MoneyRx for CRNAs and NPs

The Tax Bill Many Widowed Nurses Don't See Coming

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 protect the surviving spouse before it's too late. Brett Covers: * Why the survivor's tax bill goes up when household income goes down * The role of required minimum distributions in the problem * How filing as a single filer compresses tax brackets and cuts the standard deduction in half * The IRMAA surcharge that shows up two years after the funeral * The Survivor's Window: a multi-year plan using Roth conversions, Social Security timing, and beneficiary cleanup to reduce the lifetime tax cost by tens of thousands If you have a large pre-tax 403(b) or IRA and a spouse, this episode is worth your full attention. The window to act is only open while both of you are still here. Key Timestamps: (0:18) Predictable financial surprises and tax penalties in retirement (1:18) The widow's penalty where survivor income drops but taxes rise (2:48) Case study introduction of Diane and Paul (5:48) Structural exposure of retirement plans built only for two people (7:29) Social Security and single-life pension changes after a spouse dies (8:43) Required minimum distribution rules for a single survivor schedule (10:03) Shrinking standard deductions and compression of single tax brackets (11:15) Impact of single filer Medicare IRMAA thresholds and surcharges (12:45) Total lifetime cost breakdown of the single filer tax penalty (15:44) Exploiting the low tax bracket window while both spouses are alive (18:41) Filling joint tax brackets with multi-year Roth conversions (19:54) Setting the survivor income floor by delaying Social Security For more information and resources related to this episode, please visit the show notes [https://oakcapitaladvisor.com/the-moneyrx-for-crnas-podcast/].

Should I invest in a rental property in retirement?

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 Charleston area earning $220,000 a year who wants to buy a second rental property before retiring at 62. Brett explores the problems that arise when they explore her options. * Why most rental property owners never calculate the one number that tells them if the investment worked * The Cash Flow Illusion: why a property that "covers the mortgage" can still run hundreds per month in the red * The passive loss rule that suspends depreciation deductions for most CRNAs and NPs earning over $150,000 * What the real exit looks like after commissions, depreciation recapture, capital gains, and state taxes * Why Yvonne's 403(b) outperformed her rental property over the same six-year period * The Capital Priority Ladder: the order in which high-earning nurses should deploy capital before buying direct property * How Yvonne sheltered $71,000 from taxes in year one without buying a second rental Most CRNAs who own rental property have never run the number that tells them whether it worked: the all-in, after-tax, after-expense, after-time annualized return.  #CRNAs #NursePractitioners #RealEstate #RetirementPlanning #TaxPlanning For more information and resources related to this episode, please visit the show notes [https://oakcapitaladvisor.com/the-moneyrx-for-crnas-podcast/].

Why High-Earning Nurses Never Feel Wealthy (with Kristin Burton, PA Millionaire)

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 to talk about what holds high-earning healthcare professionals back from building wealth. They cover the identity problem around income, why student loans should never be the whole money plan, the three tax buckets that create flexibility in retirement, and what it takes to make work optional. Kristin also shares the investing philosophy that built her net worth and the financial mistakes she would do differently. Key Timestamps: (0:18) Introduction of guest Kristin Burton and her personal wealth milestones (1:38) Origins and grassroots mission of Millionaires in Medicine (3:53) Failure of non-physician medical professionals to self-identify as high earners (5:13) Time management strategies for balancing clinical practice and entrepreneurship (6:18) Shift from short-form infographics to deep long-form conversations (10:23) Inspiration for publishing a tangible and enduring financial guidebook (12:05) Why behavioral choices and mindset outweigh pure financial intelligence (16:22) Reframing student loans as a career investment instead of an emotional burden (19:03) The three-pillar framework to track earnings, multiply investments, and build net worth (22:03) Long-term advantages of a boring and fully automated dollar-cost averaging approach (27:35) Spreading assets across three tax buckets to optimize retirement withdrawal strategies (30:04) Three-step process to establish and future-proof baseline lifestyle expenses  For more information and resources related to this episode, please visit the show notes [https://oakcapitaladvisor.com/the-moneyrx-for-crnas-podcast/].

Amanda Kay on One Full Year of 1099: What She Got Wrong, What Changed Everything

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 Key Timestamps: (0:18) Return of guest Amanda Kay to review her first year of independent contracting  (1:43) Simple bookkeeping and revenue tracking methods using basic apps  (2:56) Psychological adjustments when transitioning away from W-2 employment  (4:40) Spousal communication strategies for managing variable monthly income  (6:50) Common first-year errors with S corp compliance and deductions  (10:53) Tax efficiency benefits of prioritizing business distributions over salary  (13:40) Proactive recordkeeping habits to easily track business expenses  (15:56) Evaluating the financial case for switching to 1099 contracting  (18:40) Choosing the right entity structures when managing multiple income streams  (19:58) Projected overhead costs and platform fees for digital courses  (27:13) Navigating anesthesia market shifts and establishing cancellation policies  (30:04) Protecting income through continuous clinical skill diversification For more information and resources related to this episode, please visit the show notes [https://oakcapitaladvisor.com/the-moneyrx-for-crnas-podcast/].

Should I Pay Off My Mortgage Before Retiring?

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 [https://oakcapitaladvisor.com/the-moneyrx-for-crnas-podcast/].