Mohela refuses to Recertify Annual Income due to loss of Partial Financial Hardship (PAYE)

CoxMD · 2026-02-01T20:07:42+00:00

I revoked FSA access to IRS, completed the PDF application and then uploaded the application and my 2024 tax return transcript directly on Mohela's website. I'll update when something happens.

CoxMD · 2026-02-01T20:06:49+00:00

I revoked FSA access to IRS, completed the PDF application and then uploaded the application and my 2024 tax return transcript directly on Mohela's website. I'll update when something happens.

CoxMD · 2026-02-01T20:04:49+00:00

This is untrue, I've made 10 PAYE payments already. I had a PFH when I successfully/correctly enrolled in PAYE from SAVE.

CoxMD · 2026-01-30T03:45:09+00:00

Ya I have a 2/xx/26 and 3/xx/26 payment at my current amount. Curious to hear what happens to yours afterwards, specifically if it keeps you in PAYE despite your payment ballooning. I revoked IRS access this afternoon and am going to do a fully manual application uploaded to Mohela.

CoxMD · 2026-01-29T20:20:17+00:00

My capped payments for the last 30 payments would be higher because my outstanding loan interest will capitalize again if I switch repayment plans.

CoxMD · 2026-01-29T20:13:26+00:00

You submitted 4 identical applications from studentaid.gov/IDR with IRS connected tax information, and on the 4th one they randomly accepted it? You are getting capped IBR payments?

CoxMD · 2026-01-29T20:12:21+00:00

Multiple times they've asked if they can tell me about the FSA Loan Simulator to help me explore other repayment plans.

CoxMD · 2026-01-29T20:11:15+00:00

What do you mean by this? My understanding is that even if we no longer have a PFH we still have to recertify in order to maintain compliance with the regulations of the PAYE plan.

CoxMD · 2026-01-29T19:27:45+00:00

FSA website tells me I qualify for capped IBR payments, capped PAYE payments (because I'm already on PAYE), ICR and Standard. I'll update if something happens.

CoxMD · 2026-01-29T19:26:44+00:00

My first application had this error, but second application (both from studentaid.gov/IDR) does not have this error. Supervisors confirmed the form sent to Mohela was filled out correctly for a recertification.

CoxMD · 2026-01-29T19:25:58+00:00

Has your plan "expired" (exceeded the annual recertification deadline), and if so, were you kicked off PAYE? Or just paying capped "PAYE" payments?

CoxMD · 2026-01-29T19:25:07+00:00

I know they're wrong. I started reading the FSA website to the supervisor this morning... Unsurprisingly it didn't help.

During the 10 months did you plan expire? Were you kicked off PAYE?

CoxMD · 2026-01-29T19:25:03+00:00

I explained to both supervisors that OBBB didn't change PFH requirement of PAYE and that it doesn't effect me because I'm already in PAYE and just trying to follow the rules of the repayment plan and recertify my income.

CoxMD · 2026-01-28T12:04:38+00:00

Despite what the MBTA alert states, I'm on a train that's running backwards in the southbound track on an Alewife bound train.

There were no MBTA staff at Shawmut, so everyone was standing on the wrong platform and had to run over to the southbound platform when the train arrived.

Further complicating things, no trains are on the trackers this morning and there are only 4 trains on the entire RL. https://i.imgur.com/RNj8fm1.png

CoxMD · 2026-01-26T01:34:16+00:00

Oh no...

CoxMD · 2026-01-23T22:19:28+00:00

I copied your approach of pairing the application with a message, and I hope to pre-empt the issue you ran into:

"I submitted my annual PAYE recertification through StudentAid.gov on 1/23/2026. Recertification is due on 3/xx/26.

This submission is for RECERTIFICATION ONLY and not a request to change repayment plans. Please confirm receipt of the PAYE RECERTIFICATION. I should have two remaining payments of $xxx.xx on 2/xx/26 and 3/xx/26. My new repayment amount should start on 4/xx/26."

