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 table at tax time, how the independent market has shifted heading into 2026, and what Amanda learned from a 30-minute tax return walkthrough with Brett that changed how she thinks about her money entirely.

They Cover:

• The honest financial case for going 1099 in your 40s or 50s
• Why salary vs. distributions inside an S-corp matters more than most CRNAs realize
• What CRNAs consistently get wrong with deductions and bookkeeping
• How the 1099 market has shifted since 2024 and what to expect going forward
• Running a side coaching business, and when to spin up a second LLC
• The tax return review that made her numbers finally make sense
• Baby Roths, HSAs, and what a "money machine" looks like in practice
• Three financial moves she would tell every new CRNA to make first

#CRNAs #1099CRNA #TaxPlanning #FinancialPlanning #MoneyRx

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

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 retirement account and walk into retirement debt-free. 

Brett shows why that one decision would have cost her roughly $190,000 in taxes, lost growth, and destroyed planning runway, and the three moves that got her to the same outcome for about $9,000 instead.

Brett covers:

• Why the mortgage rate versus investment return comparison is the wrong framework for most CRNAs and NPs
• The four separate tax bills hiding inside a single 403(b) withdrawal, and why almost nobody adds them up
• Why January of your first retirement year is the worst possible time to make this decision
• The three-move mortgage payoff runway that keeps retirement accounts untouched and the ACA planning window intact
• How Imani went from a $190,000 mistake to a $9,000 solution without changing her goal at all

#CRNAs #NursePractitioners #RetirementPlanning #TaxPlanning #MortgagePlanning

Key Timestamps: 

(0:18) Financial risks of pulling from pre-tax accounts for mortgage payoffs 

(1:23) Case study introduction of a nurse practitioner aiming for debt-free retirement 

(2:33) Breakdown of how the wrong asset source creates a major planning mistake 

(4:33) Failure of standard rate versus return comparisons for pre-tax accounts 

(6:38) Four separate financial liabilities triggered by a single lump sum withdrawal 

(8:13) Delayed impact of retirement account liquidations on future Medicare surcharges 

(10:28) Heightened compounding dangers of large early retirement lump sum distributions 

(11:43) Preservation of the low tax window for strategic Roth conversions 

(13:03) Alternative approach using accelerated principal payments from current cash flow 

(14:53) Structural benefits of utilizing a five to seven-year payoff runway 

(16:00) Mathematical guidelines for evaluating mortgage payoff choices based on interest rates 

(18:03) Protecting retirement accounts from accelerated debt elimination plans

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

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 leaning toward skipping every conversion. What she discovered in a planning meeting changed everything. The cost of the question she had been asking, run across twelve years of her household's life, came to $280,000.

In this episode, Brett walks through the three reasons this mistake keeps repeating, and introduces The Conversion Calendar: a 12 to 15-year framework that lets nurse households capture ACA subsidies and do Roth conversions at the same time, by placing each type of move on the right years of the retirement runway.

Brett covers:

- Why the ACA-versus-Roth binary is a false choice, and why 2026 makes it far more costly as enhanced credits expire
- The shadow tax that adds 10 to 19 percent on top of your federal bracket without showing up on your tax return
- How a household can go $3,000 over the cliff line and lose $14,000 in subsidies while saving only $300 in federal tax
- The three-step Conversion Calendar built around Renata and Ben's 13-year runway
- How this household saved $420,000 in lifetime federal taxes while capturing $45,000 in ACA subsidies

#CRNAs #NursePractitioners #RothConversion #RetirementPlanning #ACASubsidy

Key Timestamps:

(0:18) Trade-off between ACA subsidies and Roth conversions

(1:39) Case study of Renata and Ben’s early retirement transition

(2:54) Risks of the false binary approach in tax planning

(4:26) Reappearance of the hard 400% FPL cliff in 2026

(6:07) Hidden shadow tax impact on real marginal rates

(7:29) Actual cost of conversions compared to federal tax brackets

(8:58) Shifting the planning focus to the multi-year retirement runway

(10:33) Benefits of using a conversion calendar for long-term sequencing

(11:33) Visual mapping of retirement into distinct tax environments

(12:53) Strategy for pairing ACA years with measured conversions

(14:53) Impact of sequencing on future required minimum distributions

(16:08) Lifetime tax savings achieved through strategic decision ordering

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

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 doing everything right in a single account is still a problem.

Brett walks through the three reasons high-earning nurses arrive at retirement with a tax structure they can't control, and the three concrete moves any nurse can make in the next 90 days to get back on track.

Brett explores:

• Why having 96% of savings in one pre-tax account creates a retirement tax rate the IRS sets for you
• The hospital plan features most nurses never use, including a 457(b) that could have added $200,000 in contributions
• The eight-year window between retirement and Social Security that is the cheapest tax opportunity of a high-earner's life
• How to audit your hospital plan, redirect future dollars, and draw a conversion calendar
• What the Tax Diversification Reset looked like for Dana and Marcus, and how it saved their household $190,000 in lifetime federal taxes

If you have a growing balance in your plan and no real strategy for how it gets taxed in retirement, this episode is for you.

