MoneyRx for CRNAs and NPs
Go behind the scenes with host Brett Fellows, CFP®, as he explores the unique financial opportunities and challenges facing Certified Registered Nurse Anesthetists and Nurse Practitioners on the path to financial independence. Each episode delivers expert insights and actionable advice to help you lower taxes, invest smarter, and retire on your terms.
Brett's firm, Oak Capital Advisors, specializes in high-earning CRNAs and nurse practitioners and is currently accepting new clients. From retirement income strategy and tax planning to Social Security timing, Medicare, and estate planning, they offer comprehensive financial planning that goes far beyond investment management. If you're ready to work with someone who truly gets your world, the link to schedule a discovery meeting is in the show notes.
MoneyRx for CRNAs and NPs
Roth Conversion or ACA Subsidy? You Don't Have to Choose.
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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.