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Retirement Planning for Nurses and Healthcare Workers

Q: What retirement plan do nurses usually get?

Nurses at nonprofit hospitals usually get a 403(b); at for-profit employers, a 401(k); at public hospitals, often a 457(b) and sometimes a pension. Many employers offer more than one.

Q: Can I contribute to both a 403(b) and a 457(b) at a hospital?

Yes. A 457(b) has its own limit, so for 2026 you can contribute up to $24,500 to each, plus catch-up contributions if you qualify.

Q: Is a non-governmental 457(b) safe?

It carries a specific risk: under IRS rules, the assets remain the employer's property and are available to its general creditors in a lawsuit or bankruptcy. Check the employer's financial strength and the plan's payout options before relying on it.

Q: What retirement account should a travel nurse or locum use?

If you are paid on a W-2 by an agency, use its plan if one is offered. With 1099 income, a Solo 401(k) or SEP IRA lets you save far more than an IRA alone.

October 24, 2026 · Updated October 29, 2026 · By Tim Miller · 8 min read

Healthcare workers usually have unusual retirement plans. Many hospitals and clinics are nonprofits or government employers, so instead of a standard 401(k) you’re often offered a 403(b), sometimes a 457(b), and occasionally a pension. Add shift work, physically demanding jobs, student loans and the move between staff and contract work, and the usual retirement advice doesn’t fit well. This guide is for nurses, nurse practitioners, nurse anesthetists (CRNAs), physician assistants, dental hygienists, speech-language pathologists, respiratory therapists and other clinicians. It covers which accounts you probably have, the limits for 2026, and the decisions that matter most.

Dental hygienist or speech-language pathologist? Your setups differ enough that each has its own guide: retirement planning for dental hygienists (small-office plans, SIMPLE IRAs, part-time and 1099 work) and retirement planning for speech-language pathologists (school pensions, 403(b) and 457(b) plans, private practice).

The accounts you’re likely to be offered

Account	Typical healthcare employer	What to know
403(b)	Nonprofit hospitals and health systems, public schools (for school-based SLPs and nurses)	Works much like a 401(k). Check the fund menu and fees; some 403(b) menus lean on higher-cost annuity products.
401(k)	For-profit hospitals, private practices, dental offices, staffing agencies	Standard workplace plan. Small practices may offer a SIMPLE IRA instead.
Governmental 457(b)	Public, county, state and university hospitals	Has its own contribution limit on top of a 403(b) or 401(k).
Non-governmental 457(b)	Some nonprofit systems, usually for higher-paid staff	Extra savings room, but the money legally stays the employer’s asset until paid out (see below).
Pension	Many public hospitals, VA and other government employers, some unionized systems	A guaranteed monthly benefit. Learn the vesting schedule before changing jobs.
Solo 401(k) or SEP IRA	Contract, locum, per-diem 1099 and private-practice clinicians	You set it up yourself and can shelter much more than an IRA alone.

How much you can save in 2026

403(b), 401(k) and governmental 457(b): $24,500 each in employee contributions, plus $8,000 if you’re 50 or older, or $11,250 at ages 60–63 (IRS 2026 limits).
The 403(b) and 401(k) share one limit. If you work at two employers, your combined deferrals to these plans can’t exceed $24,500 (plus catch-up).
A governmental 457(b) is separate. If a public hospital offers both a 403(b) and a 457(b), you can put up to $24,500 into each.
The hospital 15-year catch-up. If your 403(b) plan allows it, employees with at least 15 years of service at the same hospital, home health agency or similar employer may add up to $3,000 more a year, with a $15,000 lifetime cap (IRS 403(b) limits).
IRAs: $7,500 for 2026, or $8,600 at 50+. Full limits and income phase-outs are in our 2026 contribution limits guide.

Non-governmental 457(b): read the fine print

Nonprofit health systems sometimes offer a 457(b) to physicians, advanced practice providers and managers. It’s valuable extra room, but the IRS is clear that in a non-governmental 457(b), plan assets are not held in trust for employees and remain the employer’s property, available to its general creditors if the employer is sued or goes bankrupt (IRS: non-governmental 457(b) plans). Before you use one, check your employer’s financial strength, the plan’s payout options when you leave, and whether you could be forced to take it as a lump sum. Most people fill their 403(b) or 401(k) first.

