MoneyRx for CRNAs and NPs

Brett Fellows, CFP®
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Go behind the scenes with host Brett Fellows, CFP®, as he explores the unique opportunities and challenges facing Certified Registered Nurse Anesthetists and  Nurse Practitioners along the path to financial independence.  In each episode, Brett shares expert financial insights and actionable advice to help you lower taxes, invest smarter, and retire on your terms.

  1. 4D AGO

    I'm a NP at 55 with $1.2M. Can I Retire in 5 Years?

    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 needHow the 80% income replacement rule nearly doubled Diane's perceived retirement cost by ignoring NP-specific work expenses that disappear at retirementWhy healthcare costs before Medicare are almost entirely a function of taxable income, not health status, and how to use that to your advantageThe account sequencing strategy that kept Diane's ACA premiums at $4,800 to $7,200 per year instead of $20,000How the years between retirement and Social Security can become the lowest-tax years of your adult life if you plan them correctlyWhy Diane retired at 60 instead of 65 with a 3.5% withdrawal rate and a portfolio still on track at age 85 and 90If 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.

    16 min

  2. MAR 3

    Health Savings Accounts: How Nurses Should Use for Triple Tax Advantages

    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 areThe 2026 HSA contribution limits, catch-up contributions, and the FICA tax savings W-2 employees get that most people overlookHow the triple tax advantage works and why the HSA outperforms both the traditional 401(k) and the Roth IRA for medical expensesThe key differences between an HSA, FSA, and HRAWhy investing your HSA balance instead of spending it is the move that separates a $2,000 balance from a $340,000 oneThe shoebox receipt strategy and how to use old medical receipts for tax-free withdrawals in retirementThe Medicare look-back rule and exactly when to stop contributing to avoid a 6% excise taxWhat happens to your HSA after age 65, and why it functions as a traditional IRA for non-medical expensesIf 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.

    14 min

  3. FEB 24

    The Retirement Tax Time Bomb in Your 403(b) or 401(k)

    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 withdrawalsWhether 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.

    18 min

  4. FEB 17

    Backdoor Roth vs Mega Backdoor Roth for Nurses: Which Strategy Fits?

    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 2010The exact step-by-step process to execute a backdoor Roth conversionWhat the pro-rata rule is and how to avoid the biggest mistake that trips people upHow the mega backdoor Roth lets you contribute up to $72,000 annually to tax-free accountsWhether 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-freeCommon mistakes to avoid when executing these strategiesTax reporting requirements and which forms you need to fileHow 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.

    29 min

  5. FEB 10

    Social Security Strategies for High Earning CRNAs & NPs

    "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 benefitsUnderstand why delaying gives you a guaranteed 8% annual return (worth $216,000 over 20 years)Maximize Your 35-Year CalculationCoordinate spousal benefits strategically when one spouse earns significantly moreUse the bridge strategy to retire early while delaying Social Security to 70Don'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 premiumsConsider Roth conversions and QCDs during your low-income "gap years"Understand the earnings test if you plan to work while claiming earlyWhether 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.

    18 min

  6. FEB 3

    Pre-Retirement Checklist: 10 Action Steps for Nurses 5 Years Before You Retire

    The five-year window before you stop working is the most critical period for your financial future. While many CRNAs and nurse practitioners (NPs) focus solely on saving, the transition to retirement requires a shift toward strategy. In this episode, Brett Fellows, CFP®, shares a 10-point checklist designed specifically to help both CRNAs and NPs manage health insurance gaps, mitigate IRMAA surcharges, and turn decades of savings into a sustainable retirement paycheck. Brett covers: Why strategy matters more than accumulation when you are five years outHow to calculate your true retirement spending instead of just replacing your incomeThe hidden Medicare cost shock (IRMAA) that high-earning nurses need to understandWhy your 403(b) might be a tax time bomb and how Roth conversions can helpHow to bridge the health insurance gap if you retire before age 65The guaranteed 8% return from Social Security and how to decide when to claimA smarter withdrawal strategy to stay in lower tax bracketsWhy your beneficiary designations matter more than your willYour retirement paycheck should include your hard-earned money, without the tax trap. #Retirement #NP #CRNA #RetirementPlanning Key Timestamps: (0:20) The Critical Five-Year Window (2:19) Step 1: Set Your Target Retirement Date (3:19) Step 2: Know Your True Retirement Expenses (4:44) Step 3: Take Inventory of Your Accounts (5:50) Step 4: Health Insurance Before Medicare (6:54) Step 5: Start Learning About Medicare & IRMAA (8:19) Step 6: Understand Your Social Security Options (9:33) Step 7: Consider Roth Conversions (11:11) Step 8: Create a Withdrawal Strategy (12:18) Step 9: Simplify Your Accounts (13:06) Step 10: Get Your Estate Documents in Order (13:58) Case Study: The Five-Year Transformation For more information and resources related to this episode, please visit the show notes.

