MoneyRx for CRNAs and NPs

Brett Fellows, CFP®
  • 5.0 (4)
  • Entrepreneurship
  • Updated Weekly

Go behind the scenes with host Brett Fellows, CFP®, as he explores the unique financial opportunities and challenges facing Certified Registered Nurse Anesthetists and Nurse Practitioners on the path to financial independence. Each episode delivers expert insights and actionable advice to help you lower taxes, invest smarter, and retire on your terms. Brett's firm, Oak Capital Advisors, specializes in high-earning CRNAs and nurse practitioners and is currently accepting new clients. From retirement income strategy and tax planning to Social Security timing, Medicare, and estate planning, they offer comprehensive financial planning that goes far beyond investment management. If you're ready to work with someone who truly gets your world, the link to schedule a discovery meeting is in the show notes.

  1. 1d ago

    How to Build a War Chest for Retirement

    Two people can retire with the same total balance, the same asset mix, the same withdrawal rate, even the same average annual return over thirty years, and still land in totally different places by the end. In this episode, Brett Fellows, CFP®, founder of Oak Capital Advisors, walks through why the order those returns show up in can carry as much weight as the returns themselves, and lays out the War Chest, a framework for setting aside three to five years of spending so a retiree is never forced to sell stocks during a downturn just to cover this month's bills. Brett covers: Why a retirement portfolio has to fund today's spending and keep growing for the next thirty years at the same timeHow a portfolio drifts from its target allocation without a single decision causing it, shown with a real dollar exampleCalendar-based vs. threshold-based rebalancing, and the tax difference between rebalancing in a 401(k)/IRA vs. a taxable brokerage accountWhat the War Chest holds, why inflation-protected securities are part of it, and how it played out for real retirees during the spring 2025 market dropSequence of return risk, the "Red Zone," and how retirement age and funding level change how much cushion a plan needsHow to size a speculative investment sleeve without putting the actual retirement plan at riskKey Timestamps: (0:18) Two retirees, same portfolio, completely different outcomes (2:16) Why a drifting plan becomes a stress problem, not just a technical one (3:10) The two jobs a retirement portfolio has to do at once (5:06) How a 60/40 portfolio drifts without a single trade being made (5:56) A dollar example of five years of portfolio drift (7:51) Calendar-based vs. threshold-based rebalancing (9:01) Tax treatment of rebalancing: retirement accounts vs. taxable accounts (9:58) Introducing the War Chest (11:04) Morningstar's findings on when retirement portfolios run out of money (12:21) What inflation-protected securities (TIPS) do inside the War Chest (13:53) Why rebalancing feels wrong even when it's working (15:10) Real example: the spring 2025 market drop and the War Chest in action (16:17) Practical habits for maintaining the War Chest and allocation (17:21) Sizing a speculative investment sleeve (19:29) Sequence of return risk explained (20:45) How retirement age and funding level change red zone exposure (22:19) Coordinating withdrawals with tax planning (24:44) The assignment: sorting your portfolio into three buckets For more information and resources related to this episode, please visit the show notes.

  2. Aug 18

    The CRNA Crystal Ball Test: What a "Perfect" 403(b) Fund Pick Is Really Worth

    Retirement charts inside a 403(b) can eat hours of attention. Five-year returns, ten-year returns, expense ratios, lined up side by side and compared fund by fund. Brett Fellows, CFP®, runs the numbers on what a decade of picking the single best-performing fund would add to a CRNA's account. He also shows where a bigger opportunity sits, in an oversized cash cushion earning next to nothing. Brett covers: What a decade of picking the single best-performing fund in a 403(b) lineup would add to a CRNA's account, in dollarsWhy that number translates to about $30 a month in retirement income once it's run through a conservative withdrawal rateWhy an oversized cash cushion builds up so easily on PRN and locum incomeHow redirecting unused cash into a 403(b) and backdoor Roth IRA over eighteen years can grow to roughly $180,000The 2026 contribution limits for a 403(b) and backdoor Roth IRA, and how much space typically goes unusedA bank statement exercise for finding a real emergency fund number this weekKey Timestamps: (0:18) The pull to find the "perfect" fund in your 403(b) (1:04) Running the crystal ball test on a decade of fund picks (3:10) The stable value fund vs. bond fund gap in a real 403(b) (4:09) The real number: under $9,000 difference over ten years (5:00) Turning $9,000 into actual monthly retirement income (6:27) Where fund selection still genuinely matters (7:46) The high-stakes decision most CRNAs get backwards (9:26) Why unused 403(b) and Roth IRA space is use-it-or-lose-it (10:07) 2026 contribution limits for a 403(b) and backdoor Roth IRA (12:33) Sarah's example: redirecting $450 a month into retirement (13:32) $450 a month grows to roughly $180,000 by 60 (15:44) Pressure-testing the number with a more conservative return (17:27) The same math at a smaller dollar amount (20:35) The bank statement exercise to run this week (24:17) The bigger lesson: where to spend your decision-making energy (26:51) Closing thoughts and how to work with Brett For more information and resources related to this episode, please visit the show notes.

