‘Any reasonable payment will not even cover the interest.’ I have 4 degrees and owe $197K in student loans. I’m now 55, have no savings, and am struggling. What should I do?

Question: I am 55 and a mental health therapist.  I have $197,000 in student loans that were for four degrees, plus some in Parent Plus loans for each of my adult children. At the time of attending school, we barely got by and some of the money was used to live on. The last time I talked to the loan servicer; they said my payment was $1,900 per month.  Most months, my bring home pay is $2,000; sometimes less. 

I am applying for income-driven repayment, but I am concerned I will never pay off the loans.  I have numerous health issues and I worry that my ability to pay the loans is dwindling. I also see that any reasonable payment will not even cover the interest.  I still have no retirement, savings, or 401(k). As my health deteriorates further, and I need to work fewer hours or not at all; what happens to the loans? The reality of the situation is that I probably need to send my entire check to them now to have any possibility of eliminating the debt. I am also concerned about whether or not the debt is released if I die. What should I do?

Answer: Having six figures in student loan debt can feel overwhelming, but the good news is that you are already making one very smart decision: trying to get on an income-driven repayment plan. These plans are “available for all direct loans including Parent PLUS loans,” explains Anna Helhoski, student loan expert at NerdWallet. Depending on which repayment plan you apply and qualify for, loans are forgiven after 20 or 25 years of payments, even if your monthly payment is $0 based on your income. In order to take advantage of one of the income-based repayment plans, you’ll have to consolidate your loans into one new direct loan. Helhoski recommends using this Federal Student Aid’s Loan Simulator to see how much you might pay under different plans. (Note that refinancing federal loans will strip them of some of the perks like income-driven repayment plans; if however, any of your loans are private loans, refinancing rates are low now ⁠— see the lowest student loan refinancing rates you might qualify for here ⁠— so a refi might be worth considering.)

Have a question about getting out of student loan or other debt? Email chill@marketwatch.com.

That all said, this is a lot of debt, so it may help you to get a pro to take a look. The Institute of Student Loan Advisors (TISLA) offers free student loan advice and the National Foundation for Credit Counseling (NFCC) assists with free debt management plans and student loan counseling as well as credit report reviews and bankruptcy counseling. “You need to work with someone who is well versed both in the different forms of federal student and Parent Plus loans, as well as a trained debt counselor,” says principal and founding member of Clarity Northwest Lisa Weil. 

What about disability?

“You might look into eligibility for a Total and Permanent Disability (TPD) discharge if your medical issues eventually keep you from being able to work,” says Andrew Pentis, certified student loans counselor and student debt expert at Student Loan Hero says. This requires that a doctor certifies that a borrower is unable to engage in substantial gainful activity because of a permanent disability; if that is accurate, their federal student loan may be discharged. “About half of private student loans offer a similar disability discharge,” says Mark Kantrowitz, author of Who Graduates From College? Who Doesn’t? .

What happens to your student loan debt when you die? 

While it’s not something borrowers want to think about, those with high debt who are older or have health concerns might be worried about what would happen if they still have student loans when they die. “The somewhat comforting news is that your loved ones won’t be stuck paying off bills for federal student loans if you die, and parents won’t have to repay PLUS loans if the student whom the parent borrowed the loan for dies,” says Helhoski. If you pass away, your spouse would need to provide a copy of the death certificate to have the remaining federal loans discharged, says Pentis. Note that private loanswork a bit differently: Debt taken out for your own schooling will likely be discharged, but a private loan that a parent co-signs might not. 

Questions edited for brevity and clarity.