Can nurses have a solo 401(k)?

Yes. Any nurse with self-employment income and no full-time employees (other than a spouse) can open and contribute to a solo 401(k). This includes 1099 CRNAs, independent nurse practitioners, travel nurses with 1099 contracts, per diem nurses with self-employment income, and home health nurses working as independent contractors.

How much can a nurse contribute to a solo 401(k) in 2026?

In 2026, a self-employed nurse can contribute up to $72,000 total to a solo 401(k) under IRC §415(c). This consists of an employee deferral of up to $24,500 ($32,500 at age 50–59 or 64+; $35,750 at ages 60–63 under the SECURE 2.0 super catch-up), plus an employer contribution of up to 25% of W-2 wages (S-corp) or approximately 20% of net self-employment income (sole proprietor).

Solo 401(k) vs SEP-IRA: which is better for a 1099 nurse?

For most 1099 nurses, the solo 401(k) allows higher contributions at the same income level, because you can make both an employee deferral ($24,500) and an employer contribution. A SEP-IRA only allows employer-side contributions (25% of compensation, no deferral, no catch-up). At income under $100,000, the solo 401(k) usually wins by $15,000–$20,000 per year. The SEP-IRA is simpler administratively and may suit nurses who want minimal paperwork.

What is the deadline to contribute to a nurse's solo 401(k)?

The solo 401(k) plan must be established by December 31 of the tax year you want to contribute. Employee elective deferrals must also be elected and contributed by December 31. Employer profit-sharing contributions can be made up to the tax return filing deadline (April 15, or October 15 with extension). Missing the December 31 setup deadline forfeits the elective deferral entirely for that year.

Can a CRNA have a solo 401(k) and also contribute to a hospital 403(b)?

Yes, with one important limit. If a CRNA has both W-2 hospital income (403b available) and 1099 self-employment income (solo 401k eligible), the employee deferral limit of $24,500 is shared across all plans. You cannot defer $24,500 into the 403(b) and another $24,500 into the solo 401(k). However, the employer contribution in the solo 401(k) is separate — a CRNA who maxes a 403(b) can still make employer-side solo 401(k) contributions on their 1099 income.

Does an S-corp affect solo 401(k) contributions for a CRNA?

Yes, significantly. An S-corp CRNA pays themselves a W-2 salary (e.g., $120,000 out of $280,000 in revenue). The employer contribution to the solo 401(k) is up to 25% of that W-2 salary ($30,000), plus the employee deferral ($24,500), for a total of $54,500 — all while saving $8,000–$15,000 in FICA tax via the S-corp structure. The solo 401(k) and S-corp election work together to maximize both tax savings and retirement contributions.

Solo 401(k) for Nurses: The Self-Employed Retirement Account That Beats Everything Else

If you're a 1099 CRNA, an independent nurse practitioner, a travel nurse on self-employment contracts, or any nurse with self-employment income and no full-time W-2 employees, the solo 401(k) is almost certainly the best retirement account available to you. It can shelter up to $72,000 per year from federal income tax — more than the hospital 403(b)+457(b) dual-bucket available to W-2 nurses — with a structure specifically designed for self-employed business owners.

Most 1099 nurses either don't have a solo 401(k) or have one they're not funding optimally. This guide covers how it works, 2026 limits, the comparison to a SEP-IRA, and the nurse-specific scenarios where it matters most.

2026 Solo 401(k) Contribution Limits

Employee deferral: $24,500 (traditional or Roth)
Catch-up contribution (age 50–59 and 64+): $8,000 additional = $32,500 total deferral
Super catch-up (ages 60–63): $11,250 additional = $35,750 total deferral (SECURE 2.0 § 109)
Employer contribution: Up to 25% of W-2 compensation (S-corp) or ~20% of net SE income (sole proprietor)
Total cap (IRC § 415(c)): $72,000 per year ($80,000 at age 50+; $83,250 at ages 60–63)

Who qualifies for a solo 401(k)?

Two requirements: self-employment income of any kind, and no full-time W-2 employees other than a spouse. That's it. You don't need to be a business owner in the traditional sense — a CRNA picking up 1099 locum shifts, an NP with a part-time telehealth practice, or a travel nurse under a 1099 contract all qualify if they have no employees.