  3. Aug 11

    The Social Security Question Early-Retiring NPs get wrong

    You retired from full-time practice, kept a couple of PRN shifts a month, and now you're looking at claiming Social Security at 62. It feels like the easy part of the plan. For most nurse practitioners and CRNAs, it isn't. In this episode, Brett Fellows, CFP®, breaks down the Social Security earnings test, the permanent benefit cut that comes with claiming at 62, the survivor benefit floor it sets for a spouse, and the ACA subsidy cliff that can turn one claiming decision into a much larger household cost. Brett covers: Why tapering into PRN work turns a simple claiming decision into a three-variable oneThe Social Security earnings test: how much you can earn before benefits get withheld, and why that money isn't gone foreverThe permanent 30% reduction tied to claiming at 62, and why it never resets once the PRN shifts stopHow a higher earner's claiming age sets the survivor benefit floor for a spouse, walked through with real numbersThe ACA subsidy cliff at 400% of the federal poverty level, and how a Social Security check can push a household over itA three-number framework to run before you file for benefitsKey Timestamps: (0:18) Retiring early, staying on with PRN shifts, and the pull toward claiming at 62 (1:41) Why two-variable Social Security models fail for tapering retirees (3:05) The Social Security earnings test and the $24,480 limit for 2026 (5:40) The permanent 30% reduction tied to claiming at 62 (8:02) How your claiming age sets your spouse's survivor benefit floor (11:47) The ACA subsidy cliff and the 400% federal poverty line (15:06) How provisional income affects the taxation of your benefit (16:45) When claiming early can genuinely be the right call (18:51) The decision tree: three variables, not two (22:59) The three numbers to estimate before you file (24:00) Why a full scenario comparison beats a generic rule of thumb (26:02) Closing thoughts and how to schedule a conversation with Brett For more information and resources related to this episode, please visit the show notes.

  4. Aug 4

    The 5 Retirement Topics That Matter (Lessons from 100 Episodes)

    One hundred episodes ago, Brett Fellows sat down in front of a microphone with no idea if a single person outside his own family would ever listen. For this milestone episode, there is no new strategy and no client case study. Brett goes back through ninety-nine episodes and pulls out the five questions that keep resurfacing for CRNAs and NPs, no matter how different two households look on paper. He also shares the honest reason he keeps making this show at all. Brett covers: Tax buckets: why the account a dollar sits in, pre-tax, Roth, or taxable, matters more over a whole career than any single year's tax billHow much is enough, and why the number itself is rarely the hard partSocial Security as a one-way door, and why the claiming decision changes the math on everything elseThe healthcare gap before Medicare, and the shadow tax created by a Roth conversion in the wrong yearWithdrawal order once the paycheck stops, and why the sequence matters as much as the totalThe honest reason Brett keeps making this show, a hundred episodes inNew episode of MoneyRx for CRNAs and NPs is out now. Key Timestamps: (0:18) Sitting down for 100 episodes and why today is different (2:49) Real-world impact on CRNAs and nurse practitioners over two years (6:09) Topic 1: Roth conversions and looking at taxes across your whole career (9:09) Topic 2: how much is enough and trusting the number to buy back time (11:34) Topic 3: Social Security claiming as a one-way door decision (14:03) Topic 4: understanding the healthcare gap before Medicare (16:32) Topic 5: figuring out where money comes from in retirement (18:53) Why helping the people who take care of everyone else matters (21:20) Reflecting on episode one, the book, and how the show evolved (23:45) Your action step for this week: pick one topic you have been avoiding #CRNAs #NursePractitioners #RetirementPlanning #MoneyRx #RothConversions For more information and resources related to this episode, please visit the show notes.