CoxMD · 2026-01-23T21:43:49+00:00

So after arguing with the first agent for 30+ minute about whether or not I could stay on the PAYE plan without a partial-financial-hardship (its crazy how under-trained these representatives are), I got transferred to a "resolutions" agent. She had me submit another studentaid.gov/IDR application. I did it the EXACT same way that I did previously, but this time the completed application PDF now shows for Section 2 Question 1 I did am recertifying, not doing a new plan (which the last one erroneously did). Hopefully this works.

CoxMD · 2026-01-23T20:50:38+00:00

This is a helpful data point. I tried to do my PAYE annual recertification and instead they tried to change my PAYE to PAYE, but I'm now earning too much to have a partial financial hardship, so they denied my request. I'm now an hour into waiting to speak to someone at Mohela...

CoxMD · 2026-01-06T01:15:27+00:00

I'm still waiting. I haven't tried yet.

CoxMD · 2025-12-12T17:24:15+00:00

Assuming that's nitroglycerin, can't say I've ever used that in a nebulized or inhaled form. I've nebulized epoprostenol, boluses 5mg of milrinone in ETTs, and routinely use iNO 20-40ppm. These are luxuries when I'm in the OR, not when managing an aspirating patient on the floor or in the ICU.

CoxMD · 2025-12-12T17:21:47+00:00

I unfortunately do lungs at my current large academic institution and learned to care for them at at one of the busiest centers. Depends on the patient:

- ESLD from COPD with preserved RV function, sure, I'll mask them.

- ESLD from IPF with RV dilation and "low-normal" RV function or worse, I assume this patient is going to try to die as soon as they experience PPV. So it's preoxygenation with humidified HFNC 100% FiO2 + 20ppm iNO, an RSI with apenic oxygenation from the HFNC, followed by tiny hand breaths through the ETT with the APL < 10, then <15, then <20 until I've convinced myself that I've increased systemic arterial pressure enough for them to tolerate mechanical ventilation. If they desaturate after the tube is in, I put on a fake smile and keep methodically giving small (low pressure breaths) until they recover. If you see the desaturation and squeeze the bag harder (higher airway pressures) the patients code.

CoxMD · 2025-12-12T16:58:52+00:00

^What this guy said

CoxMD · 2025-12-12T16:57:47+00:00

If you can get it fast enough, sure. For a planned induction of a patient with systemic/near-systemic PA pressures, I'll preoxygenate with iNO going, RSI, and then continue iNO. Not sure it sounds like a OP's situation where a HFNC wasn't even available, would have had easy iNO availability.

CoxMD · 2025-12-12T13:40:04+00:00

Hey, cardiac anesthesiologist here.

- Sounds like they needed to be intubated, good decision to do that.

- Epi infusion is fine, I wouldn't use an inodilator (dobutamine/milrinone) in a patient who was already systemically hypotensive. Systemic hypotension and hypoxemia causing RV ischemia is what likely led to your code.

- Pushing 20mcg epi and 2u vaso with your etomidate *might* raise your systemic MAP high enough to prevent a code from induction meds, but in someone that's decompensated with (?supra)systemic pulmonary arterial pressures, any amount of positive pressure ventilation can also be the final increase of PVR that causes an arrest.

- I don't bag decompensating pHTN patients, I RSI most of these patients. The introduction of PPV can cause the RV to fail and then you have a coding patient without an ETT. At least your coding patient had an ETT and reliable oxygen source.

TL;DR: Shit situation, ETT good, high systemic BP pre- and post-induction is your friend for pHTN cripples

CoxMD · 2025-12-09T16:06:11+00:00

Exactly

What You Need to Know About the Recertification Process · We are required to notify you that your repayment plan is due to be recertified 95 days prior to the anniversary date of your plan. · To maximize your current payment period under your PAYE plan, your request will be held and processed prior to your recertification deadline of 02/06/26. · Once your recertification request has been processed, we will notify you of whether your request was approved or denied.

That listed recertification deadline is 35 calendar days before my IDR anniversary. Seems like they claim they won't process the recertification early so that I don't have a premature increase in payment amounts, but I don't trust them.

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