Podcasts about rmd

Jim and Chris discuss listener questions on Social Security COLA timing, spousal claiming strategy, IRMAA tax treatment, Roth IRA rollovers from 529 plans, and a listener PSA on deferred annuity RMD rules. (8:00) Georgette asks whether her initial Social Security benefit—approved in September for a December start—will reflect the January COLA increase. (15:30) A listener […] The post Social Security, IRMAA Taxation, 529 Rollover, Deferred Annuities: Q&A #2544 appeared first on The Retirement and IRA Show.

In this episode of Behind the Wealth, Roger and Elias unpack two hot topics for retirees and pre-retirees: why some Baby Boomers may be off track for retirement — and how to decide the right time to claim Social Security. Get started on your path to financial freedom. www.premieriwm.com  Securities and advisory services offered through LPL Financial, a registered investment advisor, member FINRA/SIPC. The opinions voiced in this show are for general information purposes only and are not intended to provide specific advice or recommendations for any individual. To determine which investments may be appropriate for you, consult with your attorney, accountant, and financial or tax advisor prior to investing. Premier Investments & Wealth Management and LPL Financial do not provide tax advice, please consult your tax professional. Economic forecasts set forth may not develop as predicted and there can be no guarantee that strategies promoted will be successful. There is no guarantee that a diversified portfolio will enhance overall returns or outperform a non-diversified portfolio. Diversification does not protect against market risk. All performance referenced All performance referenced is historical and is not a guarantee of future results. All indices are unmanaged and cannot be invested into directly. There is no assurance that the techniques and strategies discussed are suitable for all investors or will yield positive outcomes. The purchase of certain securities may be required to effect some of the strategies. Investing involves risks including possible loss of principal. Consult your tax professional about eligibility to Roth and Traditional IRA contributions. Contributions and earnings in a Roth IRA can be withdrawn without paying taxes and penalties if the account owner is at least 59 ½ and has held their Roth IRA for at least five years. Traditional IRA account owners have considerations to make before performing a Roth IRA conversion. These primarily include income tax consequences on the converted amount in the year of the conversion, withdrawal limitations from a Roth IRA, and income limitations for future contributions to a Roth IRA. In addition, if you are required to take a minimum distribution (RMD) in the year you convert, you must do so before converting to a Roth IRA. This information is not intended to be a substitute for specific individualized tax advice. We suggest that you discuss your specific tax issues with a qualified tax advisor.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Paul Adams, MD Hemochromatosis, a genetic condition that causes the body to absorb too much iron from food, often goes unrecognized despite its prevalance. With unique diagnostic and management challenges, it's crucial to understand how it presents, which testing strategies are most effective, and what treatment options are available. Tune in to hear Dr. Peter Buch and Dr. Paul Adams, Professor in the Division of Gastroenterology at the Western University in London, Canada, discuss the latest on hemochromatosis.

Guest: Joel Gabre, M.D, MPH On this episode of Advances in Care, host Erin Welsh and Dr. Joel Gabre, a gastroenterologist at NewYork-Presbyterian and Columbia who specializes in cancer care, discuss the ongoing rise in colorectal cancer rates among younger individuals. Dr. Gabre lays out trends observed by the medical community in colorectal cancer rates, including the increasing likelihood by birth cohort for patients to develop this disease. He also talks about the main differences in colorectal cancer for patients from these different cohorts, most notably the location where cancers are likely to develop in the colon. In addition, Dr. Gabre shares some of the leading hypotheses for why colon cancer rates are rising in younger people, and how clinicians and researchers are focused on searching for answers to improve prevention and treatment options. He gets into the importance of the western diet in developing these forms of cancer and shares details about his team's recent findings regarding changes at the cellular level that could be contributing to the accelerated growth of these cancers. Finally, Dr. Gabre speaks to his personal experiences as a gastroenterologist who has seen first-hand the rise in colon cancer rates among his younger patients. He shares a story of what …

