Financial Advisor for CRNAs in Houston, TX
Houston is one of the strongest markets for CRNAs in the country. No state income tax, the world’s largest medical center, and abundant locum opportunities. But earning well isn’t the same as planning well. We help CRNAs in Houston protect more of what they earn, invest with a real strategy, and retire on their own terms.
Financial Advisor, 2025
No commissions. Ever.
Brett Fellows, 20+ Years
You've Earned This
Houston CRNAs Earn Among the Highest in the Country. Is Your Plan Keeping Pace?
CRNAs working in the Houston metro, across the Texas Medical Center, Memorial Hermann, Houston Methodist, and the region’s many independent facilities, typically earn $210,000 to $245,000 a year. Texas has no state income tax, which means more of that income stays in your pocket. But more income and well-planned finances aren’t the same thing, and the gap between the two is where most CRNAs quietly lose ground.
The complexity that comes with a CRNA’s financial life doesn’t go away just because the state isn’t taking a share. Federal taxes still consume a large portion of a high earner’s income. Pre-tax retirement accounts accumulate a future tax liability alongside their balance. Houston’s strong locum market means many CRNAs are managing both 1099 and W-2 income simultaneously, which most advisors aren’t equipped to handle well. Underneath all of it, the question that doesn’t go away: how much longer do you actually have to do this?
At Oak Capital Advisors, we’ve built our practice around helping CRNAs reach financial independence. We specialize in the specific planning challenges of your career, not a repurposed general practice that treats healthcare workers as a sub-specialty.
“Texas has no income tax, but I still feel like I’m giving a lot away. What am I missing?””I’m doing both hospital work and locums. How do I make the most of both from a retirement standpoint?””My 403(b) keeps growing, but all of that money is pre-tax. How bad is the tax hit going to be?””I want to retire at 58. Based on what I have right now, is that achievable?”
If those questions are on your mind, this is the right place to start.
What We See Every Day
The Financial Problems That Follow Houston CRNAs Into Retirement
We’ve worked with CRNAs across the country, and the patterns are consistent regardless of location. These are the issues that appear most frequently, and the ones that carry the biggest cost when they go unplanned.
A Pre-Tax Balance That Becomes a Tax Problem at Retirement
Texas not having a state income tax is valuable, but it doesn’t change what the IRS will collect from your 403(b) or 457(b) when you start drawing on it. Every dollar comes out as ordinary income. When required minimum distributions are added to Social Security, the result can push retirees into high federal brackets through their 70s and 80s. This is a solvable problem, but only if you start addressing it before retirement, not after.
The Texas Medical Center Locum Coordination Problem
Houston’s healthcare market generates exceptional locum opportunities. Many CRNAs are managing a staff position at one system while taking independent cases elsewhere. The tax and retirement contribution rules differ between W-2 and 1099 arrangements, and coordinating both income streams to get the most out of retirement contributions while keeping taxes low requires specialized knowledge that most advisors simply don’t have.
Burnout and the Retirement Timeline Question
The anesthesia workload at Houston’s major medical systems is high. The demand is high, the cases are complex, and the pace is sustained. We work with CRNAs who are done, or getting close to done, and who need to know whether their finances support stepping back. We build that analysis specifically, not as an estimate.
Medicare’s IRMAA Surcharge
High earners face an income-based surcharge on Medicare premiums in retirement called IRMAA. Because it’s calculated on income from two years prior, a CRNA who earns well through their final working years often walks into retirement with a premium surcharge they didn’t plan for. Strategic income management in the years before and after retirement can reduce this.
No Clear Plan for Converting Savings Into Income
Reaching retirement with strong account balances is one challenge. Converting those accounts into income efficiently, across taxable accounts, pre-tax retirement accounts, and Roth accounts, is an entirely different challenge that requires its own strategy. Getting the sequencing right can mean the difference of hundreds of thousands of dollars over a thirty-year retirement.
Social Security: A Major Decision That’s Easy to Get Wrong
CRNAs have high Social Security benefits and a lot to gain from claiming them with a good strategy. But the decision of when to claim, and how that interacts with a spouse’s benefit, with other retirement income, and with your tax situation, is more involved than it appears. This is one of the few financial decisions you cannot undo once you make it.
What We Do Together
Financial Planning That Accounts for Your Full CRNA Income Picture
We work with CRNAs who have W-2 income, 1099 income, or both, and we build plans around the whole situation, not just one slice of it.
Year-Round Tax Planning
We monitor your tax situation continuously, not just at filing time. Tax-saving opportunities rarely announce themselves in April. They surface throughout the year and require active planning to capture.
Roth Conversion Planning
We identify the most efficient years and amounts for shifting pre-tax retirement savings into Roth accounts, reducing the lifetime tax burden on your portfolio and building a tax-free income source for retirement.
Retirement Income Strategy
We design a withdrawal roadmap that coordinates your various account types in a sequence that keeps taxes low while generating the income you need throughout retirement.
Investment Management
Evidence-based portfolios aligned with your goals, timeline, and risk profile. We don’t make market predictions or recommend products tied to commission. We manage for long-term outcomes.