    16 min

  7. JAN 27

    Why CRNAs and NPs Should Say NO to the 4% rule

    The 4% rule is a staple of retirement planning, but for high-income CRNAs and nurse practitioners, it is often the wrong tool for the job. Relying on a rigid, one-size-fits-all percentage can lead to psychological stress, tax blindness, and the mistake of underspending during your healthiest years. In this episode, Brett Fellows, CFP®, explains why APRNs should move away from static rules of thumb in favor of a "Work Optional" guardrails plan. This approach replaces spreadsheet fantasies with a dynamic system that accounts for changing life seasons, tax sequencing, and the unique ability of clinicians to use income levers if markets get rough. Brett explains how to: - Identify the 5 core problems with the 4% rule, from linear spending assumptions to ignoring Medicare surcharges. - Build a retirement paycheck timeline that maps out income sources like Social Security and RMDs as distinct seasons. - Implement dynamic guardrails to know exactly when it is safe to increase spending or when to briefly cut back. - Leverage the "Clinician Advantage" by using PRN or consulting work as a strategic buffer against market volatility. - Master the tax window between stopping full-time work and starting forced distributions. This episode can help you avoid costly mistakes while understanding how to adjust your spending without feeling stuck.  #CRNAs #NursePractitioners #RetirementPlanning Key Timestamps: (0:18) Why the 4% Rule is the Wrong Tool (3:24) What the 4% Rule Is (and Is Not) (5:19) The Comfort Trap: Why We Use Rigid Rules (7:47) 5 Core Problems with the 4% Rule (12:30) Reframing Retirement as "Work Optional" (14:30) Step 1: Your Retirement Paycheck Timeline (15:52) Step 2: Finding Your Baseline Lifestyle Number (16:48) Step 3: Using Dynamic Spending Guardrails (17:52) Step 4: The Clinician Advantage (Optional Levers) (19:54) Case Study: Alicia and Jordan’s Guardrails Plan (22:14) The Elephant in the Room: Tax Strategy & RMDs (26:14) The Truth About Annuities  For more information and resources related to this episode, please visit the show notes.

    30 min

  8. JAN 20

    Top 10 Investing Mistakes That Keep CRNAs & NPs Working Longer Than They Need To

    You've worked long shifts, held everything together in high-stress situations, and saved diligently for 25 years. You think you're on track for retirement. But what if investment mistakes you don't even know you're making could force you to work five to seven more years? In this episode, Brett Fellows reveals the shocking truth about a CRNA couple with nearly $2 million in their 403(b) accounts who discovered they'd need to work an extra five to seven years because of investment decisions they'd made over the years. That's five to seven more years of night shifts, five to seven more years of being on call, all because of mistakes that could have been avoided.. Today's episode walks through the 10 biggest investment mistakes that cost nurses real years of their lives.  Brett covers:: Mistake #1: Trying to time the market (costs 3-4% annually, nearly $1M over 30 years) Mistake #2: Letting emotions drive your decisions Mistake #3: Not having proper diversification Mistake #4: Paying excessive fees and costs (a 1% fee difference costs $600,000+ over 30 years) Mistake #5: Chasing past performance Mistake #6: Not reinvesting dividends Mistake #7: Ignoring tax efficiency Mistake #8: Active stock picking instead of evidence-based investing Mistake #9: Not rebalancing your portfolio Mistake #10: Investing before addressing financial basics If you're making these mistakes, you might be adding years to your working life without even realizing it. This episode will show you exactly what to fix and how to get your retirement back on track.  #CRNAs #NursePractitioners #RetirementPlanning #InvestmentMistakes  Key Timestamps: (0:18) Welcome and Introduction (4:18) Mistake #1: Trying to time the market (5:50) Mistake #2: Letting emotions drive your decisions (7:20) Mistake #3: Not having proper diversification (8:55) Mistake #4: Paying excessive fees and costs (10:20) Mistake #5: Chasing past performance (11:40) Mistake #6: Not reinvesting dividends (12:41) Mistake #7: Ignoring tax efficiency (14:08) Mistake #8: Active stock picking instead of evidence-based investing (15:30) Mistake #9: Not rebalancing your portfolio (16:40) Mistake #10: Investing before addressing financial basics (18:40) Actionable steps and conclusion For more information and resources related to this episode, please visit the show notes.

    22 min
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Ratings & Reviews

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out of 5
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About

Go behind the scenes with host Brett Fellows, CFP®, as he explores the unique opportunities and challenges facing Certified Registered Nurse Anesthetists and  Nurse Practitioners along the path to financial independence.  In each episode, Brett shares expert financial insights and actionable advice to help you lower taxes, invest smarter, and retire on your terms.

Information

  • Creator
    Brett Fellows, CFP®
  • Years Active
    2024 - 2026
  • Episodes
    79
  • Rating
    Explicit
  • Copyright
    © 2026 MoneyRx for CRNAs and NPs
  • Show Website
    MoneyRx for CRNAs and NPs

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