Key Timestamps:

(0:18) Risks of long-term concentration in a single pre-tax account 

(1:23) Shift of financial control from the retiree to the IRS 

(2:32) Distinction between missed contributions and missed financial flexibility 

(3:38) Financial exposure of households with large pre-tax balances 

(4:54) Institutional incentives that promote the default retirement structure 

(6:03) Impact of Medicare IRMAA surcharges on retirement cash flow 

(7:38) Unlocking overlooked features in complex hospital plan documents 

(9:13) Identifying the low-tax planning window before required distributions hit 

(10:58) Gaining control through tax-aware ordering and account types 

(12:53) Three concrete steps to audit hospital plans for new options 

(14:53) Mapping the conversion runway to minimize future tax brackets 

(16:08) Lifetime tax savings achieved through strategic asset repositioning 

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

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, that's $15,000 to $22,000 per year, the plan never accounted for.

In this episode, Brett walks through a different approach: the Subtract-and-Replace Budget. Two halves, eight lines, and a starting point that's already in your paycheck.

Brett covers:

• Why the line-item budget fails: The psychology behind underestimating, and what a $500 error in your monthly estimate does to your plan's success probability.
• The Subtract side: Four expenses that disappear the day you stop working: payroll taxes, retirement contributions, debt service, and invisible work costs.
• The Replace side: Four categories that expand or appear at retirement: taxes in their retirement form, healthcare, go-go lifestyle spending, and healthcare inflation.
• David and Karen: Two CRNAs in their late 50s who thought their line-item budget was solid, until the Subtract-and-Replace method revealed the real number.

If you're within five years of retirement, this framework is worth understanding before you build the plan.

#CRNAs #NursePractitioners #RetirementPlanning #RetirementIncome #FinancialPlanning

Key Timestamps:

(0:18) Probability of success based on retirement spending accuracy

(2:03) Ineffectiveness of the traditional line item approach for future budgeting

(3:08) Discrepancy between imagined discipline and real retiree spending habits

(4:53) Identification of major work expenses that disappear after retirement

(6:06) Determining a real lifestyle baseline using current paycheck data

(7:39) Average total healthcare expenditures for retired couples over a lifetime

(9:03) Impact of healthcare inflation on long-term retirement planning

(10:33) Financial value of strategic tax control and withdrawal timing

(11:33) Moving from guessing to financial clarity with the paycheck method 

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

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 when their plan could safely support $10,500. Brett names the three reasons that happened, and the three-part retirement spending blueprint he built to fix it, including a Roth conversion strategy on track to save them over $180,000 in lifetime taxes.

Brett Covers:

• Why retirees spend 80% of their guaranteed income but only 50% of their portfolio assets
• The psychology behind treating savings as untouchable
• How underspending creates a compounding future tax problem
• The three-bucket retirement spending blueprint
• How to build a monthly "retirement paycheck" from your portfolio
• Long-term care: the real data on who actually needs it
• How to use the Roth conversion window before RMDs kick in
• Why IRMAA surcharges cost some couples $18,740 a year in Medicare alone

#CRNAs #NursePractitioners #RetirementPlanning #FinancialPlanning #MoneyRx

Key Timestamps:

(0:18) Challenges transitioning from saving to spending money

(1:20) Comprehensive financial planning services for high-earning nurses

(2:54) Potential tax liabilities of underspending in retirement

(4:44) Psychological differences between monthly income and portfolio assets

(6:36) Statistical data regarding long-term care cost risks

(8:06) Benefits of using the Roth conversion window after retirement

(9:08) Medicare surcharges and their relationship to required distributions

(10:39) Three components of the retirement spending blueprint

(12:33) Executing a Roth conversion strategy to minimize taxes

(14:18) Summary takeaways and link to free retirement assessment 

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

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 covers:

• Sign 1: Your portfolio can cover your income gap at a safe withdrawal rate, even if the market doesn’t cooperate.
• Sign 2: Your tax-deferred accounts are large enough that you’d benefit from starting Roth conversions now.
• Sign 3: You have, or can build, two years of living expenses in cash or short-term bonds outside of equities.
• Sign 4: Your plan still works under the widow’s penalty scenario, when one spouse is gone.

If two or three of these apply to you, you may not be years away from retirement. You may already be there.

#CRNAs #NursePractitioners #RetirementPlanning #FinancialIndependence #WealthManagement

Key Timestamps:

(0:18) Retirement readiness for CRNAs and nurse practitioners.

(0:46) Overview of Oak Capital Advisors comprehensive planning.

(1:47) Introduction to four specific financial signals.

(2:14) Sign 1: Replacing your paycheck and the 4% rule.

(4:39) Sign 2: Tax problems within pre-tax retirement accounts.

(6:33) Power of Roth conversions during low-income years.

(8:19) Sign 3: Protecting against the sequence of returns risk.

(9:48) Sign 4: Stress testing for the widow's penalty.

(11:28) Summary of the four markers for retirement.

(12:36) Scheduling a complimentary discovery meeting.

