available July 1, 2009 Payment based primarily on household income Family size also taken into consideration Partial subsidy available for the first 3 years Unpaid interest will not capitalize* * As long as a PFH exists and annual paperwork is submitted in a timely manner Income-Based Repayment To obtain IBR, borrower must do the following Contact each lender individually to request Inform lenders, annually, of family size Give lenders permission to access tax returns Demonstrate a Partial Financial Hardship (PFH) 19

Who Has a PFH? DEBT Level AGI* Below $ 120,000 $ 126,000 $ 130,000 $ 135,000 $ 140,000 $ 145,000 $ 150,000 $ 154,000 $ 160,000 $ 163,000 $ 170,000000 $ 172,000 $ 180,000 $ 181,000 $ 190,000 $ 191,000 $ 200,000 $ 200,000 *Rounded down to the nearest thousand, and based on a family size of 1 in the continental U.S. and a 6.8% interest rate Income-Based Repayment Formula for a Partial Financial Hardship (PFH): Standard payment* > IBR payment More likely to occur when income is lower and debt is higher Max payment in IBR is the Standard amount* 1st post-m.d. year median stipend is $46,700 * As originally determined when calculating Partial Financial Hardship 20

Income-Based Repayment Formula for a Partial Financial Hardship (PFH): Standard $2,000 payment* / mo* > IBR $381 payment / mo More likely to occur when income is lower and debt is higher Max payment in IBR is the Standard amount* 1st post-m.d. year median stipend is $46,700 * As originally determined when calculating Partial Financial Hardship Income-Based Repayment Online IBR Calculators STEP I - Determine 150% of poverty line www.ibrinfo.org www.finaid.org 21

Income-Based Repayment Dr. Median repayment after residency Plan Yrs Monthly Payment Total Interest Total Repayment* IBR 12 $2,000 $143k $303k -2 +200 -$14k -$14k 10 $2,200 129k $289k Forgiveness Options 22

Eligible Loans + + Qualifying Payments Qualifying Work Public Service Loan Forgiveness (PSLF) Public Service Loan Forgiveness Eligible Loans Federal Direct Sub and Unsubsidized Stafford Federal Direct Consolidation * Federal Direct Parent PLUS ** & Grad PLUS Federal Perkins and LDS loans *** FFEL student loans *** * Excluding FFEL spousal consolidation loans ** Does not qualify for Income-Based Repayment (even if in a Federal Direct Consolidation) *** When included in a Federal Direct Consolidation Loan 23

Public Service Loan Forgiveness Qualifying Payments 120 payments to Direct Loans made under: Income Contingent Repayment (ICR), or Income-Based Repayment (IBR), or Standard d 10-year Repayment* While simultaneously working in Public Service * Any required payment that is equal or more than the Standard 10-year Repayment amount Public Service Forgiveness Qualifying Payments (cont.) Does not have to be continuous work Payments made after October 1, 2007 Must be a required monthly payment 24

Public Service Loan Forgiveness Qualifying Work: Full-Time (30+ hours/week) Non-profit, tax exempt, 501(c)(3) organization Federal, state, local or tribal government Military service Public schools and colleges Other Programs Other programs available at AAMC website: www.aamc.org/stloan NIH Loan Repayment Programs: www.lrp.nih.gov NHSC Repayment Program: www.nhsc.hrsa.gov/loanrepayment 25

Loan Forgiveness Dr. Median s loans after 10 years of public service: Total Forgiven...$173K Other Considerations 26

Federal Loan Consolidation When to consider Consolidation: Variable rates are low Multiple lenders to repay To obtain Public Service Loan Forgiveness (DL) To make Perkins or LDS loans eligible for IBR Federal Loan Consolidation Effects of consolidating A longer term will increase the interest costs* Able to prepay or change repayment plan A new loan with new benefits** May negatively affect grace, deferment, or forgiveness options * Also, the rate will be a weighted-average that may be rounded up to the nearest 1/8 th ** Forfeiture of original borrower benefits is likely. Future borrower benefits vary by lender. 27

Federal Loan Consolidation FIRST for Residents Mailbox ~Sign up at www.aamc.org/first~ Private Loans Details of Private Loans Typically unsubsidized w/ variable rates A grace period/forbearance may be available Cannot be included in IBR or PSLF Be cautious when consolidating private loans 28

The Taxpayer Relief Act of 1997 Full Deduction Single $60,000 or less Married filing Jointly $120,000 or less Partial Deduction $60,001 to $74,999 $120,001 to $149,999 NO Deduction $75,000 or more $150,000 or more Student t loan interest t deduction d max $2,500 per year Voluntary payments may be eligible Capitalized interest may be included www.irs.gov/publications/p970 The Value of an MD Degree 29

Value of an M.D. Degree B.A. Business M.D. Internal Medicine Starting Age 22 30 Starting Salary $40,000 in 2005 $172,000 in 2012 Savings at 65?? Assumptions: Salaries grow at 3.5% per year, savings grow at 8% annually B.A.: Annual savings rate = 5% (25 to 34), 10% (35 to 65). Works 44 yrs M.D.: Annual savings rate = 2% (30 to 39), 10% (40 to 65). Practice for 36 yrs In $ Thousands $750 $675 $600 Value of an M.D Degree $525 $450 $375 $300 $225 $150 $75 ($225) Med Residency School Practice B.A. Business $0 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 ($75) Forbearance 25 yr. Extended ($150) Age: Medical School Debt 30

Value of an M.D. Degree B.A. Business M.D. Internal Medicine Starting Age 22 30 Starting Salary $40,000 in 2005 $172,000 in 2012 Savings at 65 $1.5M $3.1M Assumptions: Salaries grow at 3.5% per year, savings grow at 8% annually B.A.: Annual savings rate = 5% (25 to 34), 10% (35 to 65). Works 44 yrs M.D.: Annual savings rate = 2% (30 to 39), 10% (40 to 65). Practice for 36 yrs Time Value of Money Resident A starts saving at the age of 26 Invests $2,400 / year until retirement t Total Contribution = $100,800 Resident B starts saving at the age of 35 Invest $2,400 / year until retirement Total Contribution = $76,800 31

An investment in knowledge always pays the best interest - Benjamin Franklin Support Along the Way www.ombudsman.ed.gov 1-877-557-2575 www.aamc.org/first FIRST for Residents Mailbox FACEBOOK Fan Page; FIRST for Medical Education Your loan servicers and their websites Your residency program Your medical school financial aid office 32

FIRST for Medical Education Financial Information, Resources, Services, and Tools Questions? FIRST@AAMC.org 33