A loan modification changes the terms of your existing mortgage—typically reducing the interest rate, extending the loan term, or adding missed payments to the loan balance. You work directly with your current lender, and it doesn’t require qualifying for a new loan. Refinancing means getting a completely new mortgage to pay off the old one, which requires qualifying based on current income, credit score, and home value. When you’re behind on payments or facing foreclosure, loan modification is usually the more realistic option.