MoneyRx for CRNAs and NPs

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...

Almost every nurse walks into retirement with a short to-do list: file for Social Security, roll over the 403(b), and pull money for the things earned. On paper, it looks responsible. But in practice? Each item on that list can quietly close a door that no amount of future income can reopen. In this episode, Brett Fellows CFP®, founder of Oak Capital Advisors, walks through the story of Teresa, a...

Almost every nurse who sits down with Brett a few years before retirement asks the same question: "What is my number, and am I there yet?" The account balance keeps growing, the calculators keep confirming the money will last, and yet something still feels off. No calculator can see what a retirement date controls. In Episode 94, Brett introduces the five planning windows and explains wh...

Most retirement plans are built for two people. When one spouse dies, the survivor gets hit with a higher tax bill on lower income. At the same time. In this episode of MoneyRx for CRNAs and NPs, Brett Fellows, CFP, walks through the widow's tax penalty using a real CRNA household. He explains why this happens, what it costs over a lifetime, and the specific steps a married nurse can take to...

If you are a CRNA or nurse practitioner thinking about rental property as part of your retirement plan, watch this episode before you write the check. When you run the numbers for a high-earning nurse buying the kind of property they want at today's rates, the result often surprises people. In this episode, Brett Fellows, CFP®, walks through the story of Yvonne, a 55-year-old CRNA in the Char...

Kristin Burton paid off over $160,000 in student loan debt in 16 months, became a self-made millionaire by 31, and built a platform called Millionaires in Medicine that now reaches PAs, NPs, pharmacists, and other non-physician healthcare professionals across the country. She also just published her first book, The PA Millionaire Path. In this episode, Brett Fellows, CFP®, sits down with Kristin t...

A year ago, Amanda Kelly jumped into full 1099 independence with income goals, an S-corp, and many unknowns. Now she’s back. In this episode, Brett Fellows, CFP®, sits down with Amanda Kelly, CRNA, coach, and founder of The Mindful CRNA, to hear what happened once the theory met real life. They talk through the financial surprises that came with running an S-corp, why most CRNAs leave money on the...

If you are within five years of retirement and thinking about paying off your mortgage, you are asking the right question, but… you’re probably asking it the wrong way. In this episode, Brett walks through a sample client household, Imani, a 60-year-old nurse practitioner retiring in December with $1.7 million in her 403(b) and a $228,000 mortgage. Her plan was simple: pull the money from her reti...

Most nurses retiring in their early sixties think they face one decision when it comes to ACA subsidies and Roth conversions: pick one or the other. But there’s another way. In this episode, Brett walks through the story of Renata, a 60-year-old CRNA retiring after 28 years with $1.78 million in her 403(b). She spent six months researching the ACA-versus-Roth question, talked to two CFPs, and was...

You've worked for decades, maxed your 403(b) every year, and built a solid balance. But what if the structure of those savings is quietly setting you up for a six-figure tax problem in retirement? This episode follows Dana, a CRNA with 22 years at the same hospital and $1.4 million saved. She did everything the articles told her to do. What she found out in the first planning meeting was that...

Most retirement budgets are built around a method that almost guarantees an error. You sit down with a spreadsheet, write out every category you can think of, and estimate a number for each line. Research shows people who go through that exercise estimate what they think they can live on, not what they spend. Real retiree spending can run 20 to 30% higher than those estimates. On a $75,000 target,...

If you retired with $2.5 million and were still afraid to spend it, you would not be alone. Many CRNAs and nurse practitioners have worked so hard for so long, but nobody ever taught them how to switch gears. In this episode, Brett walks through a sample client household, Chris and Heather, a CRNA and NP couple who retired with $2.5 million in pre-tax accounts and were only spending $6,800 a month...

Many CRNAs and nurse practitioners are already financially ready to retire… they just don’t know it. And yet, they keep working three, five, sometimes ten years longer than they need to. Not because they have to, but because no one has shown them clearly that they’re okay to stop. In this episode, Brett Fellows CFP® discusses four specific financial markers that show retirement readiness. Brett co...

Making the jump from employee to business owner can feel scary for NPs and CRNAs, but it can be done successfully. In this episode, Brett Fellows sits down with Dr. Michelle Cuevas, DNP, FNP-C, a family nurse practitioner, entrepreneur, and self-described explorer who made the leap from W2 employee to 1099 business owner and has not looked back. Michelle built the NP Specialist Nursing Inc., her o...

A CRNA or nurse practitioner can save consistently, build a $1.5 to $2 million portfolio, and be just a few years from retirement and STILL lose tens of thousands of dollars a year without knowing why.  The answer? Because of these three specific decisions that got made quietly in the background right before retirement. In this episode, Brett Fellows walks through the story of Sandra, a 58-year-ol...

Where will your paycheck come from once you stop working, and which account do you pull from first? You saved well, maxed out your 403(b), and built a $2 million portfolio, but haven’t found clear answers to your retirement questions.  In this episode, Brett Fellows talks through the three hidden issues that were quietly setting up a CRNA named Janie for $80,000 to $150,000 in taxes she did not ha...

Most nurses arrive at retirement having done everything right for 30 years. The problem is not what they built. It is that nobody explained what happens when you have to start pulling money out. In this episode, Brett Fellows walks through five retirement mistakes that look responsible from the outside and only reveal their cost much later. Most nurses are making at least two of them. Some are mak...

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 Dian...

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 i...

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 work...

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 w...

"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...

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 surcha...

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...

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 thei...