Common nurse situations that qualify:

1099 CRNA (sole proprietor or S-corp): The classic use case. Whether you're billing directly or through an anesthesia group that pays you as an independent contractor, 1099 CRNA income qualifies.
Independent NP or CRNA with an S-corp: The S-corp is the plan sponsor, and you establish the solo 401(k) through the S-corp. This is the highest-leverage combination for tax savings.
Travel nurse with 1099 contracts: Travel nurses who receive 1099 income (not W-2) from agencies or direct hospital contracts qualify. Note: most travel agency arrangements are W-2, not 1099 — verify your tax form before assuming.
Per diem or PRN nurse with 1099 income: If you pick up per diem shifts as a 1099 contractor, that income qualifies — even if your primary job is W-2 at a hospital.
Home health or hospice nurse as 1099 contractor: Independent contractors in home health and hospice qualify, subject to the employee-count test.
Nurse with a side income source: Writing, consulting, travel nursing during vacation, or any other Schedule C or S-corp income makes you eligible, even if your primary income is W-2.

Who does NOT qualify: Nurses with full-time W-2 employees (other than a spouse) cannot use a solo 401(k). If you hire staff — even part-time — you likely need a SIMPLE IRA, SEP-IRA, or full 401(k) plan that covers employees.

How contributions work: the two-part structure

The solo 401(k) has two contribution components with separate rules and limits. Understanding this distinction is what separates nurses who fund it optimally from those who leave money on the table.

Employee elective deferral (you as the employee)

You can defer up to $24,500 of your own income into the plan in 2026 — the same limit as a hospital 403(b) or 457(b). This is pre-tax income, reducing your federal taxable income dollar-for-dollar. Or, if your plan document allows Roth contributions, you defer after-tax dollars and withdraw tax-free in retirement.

Critical detail: the $24,500 deferral is per person, not per plan. If you have a W-2 job with a 403(b) and also have 1099 income with a solo 401(k), your combined deferrals across both plans cannot exceed $24,500. The plans don't share an employer contribution limit — only the employee deferral limit is shared.

Employer profit-sharing contribution (you as the employer)

As the business owner, you can also make an employer contribution of up to 25% of your W-2 compensation (S-corp) or approximately 20% of your net self-employment income (sole proprietor after SE tax deduction). This contribution is on top of the employee deferral and is entirely separate from the W-2/403(b) system.

The total of both components is capped at $72,000 in 2026 per the IRC § 415(c) annual additions limit. Catch-up contributions for age 50+ are added on top of this cap.

Scenario	Employee Deferral	Employer Contribution	Total
S-corp CRNA, $150K W-2 salary	$24,500	$37,500 (25% of $150K)	$62,000
S-corp CRNA, $190K W-2 salary	$24,500	$47,500 (25% of $190K)	$72,000 (capped)
Sole proprietor NP, $120K net SE income	$24,500	~$22,100 (20% of $120K × 0.9235)	~$46,600
Sole proprietor NP, $80K net SE income	$24,500	~$14,800 (20% of $80K × 0.9235)	~$39,300
W-2 hospital CRNA + 1099 locum side income, $40K 1099	$0 (403b uses full deferral)	~$7,400 (employer only on 1099 income)	~$7,400

Sole proprietor employer contribution uses IRS-effective rate of approximately 20% of net SE income (net of SE tax deduction). S-corp contributions use 25% of W-2 wages. All figures subject to $72,000 IRC § 415(c) cap. 2026 limits per IRS Rev. Proc. 2025-43.¹

Solo 401(k) vs SEP-IRA: the comparison that matters

Both accounts serve self-employed nurses. The solo 401(k) is almost always superior for nurses with meaningful self-employment income, but the SEP-IRA has real advantages in specific situations.

