Brett K. Fellows CFP Financial Planning for CRNAs and NPs

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Brett K. Fellows CFP Financial Planning for CRNAs and NPs Helping CRNAs and NPs make work optional, pay less in taxes, and invest smarter.

Oak Capital Advisors is an independent, fee-only registered investment advisor located in Charleston, SC. We specialize in exit and retirement planning for CRNAs located in and around Charleston, SC.

10/14/2026

Your employer put money into your Roth 401(k), and now you owe tax on it.

Since SECURE Act 2.0, employers can deposit their match on the Roth side of a 401(k). The IRS counts that match as income in the year it lands in your account, and your plan reports it on a 1099-R, the same form used for withdrawals. Nothing is withheld for taxes, so the full bill falls on you.

Brett Fellows, CFP®, suggests finding out whether your plan offers a Roth match. If you’ve elected it, adjust your withholding or set money aside for estimated payments well before April.

Watch the full episode of MoneyRx for CRNAs and NPs for the details.

10/09/2026

Hollis, a 64-year-old CRNA, gives about $8,000 a year to charity. He takes the standard deduction, so his giving does little for his taxes.

With bunching, Hollis puts three years of giving, $24,000, into a donor-advised fund this year, which clears the standard deduction. For the next two years he takes the standard deduction he was taking anyway, and his two charities still receive $8,000 every December.

He retires in March, so this is his last full year of a CRNA salary. He is funding the gift with appreciated stock, so he deducts the full current value and owes no capital gains tax on the growth.

If you're near retirement with $500K or more saved, mostly pre-tax, and want a clear read on your own giving and taxes, book a complimentary introductory conversation at connectwithbrett.com.

10/06/2026

Only about 1 in 10 HSA accounts holds any invested dollars.

The rest sits in cash or a default fund, often for years, inside the account with the best tax treatment a CRNA or nurse practitioner has. Money in an HSA goes in tax-free, grows tax-free, and comes out tax-free for qualified medical expenses. Leaving it uninvested gives up the growth that makes the account so valuable in the first place.

In this clip, Brett Fellows, CFP®, suggests a check that takes about five minutes. Log in to your HSA provider, find the fund lineup on the main account page, and look at what your balance is invested in, separate from what you contribute. You'll know right away whether it's sitting in cash, a bond fund, or something built for growth.

If you decide to make changes, talk with a planner first, especially if retirement is only a few years away. The full episode of MoneyRx for CRNAs and NPs explains how the HSA fits alongside your 403(b) and brokerage account.

10/02/2026

Miriam and Russell are 63 and 65. For 18 months, they've been careful with money Brett Fellows, CFP®, had already confirmed they could spend.

"The people who underspend in retirement are almost always the same people who were disciplined enough to arrive there," Brett says. A long-term care event, a long life, or a child who needs help are legitimate reasons to hold back too. But some of these years for Miriam and Russell won't come back.

Watch the full episode to see what changed for them.

09/30/2026

Nobody withholds your taxes for you once the paycheck stops.

While you're working, your employer takes care of withholding automatically, so it's easy to never think about it. Once you retire, none of your income sources are required to withhold anything unless you specifically request it. A 403(b) or IRA distribution can have taxes withheld if you elect it. Social Security withholding is optional and easy to overlook. A brokerage account or rental property won't withhold anything at all, so the job of paying enough tax throughout the year falls on you, and skipping it can mean an underpayment penalty on top of a tax-time surprise.

Episode 108 of MoneyRx walks through what changes once a paycheck stops handling this automatically.

09/25/2026

Wesley, a CRNA retiring this spring, has $2.3M saved. However, his plan never factored in the risk of a bad first year.

He planned to draw straight from his 403(b) and file Social Security at 62 to take pressure off the portfolio. Filing that early permanently locks in his smallest possible Social Security check right when he has the most years left to fund it. A fixed withdrawal number meant that in a bad year, every dollar still had to come out of the portfolio, sold at a loss.

We built in a cash and short-term bond buffer, enough to cover two and a half years of spending. We also replaced the fixed withdrawal number with a spending range, so he spends less after a bad year and more after a good one.

If you're within five years of retirement with $500K or more saved, mostly pre-tax, and want a clear read on your own plan, book a complimentary introductory conversation at connectwithbrett.com.

09/23/2026

A $150K retirement withdrawal that looks fine on paper until you run the guardrail math.

Say a CRNA reaches a $2M portfolio by 55 and wants to withdraw $150,000 a year. Doing so puts her at a 7.5% withdrawal rate on day one, well above the range research shows holding up over a 40-year retirement. Run the guardrail math on that number, and the trigger for a spending cut sits at a 9% withdrawal rate. Her portfolio would only need to drop by 17% to get there, about the size of an ordinary market correction.

Episode 107 of MoneyRx walks through this hypothetical and what it means for anyone planning a retirement number before checking it against the guardrails.

09/18/2026

Clifford and Dana wanted to help their son buy a house. Each time it came up, they worried they might need that money themselves someday.

I take that fear seriously. Giving away money you might need later is one of the hardest retirement mistakes to undo.

The only way to know if the fear was accurate was to run the numbers. For Clifford and Dana, that meant building their own retirement plan first, before looking at their kids' needs at all. It accounted for their spending, Social Security, Dana's pension, required withdrawals, a long life, and a long-term care event.

Watch the full episode to see what the numbers showed.

This information is not a substitute for individualized tax advice. Please consult a qualified tax professional to discuss your specific situation.

09/16/2026

If any part of your career involved 1099 or locum work, there's a bill that tends to surprise people right at retirement.

Most malpractice policies only cover claims filed while the policy is active. Stepping away from clinical work for good can trigger what's called a true tail, a lump sum payment covering claims that could surface after you've stopped practicing. It's a one-time expense, often sizable, and it belongs in your financial plan well before your last shift.

09/14/2026

A practice owner I work with paid herself a $90,000 salary for eleven years and took the rest of her profit as distributions. It's the standard move to keep payroll tax down, and it's sound advice as far as it goes. A salary set that low also caps what a business owner can put into a retirement plan.

As I said in our new episode of MoneyRx for CRNAs and NPs, “What her retirement plan contribution room keys off of is that $90,000, not the $280,000.”

Eleven years of contribution room are closed now. She can't go back and fund them.

If your salary looks similar to hers, watch the full episode before another year closes.

This information is not a substitute for individualized tax advice. Please consult a qualified tax professional to discuss your specific situation.

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126 Seven Farms Drive
Charleston, SC
29492

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