In this episode of Dollars & Sense with Joel Garris, listeners are treated to an insider's perspective from a prestigious investment conference attended by just 100 select guests and hosted by one of the world's largest asset managers. Joel kicks off with a deep dive into the hottest topic in finance—Artificial Intelligence (AI). He explores AI's growing influence on investments, the labor market, and society, highlighting both its potential and the cautionary flags, such as possible overcapacity and the challenges it poses for younger generations. Joel then shifts focus to three major investment themes: the importance of national security in shaping investment decisions, the surge of private equity and private credit for everyday investors, and the need for careful portfolio allocation to avoid hidden overconcentration in growth stocks. Next, Joel breaks down everything you need to know about Required Minimum Distributions (RMDs)—from recent changes in age requirements to smart strategies for minimizing tax impact, including withholding and charitable giving. Whether you're nearing retirement or already enjoying it, this segment offers actionable advice to keep your finances on track. The episode also features a practical guide to Ladybird Deeds—an estate planning tool that helps homeowners transfer property to loved ones without the hassle of probate. Joel explains how Ladybird Deeds work, their advantages over traditional probate, and step-by-step instructions to implement this powerful tool. Rounding out the show, Joel reviews the latest market headlines, including a strong start to earnings season and how AI-driven efficiencies are helping corporate America outperform expectations. If you want to learn how AI is reshaping investments, the keys to managing your retirement withdrawals, and estate planning strategies that save time and money, this episode is packed with insights you won't want to miss.

Guest: Yana Zemkova, MD How often are ICU patients conscious during intubation despite paralysis? Hear from Dr. Yana Zemkova as she discusses new findings on the incidence of awareness with paralysis and the urgent need for improved monitoring in critical care. Dr. Zemkova is Clinical Assistant Professor of Internal Medicine specializing in Pulmonary, Critical Care and Occupational Medicine at the University of Iowa, and she spoke about this topic at the 2025 CHEST Annual Meeting.

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Michael Wang, MD For patients with mantle cell lymphoma (MCL) who relapse after BTK inhibitor (BTKi) therapy, treatment decisions can be complex and time sensitive. That's why understanding how tumor biology and risk features can guide selection between immunomodulatory regimens and CAR T-cell therapy is essential. Tune in to hear Dr. Charles Turck speak with Dr. Michael Wang about practical, evidence-based strategies for managing relapsed/refractory MCL. Dr. Wang is a Professor in the Department of Lymphoma and Myeloma in the Department of Stem Cell Transplantation at MD Anderson Cancer Center in Houston, Texas.

Guest: Gary S. Firestein, MD Despite advances in biologics, many patients with rheumatoid arthritis still experience persistent inflammation. However, cadherin-6 has recently been identified as a potential treatment target. Hear from Dr. Gary Firestein as he explains the discovery, function, and therapeutic potential of cadherin-6 in rheumatoid arthritis pathogenesis. Dr. Firestein is a Distinguished Professor of Medicine and the Senior Associate Vice Chancellor for Health Sciences at UC San Diego.

Guest: Gary S. Firestein, MD While cadherin-6 may not yet shift clinical practice in rheumatoid arthritis, its role as a surface-expressed, actionable target opens the door to rapid therapeutic development—particularly with existing antibodies already in clinical trials for urologic cancers. Dr. Gary Firestein discusses the potential for cadherin-6 to become a useful target across multiple diseases. Dr. Firestein is a Distinguished Professor of Medicine and the Senior Associate Vice Chancellor for Health Sciences at UC San Diego.

Guest: Sujith Cherian MD, FCCP, DAABIP Obesity impacts how the lungs function in a variety of ways, and understanding these impacts is essential for interpreting pulmonary function tests, identifying restrictive or obstructive patterns, and managing ventilation. Learn more with Dr. Sujith Cherian, who's an Associate Professor in the Divisions of Critical Care, Pulmonary, and Sleep Medicine at University of Texas Health-McGovern Medical School and the Director of Interventional Pulmonology and Pleural Diseases at Lyndon B. Johnson Hospital in Houston. He also spoke about this topic at the 2025 CHEST Annual Meeting.

