Reference · 2026 rule year
The 2026 repayment landscape, on one page.
Between mid-2025 and mid-2026 the federal repayment menu was rebuilt: SAVE was struck down, the One Big Beautiful Bill Act rewrote enrollment rules, and a new plan went live. Most summaries online predate some part of that. This page is the current state, each fact tied to its primary source.
Verified against Federal Register, Pub. L. 119-21, studentaid.gov · rule year 2026 · reviewed August 2026 · every source is linked in “Sources” below.
Every plan, one table
| Plan | Status (2026) | Who can enroll | PSLF-qualifying |
|---|---|---|---|
| SAVE | Terminated — vacated by appellate judgment, March 10, 2026 | No one. Former enrollees were moved off the plan with a window to choose a successor. | No longer available |
| RAP (Repayment Assistance Plan) | Live since July 1, 2026 | Borrowers with loans first disbursed on/after July 1, 2026 (and available on consolidation) | Yes |
| IBR (post-2014 terms) | Open — the enrollment hardship test was repealed by Pub. L. 119-21 (July 2025) | Any Direct Loan borrower with loans first disbursed before July 1, 2026 | Yes |
| PAYE | Open to new enrollment through June 30, 2027; plan sunsets July 1, 2028 | Borrowers with loans first disbursed before July 1, 2026 | Yes |
| ICR | Open to new enrollment through June 30, 2027; plan sunsets July 1, 2028 | Borrowers with loans first disbursed before July 1, 2026 | Yes |
| Tiered Standard | Live for post-July-2026 loans; also the automatic default if a plan-selection window lapses | Borrowers with loans first disbursed on/after July 1, 2026 | Not listed among PSLF-qualifying plans |
The July 1, 2026 line
Everything now turns on when a loan was first disbursed. Loans from before July 1, 2026 keep the legacy income-driven menu — IBR without the old hardship test, plus PAYE and ICR until their windows close. Loans first disbursed on or after July 1, 2026 choose between exactly two plans: RAP and Tiered Standard. A physician who borrows across the line — say, a 2026 fellowship loan on top of medical-school loans — holds loans in both worlds at once.
- PAYE and ICR windows: new enrollment closes June 30, 2027; both plans end July 1, 2028 (90 FR 3695). Borrowers on them then must move.
- RAP terms on record: a $10 minimum payment, a $50 per-dependent deduction, unpaid monthly interest waived, forgiveness after 360 payments — and RAP payments qualify for PSLF (FSA Dear Colleague Letter, July 18, 2025; 91 FR 23768).
- The default trap: miss a plan-selection window and placement is automatic — into Standard or Tiered Standard. Tiered Standard is not income-driven and is not listed among PSLF-qualifying plans, so drifting into it can silently stop a PSLF count.
- The payment math most PSLF-track physicians face (PAYE and post-2014 IBR): 10% of income above 150% of the poverty guideline. For a single filer in 2026 the protected amount is $23,940 (150% of the $15,960 guideline) — a PGY-1 at ~$65,000 pays roughly $345/month.
Sources
- 90 FR 3695 — PAYE/ICR enrollment window and sunset dates.
- 91 FR 23768 — the Repayment Assistance Plan rule, including PSLF qualification.
- Pub. L. 119-21 (One Big Beautiful Bill Act) — repealed IBR’s partial-financial-hardship enrollment test; created RAP.
- FSA Dear Colleague Letter, July 18, 2025 — IBR and RAP payments qualify for PSLF.
- studentaid.gov — repayment plans — current plan mechanics.
Methodology
Compiled and reviewed by the platform’s physician founder against the primary sources above; the SAVE termination (appellate judgment vacating the plan, March 10, 2026) and every date and dollar figure here were verified during the platform’s August 2026 content audit. This page is re-verified whenever the Federal Register or studentaid.gov moves one of these facts; the review date above moves with it. Deeper treatment: the PSLF Complete Guide and the PSLF & Loans library.
Cite this page
Attending Financial. “Federal Student Loan Repayment Plans for Physicians — 2026 Reference.” Reviewed August 2026. https://attendingfinancial.com/reference/physician-repayment-plans
This URL is stable. Figures are re-verified when the underlying rules change; the review date above moves with each verification.