Feature	Solo 401(k)	SEP-IRA
2026 total cap	$72,000 (+$8,000 at 50+)	$72,000 (no catch-up)
Employee deferral	Yes — $24,500 regardless of income	No — employer contributions only
At $80K net SE income, max contribution	~$39,300	~$14,800
Roth option	Yes — if plan document allows	No
Loan provision	Yes — up to 50% of balance, $50K max	No
Setup complexity	Moderate — plan document required	Low — simpler setup
Form 5500-EZ	Required when plan assets exceed $250,000	No annual filing
Employees (non-spouse)	Disqualifies solo 401(k) if any full-time W-2 employees	Can cover employees (but must contribute same % to all)

The math is decisive at most income levels: at $80,000 net SE income, the solo 401(k) allows nearly $40K in contributions while a SEP-IRA allows only $14,800. A nurse who can shelter an additional $24,500 pre-tax at the 24% or 32% bracket saves $5,880–$7,840 in federal income tax per year — a real number that compounds over a career. The SEP-IRA makes sense mainly for nurses whose income is too low to justify the solo 401(k)'s administrative overhead, or who have eligible employees they need to cover.

The S-corp and solo 401(k) combination for CRNAs

For CRNAs and NPs earning $150,000+ in 1099 income, the S-corp and solo 401(k) are the two most powerful tools available — and they work better together than separately.

Here's how the combination works for a CRNA with $280,000 in gross 1099 revenue:

Elect S-corp status. This converts the CRNA's sole proprietorship into an S-corp entity.
Pay a "reasonable compensation" W-2 salary from the S-corp — typically $130,000–$160,000 for a CRNA, based on what a CRNA employee would earn in that role.
The S-corp pays FICA taxes (7.65%) only on the W-2 salary, not the remaining S-corp distributions. At $130,000 in W-2 wages vs. $280,000 sole proprietor income, the FICA savings are roughly $9,000–$14,000 per year.
The solo 401(k) employer contribution is 25% of the W-2 salary. At $130,000 W-2: $32,500 employer contribution + $24,500 employee deferral = $57,000 total.
All $57,000 reduces the S-corp's taxable income (partially via W-2 cost, partially via plan contribution deduction).

Example: 1099 CRNA with S-corp and solo 401(k)

Gross 1099 revenue: $280,000
S-corp W-2 salary: $140,000
Solo 401(k) employee deferral: $24,500
Solo 401(k) employer contribution (25% of W-2): $35,000
Total retirement contribution: $59,500
FICA savings vs. sole proprietor structure (on $140,000 in distributions): ~$10,710
Federal income tax savings on $59,500 pre-tax (at 32%): ~$19,040
Combined annual tax benefit: ~$29,750

This is a simplified illustration. Actual figures depend on state tax, business expenses, reasonable compensation determination, and S-corp administrative costs. Model your specific situation with a fee-only advisor who works with 1099 CRNAs.

See the 1099 CRNA vs. W-2 net income calculator to model the full after-tax comparison including S-corp structure, solo 401(k) contributions, and benefits costs.

Roth vs. traditional solo 401(k)

Unlike a SEP-IRA, a solo 401(k) can allow Roth contributions — if the plan document includes this feature. Not all providers support Roth solo 401(k) contributions, so verify before opening an account if this matters to you.

The Roth vs. traditional decision in a solo 401(k) follows the same logic as a hospital Roth 403(b):

Choose traditional (pre-tax) if you're in your peak earning years (32%+ bracket) and expect to be in a lower bracket in retirement. The immediate deduction is more valuable than the long-term tax-free growth.
Choose Roth if you're earlier in your career, expect income to rise significantly, have a PSLF strategy that will eliminate the debt driving your current AGI reduction incentive, or want to build tax-free assets alongside your pre-tax retirement accounts.
Split the contribution — many nurses with both a hospital plan and a solo 401(k) make traditional contributions in the hospital plan (pre-tax, lowers AGI for PSLF IBR payment calculation) and Roth contributions in the solo 401(k) (if they want some tax-free balance).

For most CRNAs earning $200,000+, the traditional solo 401(k) wins on pure math: deferring 32–35 cents in federal tax now and paying at retirement rates that may be lower. CRNAs who own an S-corp may also have income flexibility in retirement that makes the conversion picture complicated enough to warrant professional modeling.

Critical deadlines: where nurses make expensive mistakes

The solo 401(k) has specific deadlines that are different from — and stricter than — a Roth IRA or SEP-IRA. Missing these deadlines can cost you the ability to contribute for an entire tax year.

