MoneyRx for CRNAs and NPs

Most nurse practitioners trying to answer the retirement question are using benchmarks that were never designed for them. The 4% rule. The 80% income replacement rule. Healthcare cost estimates built on worst-case assumptions. Used together, they can make a completely achievable retirement look years out of reach.
In this episode, Brett Fellows walks through an example, a 55-year-old NP named Diane with $1.2 million saved, to show exactly how three common planning beliefs were pointing her toward the wrong answer and how replacing them with the right framework changed everything.
Brett covers:
Why the 4% rule was designed for someone retiring at 65 with Social Security starting immediately, and why applying it to an early retirement overstates what you need
How the 80% income replacement rule nearly doubled Diane's perceived retirement cost by ignoring NP-specific work expenses that disappear at retirement
Why healthcare costs before Medicare are almost entirely a function of taxable income, not health status, and how to use that to your advantage
The account sequencing strategy that kept Diane's ACA premiums at $4,800 to $7,200 per year instead of $20,000
How the years between retirement and Social Security can become the lowest-tax years of your adult life if you plan them correctly
Why Diane retired at 60 instead of 65 with a 3.5% withdrawal rate and a portfolio still on track at age 85 and 90
If you want to know whether your number actually works for your retirement, visit oakcapitaladvisor.com to schedule a call. We work specifically with CRNAs and NPs.
#NursePractitioners #CRNAs #RetirementPlanning #EarlyRetirement #TaxStrategy

Key Timestamps:
(0:18) The question most NPs can't answer with confidence
(1:10) Meet Diane: NP, 55, $1.2M saved, no debt
(1:38) Why she believed she needed $2 million
(2:25) The 4% rule and why it was built for someone else
(4:19) The 80% income replacement myth
(5:32) NP work expenses that vanish at retirement
(6:07) Healthcare cost catastrophizing before Medicare
(7:18) How taxable income, not health status, drives ACA premiums
(8:09) Three beliefs, one wrong answer
(9:15) The three questions that actually matter
(10:22) The Nurse Retirement System: Step 1, map your real spend
(11:00) Step 2: Income sequencing and account order
(12:10) Roth conversions in the low-tax gap years
(12:35) Social Security at 67 drops withdrawal to 3.5%
(13:41) What the wrong benchmarks were really costing her 

For more information and resources related to this episode, please visit the show notes.

Most CRNAs and nurse practitioners treat their HSA like a checking account for medical bills. They put money in, pay bills, and move on. But the HSA is the ONLY account in the U.S. tax code that gives you 3 tax benefits at the same time, and when used correctly, it translates to hundreds of thousands of dollars in tax-free wealth.
In this episode, Brett Fellows walks through how to turn your HSA into a serious retirement savings tool, including the investment strategy most nurses skip, the shoebox receipt strategy for tax-free cash in retirement, and the Medicare timing mistake that triggers a penalty most people never see coming.
Brett covers:
Why you must be enrolled in a high deductible health plan to contribute, and what the 2026 IRS thresholds actually are
The 2026 HSA contribution limits, catch-up contributions, and the FICA tax savings W-2 employees get that most people overlook
How the triple tax advantage works and why the HSA outperforms both the traditional 401(k) and the Roth IRA for medical expenses
The key differences between an HSA, FSA, and HRA
Why investing your HSA balance instead of spending it is the move that separates a $2,000 balance from a $340,000 one
The shoebox receipt strategy and how to use old medical receipts for tax-free withdrawals in retirement
The Medicare look-back rule and exactly when to stop contributing to avoid a 6% excise tax
What happens to your HSA after age 65, and why it functions as a traditional IRA for non-medical expenses
If you want to see how an HSA fits into your full retirement plan, visit oakcapitaladvisor.com to schedule a call. We work specifically with CRNAs and NPs.
#CRNAs #NursePractitioners #HSA #HealthSavingsAccount #RetirementPlanning #TaxStrategy 
Key Timestamps:
(0:18) The HSA secret most nurses are missing
(1:17) Lisa vs. Kevin: same income, $340,000 apart
(2:35) What is an HSA, and who qualifies?
(3:05) 2026 HDHP thresholds and contribution limits
(4:15) The FICA tax savings most W-2 nurses overlook
(04:45) The triple tax advantage explained
(6:45) HSA vs. FSA: key differences (Note: HRA is not mentioned in the transcript)
(07:40) How to invest your HSA and why it matters
(08:25) The shoebox receipt strategy
(09:55) The Medicare timing trap and the look-back rule
(11:15) What happens to your HSA after age 65
(12:05) Action plan and next steps

For more information and resources related to this episode, please visit the show notes.