As Halloween approaches, and thoughts turn to ghosts,goblins and things that go bump in the night, Nevin (Adams) & Fred (Reish) turned their focus to things that SHOULD have the attention of (and perhaps even scare) plan fiduciaries.Now, there are lots of things that require careful attention, selection and monitoring of plan assets and services by planfiduciaries; advisors and plan sponsors alike. But there are some things that may sneak up on even the most attentivefiduciary – things like:Your target-date fund glidepath(s) – Is it “to”retirement or “through” retirement, is it appropriate for your participant base, and do THEY know what it is (particularly at the projected date of retirement)?The degree of personalization in a “managed” account– How personalized is it, what data elements are considered, is the cost (relative to a target-date fund alternative) reasonable for the value provided, and who pays it?  Is it structured as a qualified default investment alternative (QDIA)? Cybersecurity – What provision(s) have your providersmade in securing participant data (particularly in view of the sample questions provided by the Labor Department), and are you prepared to deal with those questions in a DOL audit?    Participants that leave their accounts “behind” – Whatprocedures do you have in place to communicate with, and in some cases track down for distributing benefits?  Are youable to appropriately track and administer required minimum distributions (RMD)?Ignorance of fees – Do you know what fees are being paid by the plan, to whom, for what, and how? Personal liability – Plan fiduciaries are personally liable for the actions they take (or don't) with regard to plan administration.  Traditional organizational insurance policies don't cover that, nor does the fiduciary bond required. What provision(s) have you made to insure against that possibility?Episode Resources5 Things That (Should) Scare Plan Fiduciaries Target- Date FundsDOL: Target Date Retirement Funds - Tips for ERISA Plan FiduciariesCybersecurityDOL Cybersecurity Program Best PracticesTips for Hiring a Service Provider with Strong Cybersecurity PracticesCybersecurity tips for participantsParticipant “Leave Behinds”National Registry of Unclaimed RetirementBenefits: https://www.unclaimedretirementbenefits.com/A nationwide, secure database listing of retirement planaccount balances that have been left unclaimed by former participants of retirement plans.Retirement Savings Lost and Found Database: https://lostandfound.dol.gov/EBSA is helping America's workers and beneficiaries searchfor retirement plans that may still owe them benefits by establishing a public Retirement Savings Lost and Found Database through the SECURE 2.0 Act of 2022. This database serves as a centralized location to find lost or forgottenbenefits and get information on how to obtain those funds.Fiduciary Insurance5 Dangerous Fiduciary AssumptionsThe value of fiduciary liability insurance How plan fiduciaries can protect themselves from litigation Fiduciary liability insurance offers protection from claims | Invesco US

Guest: David Feller-Kopman, MD Cytology via thoracentesis remains the first-line approach for diagnosing malignant pleural effusion (MPE), yet its sensitivity is limited. leaving many patients undiagnosed or delayed in treatment. In this expert-led discussion, Dr. David Feller-Kopman explores the limitations of current diagnostic methods and the evolving role of biomarkers in enhancing both diagnostic accuracy and prognostic insight. Dr. Feller-Kopman is a Professor of Medicine at the Geisel School of Medicine at Dartmouth and the Chief of Pulmonary and Critical Care Medicine at Dartmouth-Hitchcock Medical Center, and he discussed this topic at the 2025 CHEST Annual Meeting.

In this episode of Behind the Wealth, Roger and Elias break down recent trends showing more 401(k) investors shifting toward cash and bonds — and what that might signal about market sentiment heading into year-end. They also discuss a new report showing record-high credit card debt among Gen X and Millennials, and how rising balances could affect financial freedom down the road. Then, listener Jason asks: “We're 45, debt-free, and investing heavily in our 401(k)s — should we put our extra savings into a taxable account or boost our contributions?” The team explores how tax diversification, accessibility, and flexibility all play a role — especially for anyone eyeing early retirement before age 59½. Tune in to learn how to balance security and opportunity, avoid emotional moves, and keep your wealth strategy adaptable for whatever comes next. Get started on your path to financial freedom. www.premieriwm.com  Securities and advisory services offered through LPL Financial, a registered investment advisor, member FINRA/SIPC. The opinions voiced in this show are for general information purposes only and are not intended to provide specific advice or recommendations for any individual. To determine which investments may be appropriate for you, consult with your attorney, accountant, and financial or tax advisor prior to investing. Premier Investments & Wealth Management and LPL Financial do not provide tax advice, please consult your tax professional. Economic forecasts set forth may not develop as predicted and there can be no guarantee that strategies promoted will be successful. There is no guarantee that a diversified portfolio will enhance overall returns or outperform a non-diversified portfolio. Diversification does not protect against market risk. All performance referenced All performance referenced is historical and is not a guarantee of future results. All indices are unmanaged and cannot be invested into directly. There is no assurance that the techniques and strategies discussed are suitable for all investors or will yield positive outcomes. The purchase of certain securities may be required to effect some of the strategies. Investing involves risks including possible loss of principal. Consult your tax professional about eligibility to Roth and Traditional IRA contributions. Contributions and earnings in a Roth IRA can be withdrawn without paying taxes and penalties if the account owner is at least 59 ½ and has held their Roth IRA for at least five years. Traditional IRA account owners have considerations to make before performing a Roth IRA conversion. These primarily include income tax consequences on the converted amount in the year of the conversion, withdrawal limitations from a Roth IRA, and income limitations for future contributions to a Roth IRA. In addition, if you are required to take a minimum distribution (RMD) in the year you convert, you must do so before converting to a Roth IRA. This information is not intended to be a substitute for specific individualized tax advice. We suggest that you discuss your specific tax issues with a qualified tax advisor.