Plan establishment: December 31. A solo 401(k) plan must be formally established (account opened, plan document signed) by December 31 of the year you want to contribute. You cannot open a solo 401(k) in April and retroactively make contributions for the prior year — unlike a SEP-IRA, which can be opened and funded up to the tax return deadline.
Employee deferral election: December 31. The employee elective deferral must be elected (and for W-2 employees of an S-corp, actually contributed via payroll) by December 31. Missing this forfeits the $24,500 deferral for that year. Employer contributions have until the tax return filing deadline (typically October 15 with extension).
Employer contributions: April 15 (or October 15 with extension). The profit-sharing employer contribution can be made up to the tax return filing deadline, giving you until fall of the following year if you file an extension. Sole proprietors paying estimated taxes quarterly need to track their net SE income throughout the year to estimate the employer contribution.
Form 5500-EZ: July 31. Once solo 401(k) plan assets exceed $250,000, you must file Form 5500-EZ annually with the IRS. Failure to file triggers a $250/day penalty. This is a recurring compliance obligation that many self-employed nurses are unaware of until the balance crosses the threshold.

The December 31 problem for CRNAs: Many 1099 CRNAs open solo 401(k) accounts in January or February when filing taxes — too late to elect the prior-year employee deferral. If you're starting as an independent CRNA and want to contribute for the current tax year, open the plan and establish the election before December 31. The employer contribution can always wait until filing.

Nurse-specific scenarios

CRNA with mixed W-2 and 1099 income

Many CRNAs work primarily at a hospital (W-2) and take locum assignments on the side (1099). If the locum income is at least $20,000–$30,000, a solo 401(k) is worth establishing. Because the W-2 403(b) at the hospital already captures the full $24,500 employee deferral, the solo 401(k) can only receive employer contributions — approximately 20–25% of the 1099 net income, depending on structure. At $40,000 in locum income, that's roughly $7,400–$10,000 additional retirement savings per year that would otherwise be unavailable. Over 10 years, with growth, that difference is material.

Independent NP in private practice

An NP running a solo practice — DPC, telehealth, or fee-for-service — should establish a solo 401(k) immediately upon starting self-employment income. Even at $80,000 in net practice income, the solo 401(k) allows ~$39,000 in total contributions. At $120,000 in net income, the number rises to ~$46,600. This is dramatically more tax-efficient than a traditional IRA, and entirely unavailable to W-2-only nurses. An NP who starts practice at 38 and contributes aggressively for 25 years can accumulate $2M–$3M+ in tax-advantaged retirement savings without touching taxable accounts.

Travel nurse with 1099 contracts

Most travel nurses work under W-2 arrangements through agencies. But some experienced travel nurses contract directly with facilities or work through a staffing company that classifies them as 1099 contractors. If your travel income is 1099, you qualify for a solo 401(k). Be careful: a nurse cannot choose 1099 classification to access the solo 401(k) if the working relationship is actually W-2 under IRS rules. The IRS worker classification test (behavioral control, financial control, type of relationship) determines the proper classification — not what the nurse prefers.

Home health or hospice nurse as 1099 contractor

Independent home health nurses and hospice case managers who contract directly with patients or agencies as 1099 workers qualify. Mileage is a significant Schedule C deduction ($0.725/mile in 2026 per IRS Rev. Proc. 2025-72²), reducing net SE income and, consequently, the employer contribution calculation — but the employee deferral ($24,500) is unaffected by mileage deductions. A home health nurse with $75,000 in 1099 revenue and $10,000 in mileage deductions has $65,000 in net SE income, supporting total solo 401(k) contributions of approximately $36,500.

Nurse educator or consultant with side income

A hospital nurse educator on a W-2 who earns $15,000 in consulting, education, or speaking income qualifies for a solo 401(k) on that side income. Because the primary W-2 job already uses the full $24,500 employee deferral, the solo 401(k) can only receive employer contributions — roughly $2,700–$3,000 at $15,000 net SE income. Worth doing for the tax deduction, but not transformative at that income level. As consulting income grows past $40,000–$50,000, the math becomes significantly more compelling.