  5. Jul 28

    Your Retirement Has to Survive 35 Years of Inflation, Not 25

    Retire at 53, and your plan needs to survive 35 years of retirement, not 25. Most retirement calculators were never built for that math, and the gap shows up first in your health insurance bill. In this episode of MoneyRx for CRNAs and NPs, Brett Fellows, CFP®, founder of Oak Capital Advisors, breaks down why the standard retirement math quietly falls apart for anyone leaving full-time work before Medicare age, and what to do instead. Brett covers: Why the 4% rule and most retirement software were built for a 30-year retirement, not 35Medical inflation running nearly 40 points ahead of general inflation since 2000, and why that gap compounds every yearColleen's story: how a "safe" $72,000 withdrawal actually needs to support close to $109,000 a year by year tenThe ACA subsidy cliff returning for 2026, and how $1,400 of extra income can erase an entire subsidy at onceWhy pulling the same dollar from a Traditional IRA versus a Roth or brokerage account can decide whether you keep that subsidyWhat changes, and what doesn't, once Medicare starts at 65Key Timestamps: (0:18) Why retiring at 53 is the hardest stress test a retirement plan can face (1:05) The 4% rule and the 30-year model it was built around (1:34) Why that model was only ever stress tested to 30 years (2:02) Why a 35-year retirement is the realistic case, not the aggressive one (3:05) The flat inflation assumption almost every calculator makes (3:43) Medical inflation since 2000: 121% versus 86% for everything else (7:05) Meet Colleen: 53, a $1.8 million portfolio, and a calculator that says she's fine (8:51) Splitting $72,000 into two inflation buckets instead of one (10:16) The real gap: $37,000 a year, and the sequence of returns risk it creates (12:32) The ACA subsidy cliff returning for 2026 (16:27) Why which account you draw from is now a health insurance decision (18:49) What changes, and what doesn't, once Medicare starts at 65 (24:33) Running the plan to 90 instead of the standard 25 to 30 year horizon If your retirement starts before Medicare eligibility, or you want your own plan stress-tested against 35 years of real, two-track inflation, schedule a free Pre-Op Retirement Assessment at https://connectwithbrett.com/ and subscribe for more information.  #CRNAs #RetirementPlanning #EarlyRetirement #HealthcareCosts #MoneyRx For more information and resources related to this episode, please visit the show notes.

  6. Jul 21

    The 2026 Roth Catch-Up Rule Just Changed The Math For Every Nurse Over 50

    The IRS didn't reduce this tax break for high-earning nurses over 50. They took it away. Starting this year, catch-up contributions can no longer go in pre-tax if your wages cross $150,000, and most CRNAs and NPs haven't adjusted their plan for it. In this episode of MoneyRx for CRNAs, Brett Fellows, CFP, walks through the new Mandatory Roth Catch-Up Rule, what it costs the people who ignore it, and three accounts most CRNAs and NPs are not using together that can more than offset the change. He walks through a hypothetical CRNA named Dana to show what structuring it properly can mean over time. Brett Covers: Why catch-up contributions now have to go into Roth accounts for anyone whose wages cross $150,000What it actually costs this April if your plan defaults you into Roth and you don't adjust anythingWhy most CRNAs and NPs are only using one of the three tax-advantaged accounts available to themHow the 457(b) special three-year catch-up and a solo 401(k) can offset the new Roth mandateWhat structuring all three accounts properly could mean over a hypothetical 14-year periodKey Timestamps: (0:18) The retirement rule that quietly changed for nurses over 50 (3:16) How the Mandatory Roth Catch-Up Rule works under Secure 2.0 (5:55) What doing nothing costs you this April (8:10) Why this is an awareness mistake, not a financial one (8:40) The three accounts most CRNAs and NPs aren't using together (13:50) Case study: Dana, a 51-year-old CRNA earning $230,000 (17:55) The dollar difference between reacting and structuring it right (20:41) The exact questions to ask your plan administrator (25:50) How to get help modeling your own numbers For more information and resources related to this episode, please visit the show notes.

  7. Jul 14

    The Three Retirement Phases Nobody Plans For — And Why They Hit CRNAs Differently