If your body sets the finish line

Bedside nursing, respiratory therapy, dental hygiene and anesthesia are physically demanding, and many clinicians cut back or stop before the “normal” retirement age. Plan for a bridge:

The age-55 rule. If you leave your employer in or after the year you turn 55, withdrawals from that employer’s 401(k) or 403(b) avoid the 10% early-withdrawal tax. The age is 50 for certain public safety employees in governmental plans (IRS exceptions). Rolling that money into an IRA first gives up this exception.
Governmental 457(b) money isn’t subject to the 10% early-withdrawal tax once you leave the employer, which makes it a useful bridge account.
Health insurance before 65 is often the biggest cost of retiring early. Price it before you set a date.
Part-time or per-diem work in your late 50s and early 60s can cover expenses and delay withdrawals. Our early retirement guide covers the bridge years.

Student loans and retirement savings

Many advanced practice clinicians start their careers with large student loans. If you work full-time for a government or 501(c)(3) nonprofit employer, which includes many hospitals, you may qualify for Public Service Loan Forgiveness. If you’re on an income-driven repayment plan, pre-tax 403(b) and 457(b) contributions can lower the income your payment is based on. Ask a student-loan specialist to run your numbers. In many cases, paying off loans and saving for retirement aren’t an either/or choice.

Contract, travel and locum work

Travel nurses, locum CRNAs and contract therapists are often paid on a W-2 by an agency (use the agency’s plan if it has one) or as 1099 contractors. If you have 1099 income, a Solo 401(k) lets you contribute both as the “employee” (up to $24,500 in 2026, shared with any other 401(k)/403(b) deferrals) and as the “employer,” up to a $72,000 combined cap per plan (IRS Notice 2025-67). A SEP IRA is simpler but allows only employer-style contributions.

If you have a pension

A pension from a public hospital or the VA can cover a large share of your retirement spending, which means you may need a smaller nest egg than a coworker without one. Check three things: when you’re vested, how the formula rewards your final years (some reward staying to a certain age or years-of-service milestone), and whether benefits rise with inflation. If you’re weighing a job change, find out what you’d leave behind first.

What to do this week

Find out exactly which plans your employer offers (403(b), 401(k), 457(b), pension) and what the match is. Contribute at least enough to get the full match.
Check your 403(b) fund menu for low-cost index funds, and move away from high-fee products if better options exist.
Estimate your target with the how much do you need to retire calculator, then see whether your savings rate gets you there with the retirement savings calculator.
If you plan to stop clinical work early, test an earlier date in the savings goal calculator.

For other professions, see our retirement planning by profession hub.

Common questions

What retirement plan do nurses usually get?

A 403(b) at nonprofit hospitals, a 401(k) at for-profit employers, and often a 457(b) and sometimes a pension at public hospitals.

Can I contribute to both a 403(b) and a 457(b) at a hospital?

Yes. Each has its own $24,500 limit for 2026, plus any catch-up you qualify for.

Is a non-governmental 457(b) safe?

It carries employer-credit risk: the assets stay the employer’s property and are reachable by its creditors.

Can healthcare workers retire early without penalties?

Leaving at 55 or later unlocks penalty-free withdrawals from that employer’s 401(k) or 403(b), and governmental 457(b) money has no 10% early-withdrawal tax after you leave.

What retirement account should a travel nurse or locum use?

The agency’s plan if you’re W-2; a Solo 401(k) or SEP IRA for 1099 income.

Sources

IRS — 2026 retirement plan and IRA limits
IRS Notice 2025-67 (total defined-contribution limit)
IRS — 403(b) contribution limits (15-year service catch-up)
IRS — Non-governmental 457(b) plans
IRS — Exceptions to tax on early distributions
Federal Student Aid — Public Service Loan Forgiveness

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