Provider options for solo 401(k) accounts

Several major custodians offer solo 401(k) plans with no account fees and broad investment menus. Key differences:

Fidelity: No fees, wide fund selection including zero-expense-ratio index funds. Does not support Roth solo 401(k) contributions as of 2026 — contributions are traditional only. Preferred by many 1099 CRNAs for simplicity and fund quality.
Vanguard: Migrated individual 401(k) accounts to Ascensus administration; some users report more paperwork. Strong fund lineup but reduced custodian flexibility.
Charles Schwab: No fees, supports both traditional and Roth solo 401(k) contributions. Good choice for nurses who want the Roth option.
TD Ameritrade/Schwab (merged): Now operating under Schwab. Plan documents and processes have consolidated.
Self-directed custodians (Equity Trust, Advanta IRA): Allow alternative investments (real estate, private equity) inside the solo 401(k). Significantly higher fees and complexity. Not appropriate for most nurses without a specific alternative-investment strategy.

For most 1099 nurses, a major custodian with no fees, broad index fund access, and support for Roth contributions (if desired) is the right choice. If you have an S-corp, confirm the custodian can establish the plan in the S-corp's name (not your personal name) — this is standard but worth verifying.

How the solo 401(k) compares to a hospital 403(b)+457(b)

W-2 hospital CRNAs often assume the 403(b)+457(b) dual-bucket ($49,000 combined in 2026) is the best retirement structure. It's excellent for W-2 nurses. But 1099 CRNAs with a solo 401(k) often access more total contribution room:

403(b) + 457(b) (W-2 CRNA): $24,500 + $24,500 = $49,000 maximum, before any employer match. Catch-up adds $8,000–$11,250.
Solo 401(k) (1099 CRNA with S-corp, $180K W-2 salary): $24,500 employee deferral + $45,000 employer (25% of $180K) = $69,500. Catch-up adds $8,000–$11,250.

At S-corp W-2 wages above ~$98,000, the solo 401(k) total (employee deferral + 25% employer) exceeds the hospital 403(b)+457(b) combined maximum. The crossover point is where the S-corp employer contribution alone — at 25% of W-2 wages — covers the gap left after the employee deferral.

This doesn't mean the solo 401(k) is always better than hospital employment — the W-2 position includes employer-paid benefits (malpractice, health insurance, PSLF eligibility) that have real dollar value. The retirement account comparison is one factor in a broader decision. Use the 1099 CRNA calculator to model the full picture.

Related guides

Get your solo 401(k) strategy right

Setting up a solo 401(k) is straightforward; optimizing it — the W-2 salary split for S-corp CRNAs, traditional vs Roth allocation, the interaction with PSLF or a hospital plan — requires someone who understands 1099 nurse finances specifically. Our network connects self-employed nurses with fee-only advisors who specialize in CRNA and NP financial planning. No commissions, no product sales.

IRS Rev. Proc. 2025-43 — 2026 retirement plan contribution limits: 401(k)/403(b)/457(b) employee deferral $24,500; IRC § 415(c) annual additions limit $72,000; catch-up (age 50+) $8,000; super catch-up (ages 60–63, SECURE 2.0 § 109) $11,250. Published October 2025. IRS Rev. Proc. 2025-43.
IRS Rev. Proc. 2025-72 — standard business mileage rate for 2026: $0.725 per mile for business use of a vehicle. Applies to Schedule C mileage deductions for 1099 nurses, including home health and hospice nurses.
IRS Publication 560 (2025) — Retirement Plans for Small Business: Solo 401(k) contribution rules, employer contribution calculation, Form 5500-EZ filing requirement at $250,000 in plan assets, and plan establishment deadline. IRS Pub 560.
IRS — One-Participant 401(k) Plans overview: employee deferral limits, employer contribution formula for sole proprietors and S-corp owners, deadline rules, and comparison to SEP-IRA. IRS.gov — One-Participant 401(k) Plans.

Solo 401(k) contribution limits and rules verified for 2026 tax year against IRS Rev. Proc. 2025-43 and IRS Pub. 560. Employer contribution calculations are approximate and depend on actual compensation structure (S-corp vs. sole proprietor), plan document provisions, and net SE income. Consult a CPA or tax advisor for your specific situation. Values verified as of July 2026.

Disclaimers: NurseAdvisorMatch is a referral service, not a licensed advisory firm. We may receive compensation from professionals in our network. Content is for informational purposes only and does not constitute financial, tax, or investment advice.