I’m a 62-year-old nurse with about $100K in student loans, on top of $13K in credit card debt. When I have to start repaying the loans, I’ll have a $200-a-month budget deficit. What can I do?

Question: I work as a nurse for a small for-profit agency.  I am salaried and have no option for overtime. I only have every other weekend where I could work any extra hours. I have serious medical issues with huge medical bills to boot. I have $13,000 in credit card debt, over $100,000 in student loan debt, I owe about $40,000 on my home loan, and I have a car payment. I’m 62 and my full retirement age is 67. I have very little in retirement savings. My student loan payment is over $700 a month with an income-driven repayment plan. When that resumes in August I will have a $200/month budget deficit!  What can I do? When do you think I should take my retirement with regards to the student loan? 

Answer: You’re already doing some things right, like getting on an income-driven repayment plan to help you manage debt. But here’s the rub: “Since you work for a for-profit agency, you’re not eligible for Public Service Loan Forgiveness (PSLF), which is unfortunate as your loans would be forgiven after 120 qualifying payments if you had worked full-time for a government agency or non-profit while repaying the loans in an income-driven repayment plan in the Direct Loan program,” says Mark Kantrowitz, author of Who Graduates from College? Who Doesn’t?.  

Have a question about getting out of debt? Email chill@marketwatch.com.

You could also try asking your employer for a raise or bonus. “Your loan payments will increase as your income increases, but your income might increase enough to cover your budget deficit. Nurses are in demand, so your employer might be willing to pay more to keep you as an employee. Mention your high student loan debt as a reason why you need a pay increase,” says Kantrowitz.

If you’re unable to make all of your debt payments, Anna Helhoski, student loan expert at NerdWallet, says you should contact your lenders or servicers to see which options are available to you. “If your discretionary income has changed, you may be eligible for a lower student loan payment,” says Helhoski.

Note that because your loans are federal and you are on an income-driven repayment plan, you do not want to refinance your loans. For readers with private loans with higher interest rates, however, here are the lowest student loan refi rates you might qualify for.

Retirement savings and student loan debt

One thing to consider about being on an income-driven repayment plan and having no retirement savings is this: “If you do reach retirement age with no retirement savings, you’ll depend on Social Security for your living expenses. The loan payment under an income-driven repayment plan is zero if your income is less than 150% of the poverty line,” says Kantrowitz.  So, there’s a possibility you may have a much lower student loan payment when you retire. Surprisingly, a calculated student loan payment of zero under an income-driven repayment plan counts as repayment and after a total of 240 (20 years) or 300(25 years)  payments, depending on the type of income-driven repayment plan, the remaining debt may be forgiven.

Something else to consider is that delaying retirement age will increase the amount you get from Social Security each month, which could help you better deal with your debts. That said, sometimes you have no choice about when you retire, as health can get in the way. 

Dealing with other debt

Given you have a variety of debts, Andrew Pentis, certified student loan counselor and student debt expert at Student Loan Hero, says he recommends consulting a no- or low-cost credit counselor at a nonprofit credit counseling agency like the National Foundation for Credit Counseling or InCharge. “They can review with you the option of a debt management plan, which would organize your various outstanding balances and potentially lower your payments while working toward a debt-free income,” says Pentis.

It’s also key that you work on either making more money or spending less, or both,  says Tatiana Tsoir, certified public accountant and author of Dream Bold, Start Smart. “Having a side gig, even if it’s rare and off hours, could be an opportunity to increase your income,” says Tsoir. Something else you can try to do, according to Tsoir, is to negotiate with your credit card companies to reduce your debt. “If you can improve your cash flow, you might try paying down the credit card debt aggressively without running up the balance again. This could free up a few hundred dollars you can save toward retirement and as you pay off other debts, your savings can increase,” says Kantrowitz.

Creating a descriptive budget to track where your money goes every month is also something to consider. Kantrowitz recommends keeping receipts for every expense and recording them in a spreadsheet where you tag each expense as mandatory or discretionary. “Also assign them to broad categories like food, entertainment, housing, taxes and insurance. At the end of each month, total up the categories and tags and this will show you where you’re spending your money,” says Kantrowitz. 

And Bobby Matson, founder and CEO of Payitoff, a fintech company that enables financial institutions to offer student loan refinancing and restructuring plans, says you may want to consider giving up your car and using public transportation, or seeing if you’re eligible for free or reduced-rate  public transportation depending on your medical issues. “Some or all of your medical debt may be able to be negotiated for a lower sum and similarly, you can likely negotiate a lower pay off amount for your credit card or refinance the balance for a significantly lower interest rate,” says Matson.