A stock and bond mix based on your age can only carry a retirement so far. In this episode, Brett explains why retirement runs on income rather than investment performance, and why that distinction carries extra weight for CRNAs and nurse practitioners juggling multiple account types, variable per diem income, and no pension to lean on. He covers the essential-versus-flexible spending framework, how Social Security fits as a deliberate income decision, the malpractice tail coverage bill that catches many retiring clinicians off guard, and a full hypothetical walking through how it all comes together for a 62-year-old CRNA closing out her practice.

This is illustrative only and not a substitute for an individualized financial plan.

Key Timestamps:

(0:18) Why a stock-and-bond mix isn't a retirement plan

(4:46) The cookie-cutter retirement plan, and why it doesn't hold up for CRNAs and NPs

(6:25) Building the income-first plan: essential versus flexible spending

(9:31) Social Security as an income decision, not a default setting

(10:30) Why multiple retirement accounts complicate withdrawal order for CRNAs and NPs

(12:46) The malpractice tail coverage bill most retirees never plan for

(15:16) A hypothetical: sequencing income for a 62-year-old CRNA

(17:15) Claim early, wait, or bridge the gap: running the numbers

(20:09) The one thing to take from this episode

(22:28) Closing: what your income needs to cover, and when

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

The age on your Social Security application shapes your retirement more than your portfolio balance or your withdrawal rate. In this episode, Brett explains why the first ten years of retirement carry outsized risk, what claiming early versus delaying does to a portfolio during a bad market, and a bridge-income option available to CRNAs and nurse practitioners that a typical retiree doesn't have. He also runs a full hypothetical, a 60-year-old CRNA with $2.1 million saved, through both claiming paths and a market downturn to show the dollar difference between the two choices.

This is illustrative only and not a substitute for an individualized analysis of your own earnings record and portfolio.

Key Timestamps:

(0:08) The one number that decides how a market drop affects your retirement

(3:23) Why the first 10 years of retirement are the most fragile

(6:50) How your claiming age protects or exposes your portfolio

(11:25) Why CRNAs and NPs often have a different earnings record problem

(15:08) The bridge income option most retirees don't have

(18:13) A $2.1 million example: two paths, one market downturn

(22:06) The dollar cost of delaying, laid out plainly

(24:56) So which path is right? The factors that actually decide it

(28:43) Why your spouse's claiming age matters too

(31:22) Your practical next step before you file

(34:45) How to run this analysis with your own numbers

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

A CRNA retires at 55 with $2,800,000 saved, a paid-off house, and every account funded the way a plan is supposed to look. A few months later, that same person turns down a $6,000 family trip because they might need the money.

In this episode, Brett Fellows CFP®, founder of Oak Capital Advisors, works through a composite retiree built from a pattern he sees again and again with CRNAs and NPs who saved for decades and still can't bring themselves to spend a dollar of it. He runs the withdrawal numbers on a $2,800,000 portfolio, walks through why the account a withdrawal comes from can change its tax and Medicare cost by thousands of dollars, and explains the psychological reflex that makes a completely safe expense feel like a threat. Brett closes with a simple exercise for putting your own number to use.

Brett covers:

• Why a mathematically safe $6,000 trip can still feel dangerous to someone with $2,800,000 saved
• What a safe withdrawal rate supports on a $2,800,000 portfolio for someone who retired at 55
• Three specific purchases, a 529 gift, an international trip, and a home renovation, this plan could fund without putting it at risk
• Why pulling the same $50,000 from a 401(k), a Roth, or a taxable brokerage account produces three different outcomes at tax time
• The Medicare and ACA subsidy cliffs that can turn a single large withdrawal into a five-figure surprise
• Loss aversion, the one more year syndrome, and why the instinct to keep working can outlast the need to
• A simple 1% exercise for finding your own spending number and using it on purpose

Key Timestamps:

(0:18) Why a $2,800,000 retiree still turned down a $6,000 family trip

(1:59) What this pattern is really about beneath the dollar amount

(4:03) Research showing why running out of money isn't the risk for consistent savers

(5:34) What a safe withdrawal rate supports on a $2,800,000 portfolio

(9:11) Three specific purchases this plan could fund without putting it at risk

(12:03) Why the account a withdrawal comes from changes what it costs

(18:10) The psychological reason a mathematically safe expense still feels dangerous

(20:54) The one more year syndrome and what it costs

(21:46) Why the same reflex hits savers and spenders differently in one household

(23:11) Back to the $2,800,000 example with the numbers now in view

(25:47) A simple exercise for finding and using your own number

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

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 time
• How a portfolio drifts from its target allocation without a single decision causing it, shown with a real dollar example
• Calendar-based vs. threshold-based rebalancing, and the tax difference between rebalancing in a 401(k)/IRA vs. a taxable brokerage account
• What 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 drop
• Sequence of return risk, the "Red Zone," and how retirement age and funding level change how much cushion a plan needs
• How to size a speculative investment sleeve without putting the actual retirement plan at risk

Key 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. 

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 dollars
• Why that number translates to about $30 a month in retirement income once it's run through a conservative withdrawal rate
• Why an oversized cash cushion builds up so easily on PRN and locum income
• How redirecting unused cash into a 403(b) and backdoor Roth IRA over eighteen years can grow to roughly $180,000
• The 2026 contribution limits for a 403(b) and backdoor Roth IRA, and how much space typically goes unused
• A bank statement exercise for finding a real emergency fund number this week

Key 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. 

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 one
• The Social Security earnings test: how much you can earn before benefits get withheld, and why that money isn't gone forever
• The permanent 30% reduction tied to claiming at 62, and why it never resets once the PRN shifts stop
• How a higher earner's claiming age sets the survivor benefit floor for a spouse, walked through with real numbers
• The ACA subsidy cliff at 400% of the federal poverty level, and how a Social Security check can push a household over it
• A three-number framework to run before you file for benefits

Key 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. 

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 bill
• How much is enough, and why the number itself is rarely the hard part
• Social Security as a one-way door, and why the claiming decision changes the math on everything else
• The healthcare gap before Medicare, and the shadow tax created by a Roth conversion in the wrong year
• Withdrawal order once the paycheck stops, and why the sequence matters as much as the total
• The honest reason Brett keeps making this show, a hundred episodes in

New 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. 

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 35
• Medical inflation running nearly 40 points ahead of general inflation since 2000, and why that gap compounds every year
• Colleen's story: how a "safe" $72,000 withdrawal actually needs to support close to $109,000 a year by year ten
• The ACA subsidy cliff returning for 2026, and how $1,400 of extra income can erase an entire subsidy at once
• Why pulling the same dollar from a Traditional IRA versus a Roth or brokerage account can decide whether you keep that subsidy
• What changes, and what doesn't, once Medicare starts at 65

Key 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. 

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 $150,000
• What it actually costs this April if your plan defaults you into Roth and you don't adjust anything
• Why most CRNAs and NPs are only using one of the three tax-advantaged accounts available to them
• How the 457(b) special three-year catch-up and a solo 401(k) can offset the new Roth mandate
• What structuring all three accounts properly could mean over a hypothetical 14-year period

Key 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. 

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.