As medicine shifts toward race-neutral lung function interpretation, new challenges emerge in ensuring equitable access to care. Dr. Ajay Sheshadri explores how race-neutral spirometry may impact patient selection for lung resection surgery and hematopoietic cell transplantation. Dr. Sheshadri is an Associate Professor in the Department of Pulmonary Medicine at the University of Texas MD Anderson Cancer Center.

Race-based spirometry adjustments have long influenced pulmonary risk assessments, often underestimating disease severity in Black patients. Hear from Dr. Ajay Sheshadri as he examines the historical misuse of race in lung function testing, explores race-neutral modeling in surgical risk prediction, and highlights the need for data-driven, continuous risk assessment tools in caring for patients with non-small cell lung cancer. Dr. Sheshadri is an Associate Professor in the Department of Pulmonary Medicine at the University of Texas MD Anderson Cancer Center.

Guest: Jaime Moore, MD Discussing weight with pediatric patients and families is a nuanced challenge shaped by stigma, culture, and access—but it's also a vital opportunity for early intervention. Dr. Jaime Moore shares how to build confidence, counter bias, and leverage practical tools and partnerships that support long-term, personalized care. Dr. Moore is an Assistant Professor of Pediatric Nutrition at the University of Colorado Anschutz School of Medicine and part of the Children's Hospital Colorado Lifestyle Medicine Program. She also spoke about this topic at the 2025 American Academy of Pediatrics (AAP) National Conference and Exhibition.

Host: Ryan Quigley New research presented at the 2025 American College of Rheumatology Convergence highlights a critical link between adverse childhood experiences and mental health outcomes in adolescents with childhood-onset systemic lupus erythematosus (cSLE). In this AudioAbstract, Ryan Quigley explores the findings, the implications for trauma-informed care, and the need to assess psychosocial history in managing cSLE.

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Sarah Sammons, MD About 40 percent of patients with metastatic HR+/HER2- breast cancer have an activating mutation in the PIK3CA gene,1,2 which plays a key role not only in tumor growth, but also in driving resistance to endocrine therapy.3-5 And while there are several FDA-approved PI3K pathway-targeted agents for patients with PIK3CA tumor mutations,6-8 they come with challenges, like modest efficacy and on-pathway effects.9-12 Given this unmet need, the ReDiscover trial evaluated the investigational agent RLY-2608 in combination with fulvestrant in in patients with PIK3CA-mutated HR+/HER2- aBC previously treated with a CDK4/6 inhibitor.13 Joining Dr. Charles Turck to share updated safety and efficacy data from the trial is Dr. Sarah Sammons, a Senior Physician at the Dana-Farber Cancer Institute and an Assistant Professor of Medicine at Harvard Medical School in Boston. References: Vasan N, Cantley LC, Vasan N, Cantley LC. At a crossroads: how to translate the roles of PI3K in oncogenic and metabolic signalling into improvements in cancer therapy. Nat Rev Clin Oncol. 2022;19(7):471-485. doi:10.1038/s41571-022-00633-1 Network TCGA. Comprehensive molecular portraits of human breast tumours. Nature. 2012;490(7418):61-70. doi:10.1038/nature11412 Saal LH, Johansson P, Holm K, et al. Poor prognosis in carcinoma is associated with a gene expression signature of aberrant PTEN tumor suppressor …

John asks if taking larger IRA withdrawals beyond his RMD to fund his daughter's Roth IRA makes sense as a strategy to reduce future RMDs, lower estate taxes, and pass on tax-free assets. Although this show does not provide specific tax, legal, or financial advice, you can engage Devin or John through their individual firms. 