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

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 own clinical 1099 company, and then launched the NP Travel Specialist, a travel business that gives her flexible income and the freedom to explore the world with her family. Brett and Michelle share insights for anyone considering a similar move.

In this episode, they explore:

• What finally pushed Michelle to leave the W2 world after nearly three decades
• The costly legal and financial mistakes she made going 1099, and what she wishes she had known
• How to evaluate a side business or second income stream as a nurse practitioner
• Why the DNP did not necessarily increase her direct income, but absolutely opened doors
• Her approach to managing student loan debt with intention
• How full practice authority and state-level legislation directly impact NP income and opportunity
• What a solo 401(k) looks like for a self-employed NP
• The one piece of money advice she would give her younger self

Whether you are a nurse practitioner dreaming of going 1099, considering a side business, or trying to figure out what financial freedom looks like in practice, this episode is for you.

#NursePractitioner #1099Life #NurseEntrepreneur #FinancialFreedom #MoneyRx

Key Timestamps:

(0:18) Welcome and Introduction to Dr. Michelle Cuevas

(5:18) How Diverse Clinical Experience Impacted Her Earning Power

(7:18) Why Michelle Chose Nursing and Pursued Her Doctorate

(11:18) The Catalyst for Transitioning from W2 to 1099 Clinical Work

(21:18) Lessons Learned: Legal Mistakes and Business Structure Errors in California

(26:18) The Reality of Financial Complexity and Choosing Retirement Accounts

(31:18) Diversifying Income: Launching "The NP Travel Specialist" Business

(35:18) Evaluating the ROI of a DNP Degree

(36:18) Managing Student Loans: What Nurse Practitioners Often Get Wrong

(39:18) Managing a Large Family and Long-Term Financial Planning

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

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-old CRNA with $1.9 million saved. Two of those decisions had already been made wrong. The third she didn't know existed. 

Brett covers:

• Why the account you pull from in early retirement can create a $12,900 per year difference in health insurance premiums for the exact same plan and coverage
• How the ACA subsidy cliff works and why crossing it by $1 can wipe out more than $10,000 in subsidies
• Why Medicare looks at income from two years ago and how high-earning nurses get hit with IRMAA surcharges they never planned for
• The overlap between Roth conversions, ACA premiums, and future Medicare costs that most advisors don't model together
• What tail coverage is, why most APRNs don't know it exists, and why the negotiation window closes the moment you give notice
• The Healthcare Retirement Clearance: three checkpoints that need to be addressed two and a half to five years before your target retirement date

If you are within five years of retirement, these decisions are already in motion whether you have planned for them or not.

Visit oakcapitaladvisor.com to schedule a call. We work specifically with CRNAs and NPs.

#CRNAs #NursePractitioners #RetirementPlanning #EarlyRetirement #HealthcareCosts

Key Timestamps:

(0:18) Intro

(1:25) Meet Sandra: CRNA, 58, $1.9M, two years from retirement

(2:05) Decision 1: Which accounts fund your life before Medicare?

(2:48) Two nurses, same plan, $12,000 difference in premiums

(3:46) The ACA subsidy cliff and how income triggers it

(5:18) Decision 2: The Medicare surcharge tied to income you no longer earn

(6:16) IRMAA explained, and the appeal most nurses never file

(6:55) The overlap: Roth conversions, ACA subsidies, and Medicare costs

(8:28) Decision 3: The charge hiding in your exit paperwork

(9:20) Tail coverage: what it costs and when you can negotiate it

(11:22) The Healthcare Retirement Clearance

(12:05) Sandra's corrected plan and outcomes

(13:35) These decisions are already in motion

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

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 have to pay, and the three-act retirement paycheck framework that changed her outcome.

Brett covers:

• Why the 4% rule understates your real take-home by design when every dollar is pre-tax
• The age 73 collision: what happens when a $2 million 403(b), Social Security, and forced RMDs all hit in the same year
• Why the window between retirement and RMDs is the highest-leverage tax planning period of a CRNA's entire financial life (and why most people waste it)
• How Roth conversions done at $75,000 per year from age 62 to 70 reduced Janie's 20-year federal tax bill by $170,000
• The three-act retirement paycheck framework: the bridge, the window, and the forced years
• What Janie's monthly paycheck looked like at age 70 after stopping work at 62 with a structured, tax-efficient sequence

If your numbers raise more questions than they answer, get your retirement pre-op assessment: https://oakcapitaladvisor.com/schedule-a-call/  

Click here to download the Free Retirement Checklist https://oakcapitaladvisor.com/retirement-checklist/

#CRNAs #RetirementPlanning #RothConversion #TaxStrategy #RetirementPaycheck

Key Timestamps:

(0:18) Why retirement feels unclear with $2M

(2:44) Janie: CRNA case study at age 58

(4:10) The 4% rule and the age 73 collision

(6:51) IRMAA and the conversion window

(9:30) Filling your tax brackets on purpose

(11:57) The three act retirement paycheck framework

(13:06) Act 1: Funding the bridge years

(15:15) Final results: Janie's $170,000 savings 

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