Updated July 2026 · 7 min read

Expense Ratios for Nurses 2026

Part of the Nurse Money & Investing Hub — browse every related guide in one place.

Financial Disclaimer: This article is general educational information, not individualized financial, tax, or investment advice. Everyone's situation differs. Consult a fiduciary advisor or a tax professional before making decisions with real money.

There is one number in investing you control completely, that predicts fund performance better than star ratings, and that most nurses have never looked up: the expense ratio. It's the annual fee a fund charges, quietly skimmed from your balance whether the market goes up or down. The difference between a cheap fund and an expensive one, compounded over a nursing career, is routinely a six-figure sum — and hospital 403(b) plans are one of the worst places in America for hidden fund fees.

What the number means

An expense ratio is the percentage of your invested balance the fund keeps each year to run itself. A 0.04% expense ratio on a $50,000 balance costs you $20 a year. A 1.00% ratio on the same balance costs $500 a year. You never see a bill — the fee is deducted from the fund's returns before they reach you, which is exactly why it goes unnoticed.

Fees are often quoted in basis points: one basis point is 0.01%. A "4 bps" index fund charges 0.04%; a "95 bps" actively managed fund charges 0.95%. The fee is charged on your whole balance every year — not on your gains — so it compounds against you the same way returns compound for you.

What 1% actually costs over a career

Same paychecks, same market, same 30 years of night shifts — and the high-fee version quietly hands roughly $236,000 to a fund company. That's several years of retirement spending, gone to a line item you were never shown. And unlike market risk, this cost is guaranteed: the fee is charged in good years and bad.

How to find your actual fees in 15 minutes

Log into your 403(b) portal and pull up each fund you own. The expense ratio is on the fund's fact sheet or prospectus page — or search the fund's ticker plus "expense ratio." Then check the plan level: look for administrative fees, wrap fees, or M&E charges in the plan's annual fee disclosure (the 404(a)(5) notice your employer must provide). Your real cost is the fund fee plus the plan fee, added together.

Watch for the fund-of-funds wrinkle: a target-date fund reports one expense ratio that includes its underlying funds — fine if it's an index-based series (often 0.08–0.15%), a problem if it's active (often 0.5–0.8%) for the identical glide path.

What's a fair fee in 2026

Higher fees would be defensible if expensive funds reliably beat cheap ones. The evidence says the opposite: fund-research firms have repeatedly found that low fees are the strongest single predictor of a fund outperforming its peers, for the simplest possible reason — the fee is subtracted from whatever the fund earns. Cost is the one part of future returns you can read today.

What to do if your plan is expensive

First, don't stop contributing — the employer match and tax break usually beat even an ugly fee menu. Capture the match, then optimize. Second, pick the cheapest broad index funds your plan offers and build your three-fund portfolio from those; almost every menu hides at least one cheap S&P 500 fund among the expensive options. Third, route money you invest beyond the plan into accounts you fully control — a Roth IRA, an HSA, or a taxable brokerage account — where 0.03–0.05% index funds are one click away. Finally, when you change hospitals, roll the old 403(b) into an IRA or your new employer's cheaper plan; old annuity-wrapped balances left behind keep paying the toll for decades.

The bottom line

Related: The three-fund portfolio, Target-date funds, Index fund investing, and 403(b) vs. 457(b).