In this episode of Behind the Wealth, Roger and Elias break down a few headlines that hit close to home, and the wallet. First up: the growing trend of people turning to AI for financial advice. Then, they turn to the rising number of student loan borrowers pressing “pause” on payments and what that means for household budgets and long-term goals. Finally, listener Rick asks a question many parents face: should you prioritize college savings or your own retirement? The team compares the pros and cons of each path and shares practical strategies to help families balance both — without shortchanging their future selves. If you've ever wondered how to invest in your children's education and your own financial independence, this conversation is for you. Get started on your path to financial freedom. www.premieriwm.com  Securities and advisory services offered through LPL Financial, a registered investment advisor, member FINRA/SIPC. The opinions voiced in this show are for general information purposes only and are not intended to provide specific advice or recommendations for any individual. To determine which investments may be appropriate for you, consult with your attorney, accountant, and financial or tax advisor prior to investing. Premier Investments & Wealth Management and LPL Financial do not provide tax advice, please consult your tax professional. Economic forecasts set forth may not develop as predicted and there can be no guarantee that strategies promoted will be successful. There is no guarantee that a diversified portfolio will enhance overall returns or outperform a non-diversified portfolio. Diversification does not protect against market risk. All performance referenced All performance referenced is historical and is not a guarantee of future results. All indices are unmanaged and cannot be invested into directly. There is no assurance that the techniques and strategies discussed are suitable for all investors or will yield positive outcomes. The purchase of certain securities may be required to effect some of the strategies. Investing involves risks including possible loss of principal. Consult your tax professional about eligibility to Roth and Traditional IRA contributions. Contributions and earnings in a Roth IRA can be withdrawn without paying taxes and penalties if the account owner is at least 59 ½ and has held their Roth IRA for at least five years. Traditional IRA account owners have considerations to make before performing a Roth IRA conversion. These primarily include income tax consequences on the converted amount in the year of the conversion, withdrawal limitations from a Roth IRA, and income limitations for future contributions to a Roth IRA. In addition, if you are required to take a minimum distribution (RMD) in the year you convert, you must do so before converting to a Roth IRA. This information is not intended to be a substitute for specific individualized tax advice. We suggest that you discuss your specific tax issues with a qualified tax advisor.

In this extended Friday Q&A episode, Don answers six listener-submitted questions covering a wide range of personal finance and investing topics. He kicks off with a fiery takedown of cryptocurrency as a viable asset class, arguing it's based on hype and the greater fool theory. Other questions explore whether pensions should count as fixed income in asset allocation, the performance of Dimensional and Avantis funds versus traditional index funds, the pros and cons of Collective Investment Trusts in 401(k)s, and the strategic timing of Social Security. He ends by clarifying a common misconception about RMDs and Secure Act 2.0. Expect smart insights, a little snark, and the kind of blunt honesty that's rare in financial media. 0:04 Listener Q&A returns with an extra dose—six questions this time 1:07 Confusing podcast scheduling clarified (sort of) 2:11 Crypto as an asset class? Don calls it “entirely invented” and dismantles the use case hype 4:32 If civilization collapses, your Bitcoin won't save you 6:06 Crypto = greater fool theory; Don braces for hate mail 7:30 Dimensional/Avantis vs. index funds—do the extra fees pay off? 9:13 A 15-year comparison: Dimensional Global Equity vs. VT 11:43 Should a pension count as fixed income? Don says no—it's a volatility game, not income 15:48 CITs (Collective Investment Trusts) in 401(k)s—cheaper, but less transparent 18:58 Index funds should be your benchmark; Don suspects this one's active 20:02 Claiming Social Security early to preserve Roth? Don says the math rarely supports it 23:59 Secure 2.0 and RMD confusion—born in 1959? You still take RMDs at 73, not 75 26:15 Tech keeps improving—Don urges retirees to stay sharp, stay curious Learn more about your ad choices. Visit megaphone.fm/adchoices

