Updated June 2026 · 8 min read
Part of the Nurse Money & Investing Hub — browse every related guide in one place.
Hospital nurses almost always have a 403(b), not a 401(k). They work similarly — but the differences matter when you switch jobs, go travel, or start CRNA school.
| Account Type | 2026 Employee Limit | Catch-Up (50+) | Total with Employer |
|---|---|---|---|
| 403(b) | $23,500 | +$7,500 | $70,000 |
| 401(k) | $23,500 | +$7,500 | $70,000 |
| 403(b) — 15-Year Rule* | Up to +$3,000 extra | — | — |
*403(b) only: nurses with 15+ years at the same employer who have averaged less than $5,000/year in contributions may qualify for an additional $3,000/year catch-up beyond the standard limit.
Investment options: 403(b) plans historically offered annuity products from insurance companies in addition to mutual funds — and some older plans still have limited, high-fee options. Before you contribute beyond the match, check the expense ratios on your plan's available funds. A 1.2% expense ratio vs. 0.03% on a Vanguard index fund costs you tens of thousands over a career. If your hospital's 403(b) only offers expensive funds, max the match, then put additional retirement savings in your Roth IRA where you control the investments.
Vesting schedules: Employer match in 403(b) plans at hospital systems often vests over 3–6 years. At Banner Health, for example, employer contributions vest 20% per year starting year 2. Leaving at year 1 means you leave the employer match behind. This is the cost analysis nurses miss when job-hopping or going travel — you may be walking away from unvested employer contributions worth $3,000–$8,000.
You have four options when leaving a hospital job: leave it in the old plan (only makes sense if the investment options are excellent), roll it into your new employer's plan, roll it into an IRA, or cash it out (almost always the wrong choice — 10% penalty plus ordinary income tax). Rolling to an IRA gives you the most investment flexibility and lowest fees. Rolling to a new employer plan consolidates accounts but limits you to that plan's options. Most nurses who change hospitals multiple times over a career end up with 3–5 small old 403(b) accounts — consolidating them into one IRA simplifies management and often improves investment options.
CRNA school means no employer and no 403(b) contributions for 3 years. Your existing 403(b) balance continues to grow — you just can't add to it. Roll old 403(b) accounts from previous employers into an IRA before school starts, so you're managing one account with low-fee index funds rather than multiple old employer plans you can no longer contribute to.
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