    Most retirement plans do an excellent job modeling the money, but almost none of them model the time. For CRNAs specifically, that missing piece changes everything about when stepping back actually becomes possible and what it looks like when you get there. In this episode, Brett Fellows, CFP®, founder of Oak Capital Advisors, shows why standard financial plans built around a flat spending model can lead high-earning nurses to stay in the OR much longer than necessary.  Brett Covers: The Time vs. Money Blindspot: Why the real question isn't just how much money you have, but what kind of time you will have and when.The Three Distinct Phases: Breaking down the Go-Go, Slow-Go, and No-Go years and how capacity and discretionary spending naturally shift across them.The Flat Model Flaw: How standard inflation-adjusted spending models cause CRNAs to overestimate late-life needs and underestimate early-retirement freedom.The Locum Bridge: How picking up just 10 to 15 days of locum anesthesia per year can fill early retirement gaps on your own terms.The 73 Collision: Why ignoring transitional gap years causes pre-tax RMDs and Social Security to collide into an unnecessarily high tax bracket.The Conversion Window: How to systematically move $50,000 to $70,000 a year from your pre-tax 403(b) into a Roth IRA while your bracket is temporarily low.Sequenced Withdrawal Strategy: The optimal account order (taxable first, pre-tax second, Roth last) to extend portfolio longevity.Key Timestamps: (0:18) Most retirement plans model the money, but fail to model the time. (1:26) Why standard financial conversations ignore the realities of health and energy timelines. (4:17) Defining the three distinct phases of retirement: Go-Go, Slow-Go, and No-Go years. (6:55) How flat spending assumptions trick CRNAs into overestimating late-life financial needs. (8:19) Navigating the personal identity shift when stepping back from clinical expertise. (9:26) Case study: The 10-year window for a 58-year-old CRNA named Maria. (11:27) The Locum Bridge: How 10 to 15 days of temporary work changes the retirement math. (13:20) Introducing the conversion window to shelter your nest egg from future IRS claims. (15:32) The 73 Collision: What happens when pre-tax RMDs and Social Security stack together. (17:26) Concrete actions to evaluate your personal timeline, local locum rates, and account mix. (20:27) How to access a complimentary 30-minute Pre-Op Retirement Assessment. Find out how to structure your retirement timeline and learn more about Oak Capital Advisors at https://oakcapitaladvisor.com/. #CRNAs #RetirementPlanning #TaxPlanning #LocumTenens #MoneyRx  For more information and resources related to this episode, please visit the show notes.

  8. Jul 7

    Can I Afford to Cut Back to Part-Time as an NP?

    Most CRNAs and NPs who want to cut back to part-time have already decided it's impossible, because they're running the wrong number. In this episode of MoneyRx for CRNAs, Brett Fellows, CFP, walks through the framework for figuring out whether cutting back is actually financially viable, using the story of a hypothetical NP named Sarah who was $130,000 away from her real number, not $920,000 away from it. Brett Covers: Why the 2026 Nurse.org State of Nursing Survey points to a math problem, not a career problemWhy modeling full retirement for a part-time decision always makes the numbers look impossibleHow to find your real healthcare cost after ACA subsidies instead of assuming the sticker priceWhy the 4% rule is the wrong tool for someone who's cutting back rather than stopping entirelyHow Roth conversion timing and account sequencing change the picture over timeIf you're 50 or older with at least $750,000 saved and you've been telling yourself you can't afford to slow down, this episode is worth your full attention. Key Timestamps: (0:18) Survey data on nursing burnout and financial necessity (1:25) Realities of dropping job satisfaction and growing career fear (2:58) Distinguishing full retirement from cutting back to part-time hours (4:34) Financial profile and baseline savings of case study subject Sarah (6:33) Accessing meaningful ACA marketplace subsidies with lower clinical income (8:38) Health insurance premium deductions within a 1099 independent contract model (9:58) Misapplying traditional investment drawdown metrics to partial retirement scenarios (11:13) Calculating the real net portfolio gap required to cover downshifted schedules (13:13) Optimal multi-bucket asset sequencing guidelines for tactical cash flow (14:28) Leveraging transitional low-tax windows for strategic Roth conversions (16:13) Chronological timeline walkthrough of Sarah's dynamic downshift plan (18:18) Navigating the professional identity shift when reducing clinical commitments For more information and resources related to this episode, please visit the show notes.

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About

Go behind the scenes with host Brett Fellows, CFP®, as he explores the unique financial opportunities and challenges facing Certified Registered Nurse Anesthetists and Nurse Practitioners on the path to financial independence. Each episode delivers expert insights and actionable advice to help you lower taxes, invest smarter, and retire on your terms. Brett's firm, Oak Capital Advisors, specializes in high-earning CRNAs and nurse practitioners and is currently accepting new clients. From retirement income strategy and tax planning to Social Security timing, Medicare, and estate planning, they offer comprehensive financial planning that goes far beyond investment management. If you're ready to work with someone who truly gets your world, the link to schedule a discovery meeting is in the show notes.

Information

  • Creator
    Brett Fellows, CFP®
  • Years Active
    2024 - 2026
  • Episodes
    103
  • Rating
    Clean
  • Copyright
    © 2026 MoneyRx for CRNAs and NPs
  • Show Website
    MoneyRx for CRNAs and NPs

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