Social Security Optimization
We model Social Security claiming scenarios specific to your benefit record and your situation, spouse coordination, early retirement scenarios, tax interaction, so you can decide with full information.
Estate and Legacy Planning
We coordinate with your estate attorney to ensure your wealth is positioned to transfer to your intended heirs efficiently, with as little tax friction and legal delay as possible.
How It Works
Getting Started Is Simpler Than You Think
We don’t believe in pressure. We believe in fit. Our process is designed to give you a clear picture of how we can help before you make any commitment
1
Schedule Your Introductory Call
Think of it like your Pre-Op Assessment. Share your plans and your current challenges. We’ll talk about our process and see if we’re a good fit for working together.
You’ll see, at a high level, how our firm can improve your finances and help you build, grow, and preserve your wealth. To learn more about what to expect, check out our full discovery process.
2
Take a Time-Out
We’re looking for a long-term relationship, not a quick transaction. After your call, take the time you need to decide if working together makes sense. If we aren’t the right fit, we’ll do our best to point you toward someone who is.
3
Induction of Ongoing Advice
Once you decide to move forward, we get to work. We gather a full picture of your finances, build your personalized plan, and become your ongoing financial partner. You delegate the complexity. We handle it.
Why Oak Capital Advisors
Why CRNAs Choose Oak Capital Advisors
Most financial advisors serve everyone. We’ve built our practice around the specific financial planning needs of nurses and advanced practice providers. That focus changes the quality of advice you receive.
Specialized Focus on CRNAs
We’ve built our practice specifically around the financial planning needs of nurse anesthetists. The account types, the income structures, the career dynamics, we know them in detail. You won’t spend time educating us on what your job involves.
Fee-Only and Fiduciary
Our revenue comes entirely from client fees, not from products, not from referrals, not from commissions of any kind. As fiduciaries, we are legally bound to act in your best interest at all times.
Wealthtender Voice of the Client™ Award
In 2025, Brett Fellows was named a Wealthtender Highly Rated Advisor, recognizing advisors who consistently earn superior client reviews with an average rating of 4.75 or higher.
Serving Houston CRNAs via Phone and Zoom
Our office is in Mt. Pleasant, SC. We work with CRNAs throughout Texas and the country remotely. The planning quality is identical whether you’re in Houston or anywhere else.
Two Decades of Planning Experience
Brett Fellows has been a financial planner since 2005, through recessions, tax code overhauls, market swings, and the full range of retirement planning situations that CRNAs tend to face as their careers mature.
CFP® Certified
The CERTIFIED FINANCIAL PLANNER™ designation represents the highest standard in the financial planning profession. It’s held by roughly one-quarter of practicing advisors in the U.S. Brett has held it for years.
Common Questions
What CRNAs in Houston Ask Us Most
It’s a genuine advantage. The absence of state income tax means more of your income stays available to invest or save. But the federal picture is unchanged, and at a CRNA’s income level, federal taxes are where the biggest opportunities and the biggest risks live. The lack of state tax doesn’t reduce the pre-tax liability in your 403(b), or change how required minimum distributions work. Federal planning, especially Roth conversion strategy, remains the primary focus of our work with Houston CRNAs.
This is one of the most common situations we work through with Houston-area CRNAs. Your 1099 locum income may allow you to contribute to a Solo 401(k), which operates separately from your hospital plan and has its own contribution limits. The interaction between the two plans, and how to get the most out of contributions without exceeding IRS limits, requires precise coordination. Done correctly, it can accelerate your tax-deferred savings. Done poorly, it creates compliance exposure.
A large pre-tax 403(b) is a valuable asset with a tax liability built in. Required minimum distributions will eventually force you to take taxable income from it whether you need the money or not. The most effective approach for most CRNAs is a Roth conversion strategy, moving portions of the 403(b) into Roth in the years between retirement and age 73, while tax brackets are still favorable. The right conversion amounts depend on your Social Security timeline, your other income sources, and your total tax picture.
IRMAA is a surcharge added to Medicare Part B and Part D premiums for high earners. It’s calculated based on your Modified Adjusted Gross Income from two years prior, meaning the income you earned during your last years of full-time work directly affects what you pay for Medicare in early retirement. For CRNAs, this is often a surprise. Proactive income management and Roth conversion strategy in the years approaching and following retirement are the primary tools for reducing it.
We do this analysis for CRNAs on a regular basis. The evaluation covers your investable assets, your projected retirement expenses, healthcare costs before and after Medicare eligibility, Social Security timing options, and the tax efficiency of your account mix. Once we’ve worked through it, you’ll know specifically where you stand, not just whether you ‘probably’ have enough, but what the numbers actually say.
Yes. We work with CRNAs in Texas and throughout the country via phone and Zoom. Geography has never been a limiting factor in the relationships we build or the quality of planning we provide.
Texas keeps more of your income. Now make sure your plan does too.
Start with a free 30-minute call. We’ll dig into your situation, walk through our process for CRNAs, and you’ll leave knowing whether we’re the right fit. No hard sell. No obligation.
Oak Capital Advisors
126 Seven Farms Drive Suite 160
Charleston, SC 29492 • (843) 284-0798
© 2024 Oak Capital Advisors, LLC. All rights reserved.