Do you have a retirement tax bomb? Many CRNAs and nurse practitioners spend 30 years following traditional financial advice: max out your 403(b), live below your means, and defer taxes as long as possible. However, this strategy often leads to a "retirement tax bomb" where required minimum distributions (RMDs) and Social Security push you into a higher tax bracket than when you were working. AKA your tax bill might be jaw-dropping in your Golden Years. 
In this episode, Brett Fellows, CFP®, explains how to avoid this expensive mistake through strategic tax bracket filling. He shares real-world case studies of nurses who saved over $130,000 in lifetime taxes by utilizing the 0% capital gains rate and well-timed Roth conversions. See how to manage your three tax buckets and why asset location is just as important as asset allocation.
Brett Covers:
How RMDs and Social Security create the retirement tax bomb.
The three tax buckets: tax-deferred, tax-free, and taxable.
A strategy to pay 0% federal tax on capital gains during early retirement.
How to execute Roth conversions without triggering Medicare surcharges.
The four biggest tax mistakes nurses make.
A three-phase framework for tax-efficient retirement withdrawals
Whether you are a decade away from retirement or already considering your exit date, these strategies can help ensure your savings remain in your pocket rather than going to the IRS.
#CRNAs #NursePractitioners #RetirementPlanning #TaxStrategy 
Key Timestamps:
(0:18) David and Karen’s $1.4 Million Tax Mistake
(2:37) Defining the Retirement Tax Bomb
(3:27) Tax Bracket Filling and the Three Buckets
(4:35) Case Study: Saving $130,000 in Lifetime Taxes
(5:34) How the 0% Capital Gains Rate Works
(6:25) Strategic Roth Conversions and Social Security
(7:20) Asset Location: Where to Put Your Investments
(8:30) Managing IRMAA and Medicare Surcharges
(9:10) The Three Phases of a Tax-Efficient Retirement
(10:10) The Four Biggest Tax Mistakes APRNs Make
(11:24) Angela’s Example: A Plan for Single Providers 

For more information and resources related to this episode, please visit the show notes.

If you're a CRNA or nurse practitioner earning over the Roth IRA income limits, you're locked out of one of the best retirement accounts available. But there's a legal workaround. In this episode, Brett Fellows explains two powerful tax strategies that can save you hundreds of thousands of dollars over your career.
In this episode, Brett covers:
How the backdoor Roth IRA works and why it's been IRS-approved since 2010
The exact step-by-step process to execute a backdoor Roth conversion
What the pro-rata rule is and how to avoid the biggest mistake that trips people up
How the mega backdoor Roth lets you contribute up to $72,000 annually to tax-free accounts
Whether your employer plan allows mega backdoor Roth contributions (and what to ask HR)
Real-world examples showing how nurses can accumulate $4.5 million tax-free
Common mistakes to avoid when executing these strategies
Tax reporting requirements and which forms you need to file
How self-employed CRNAs can maximize these strategies with a solo 401(k)
Whether you're just starting out or nearing retirement, these strategies can help you build millions in tax-free savings and potentially save over $1 million in taxes throughout your career.

Key Timestamps:
(0:45) Why "High-Earners" Are Locked Out of Roth IRAs
(2:54) The Backdoor Roth IRA: A Simple 2-Step Process
(4:54) The Pro-Rata Rule: Avoiding the #1 Backdoor Mistake
(7:09) Step-by-Step: How to Execute a Clean Backdoor Conversion
(8:59) What is a Mega Backdoor Roth?
(11:49) Two Must-Have Features Your 401(k) Plan Needs
(15:44) Common Mistakes: From Missing Conversions to Paperwork Messes
(17:49) The $43,000 Strategy: Can You Do Both?
(21:19) Case Study: Saving $1 Million in Taxes Over a Career
(24:49) What to Do if Your Plan Doesn't Allow the "Mega" Strategy

#CRNA #TaxStrategies #RothIRA #Nurse

For more information and resources related to this episode, please visit the show notes.

"I've been earning $200,000 or more a year for most of my career. Social Security is going to be a drop in the bucket." If that's what you're thinking, you could be leaving hundreds of thousands of dollars on the table.
In this episode, Brett Fellows walks through nine critical Social Security strategies specifically for high-earning CRNAs and nurse practitioners. Using a real-world example of David and Sarah, both age 62 CRNAs with $1.8 million saved, he explains how to maximize lifetime benefits while minimizing taxes.
Brett Covers:
Know your full retirement age and how early claiming permanently reduces benefits
Understand why delaying gives you a guaranteed 8% annual return (worth $216,000 over 20 years)
Maximize Your 35-Year Calculation
Coordinate spousal benefits strategically when one spouse earns significantly more
Use the bridge strategy to retire early while delaying Social Security to 70
Don't forget survivor benefits (delaying can mean $162,000 more for your surviving spouse)
Watch out for IRMAA surcharges that could cost $10,000+ per year in Medicare premiums
Consider Roth conversions and QCDs during your low-income "gap years"
Understand the earnings test if you plan to work while claiming early
Whether you're planning to retire at 62, 65, or 70, this episode shows you how to turn Social Security from an afterthought into a strategic anchor for your retirement income.
#CRNAs #NursePractitioners #SocialSecurity #RetirementPlanning #FinancialPlanning #MoneyRx
Key Timestamps:
(0:18) Welcome to Money RX: Social Security for High-Earning CRNAs and NPs
(1:28) Case Study: David and Sarah’s $200,000 Income Strategy
(2:44) #1: Know Your Full Retirement Age
(3:51) #2: Why Delaying Pays Off (The Guaranteed 8% Return)
(4:17) #3: Maximize Your 35-Year Calculation
(7:11) #4: Coordinate Spousal Benefits Strategically
(8:13) #5: Use the Bridge Strategy
(9:33) #6: Do Not Forget Survivor Benefits
(11:01) #7: Watch Out for IRMAA Surcharges
(12:16) #8: Consider Roth Conversions and QCDs
(14:09) #9: Understand the Earnings Test
(15:18) Summary: How a Strategy Adds Hundreds of Thousands in Value 

For more information and resources related to this episode, please visit the show notes.