You asked, and we listened. In this episode of Coffee with Your Retirement Coach, we tackle one of the most common questions we get: "I'm 58 and have $2.4 million saved. Can I retire?" But as you'll hear, it's not just about the number on the page. We dive deep into what that figure could mean for your income, lifestyle, taxes, healthcare, and overall retirement vision. Join us as we break down the math behind the 4% rule and explore the often-overlooked factors that make or break a retirement plan—things like purpose, timing, Social Security strategy, and where and how you want to live. Plus, we share a real-life success story of a couple who made their beachside retirement dreams a reality.   **Timeline Summary** [0:06] - The $2.4 million question: Can I retire at 58? [1:25] - Why cash flow isn't the whole picture (think taxes and purpose) [2:38] - What a 4% withdrawal rate means for your retirement income [5:03] - Taking Social Security early: a controversial yet practical option [6:35] - Bridging the healthcare gap before Medicare kicks in [9:38] - The missing piece: lifestyle planning and location-based costs [13:08] - Real-life case: high-end travel vs. smart budgeting trade-offs [14:52] - Tax planning strategies to keep more of what you've earned [16:48] - The power of a retirement coach and building your dream team [18:08] - Client success story: from $2.4M to sunset strolls by the beach   **Final Thoughts** Retiring at 58 with $2.4 million? It's possible—but your success depends on your income needs, healthcare planning, tax strategy, and what kind of life you want to lead. If this episode hit close to home, subscribe, share it with a friend, and leave us a review. And as always, stay coachable!  

A 2025 study in Chest evaluated PREDICT, a precision medicine program at a large academic-community practice, designed to streamline testing and expand access to personalized treatment for non-small cell lung cancer (NSCLC). Hear from ReachMD's Ryan Quigley as he shares the key impacts of this approach and implications for care delivery.

In this episode of Behind the Wealth, we step back and look at what recent news and market conversations mean for long-term investors. From uncertainty in Washington to changing trends in the workplace, and even questions about where we may be in the market cycle, our goal is to help listeners put the headlines into context.   Securities and advisory services offered through LPL Financial, a registered investment advisor, member FINRA/SIPC. The opinions voiced in this show are for general information purposes only and are not intended to provide specific advice or recommendations for any individual. To determine which investments may be appropriate for you, consult with your attorney, accountant, and financial or tax advisor prior to investing. Premier Investments & Wealth Management and LPL Financial do not provide tax advice, please consult your tax professional. Economic forecasts set forth may not develop as predicted and there can be no guarantee that strategies promoted will be successful. There is no guarantee that a diversified portfolio will enhance overall returns or outperform a non-diversified portfolio. Diversification does not protect against market risk. All performance referenced All performance referenced is historical and is not a guarantee of future results. All indices are unmanaged and cannot be invested into directly. There is no assurance that the techniques and strategies discussed are suitable for all investors or will yield positive outcomes. The purchase of certain securities may be required to effect some of the strategies. Investing involves risks including possible loss of principal. Consult your tax professional about eligibility to Roth and Traditional IRA contributions. Contributions and earnings in a Roth IRA can be withdrawn without paying taxes and penalties if the account owner is at least 59 ½ and has held their Roth IRA for at least five years. Traditional IRA account owners have considerations to make before performing a Roth IRA conversion. These primarily include income tax consequences on the converted amount in the year of the conversion, withdrawal limitations from a Roth IRA, and income limitations for future contributions to a Roth IRA. In addition, if you are required to take a minimum distribution (RMD) in the year you convert, you must do so before converting to a Roth IRA. This information is not intended to be a substitute for specific individualized tax advice. We suggest that you discuss your specific tax issues with a qualified tax advisor.

What if you’re missing out on thousands by ignoring the latest tax law changes? This episode breaks down the new rules for Social Security, Roth conversions, and self-directed IRAs, plus why timing matters for year-end retirement moves. Damon Roberts and Matt Deaton explain how to take advantage of low tax rates, avoid costly RMD penalties, and make smart decisions before December 31st. For more information or to schedule a consultation, call 480-680-6868 or visit www.successinthenewretirement.com! Follow us on social media: Facebook | LinkedInSee omnystudio.com/listener for privacy information.

CME credits: 0.75 Valid until: 07-10-2026 Claim your CME credit at https://reachmd.com/programs/cme/Comprehensive-Biomarker-Testing-in-mBC-Informs-Clinical-Decision-Making/37332/ The PI3K-AKT-mTOR pathway is a crucial signaling network dysregulated in many cancers, promoting cell survival, growth, and proliferation, and often implicated in resistance to cancer therapies. Inhibition of this pathway by PI3K inhibitors disrupts a complex network of cellular processes that contribute to breast cancer, markedly reducing cell proliferation, promoting apoptosis, inhibiting angiogenesis, and ultimately preventing tumor formation and progression. In hormone receptor–positive (HR+), activating PIK3CA mutations occur in approximately 35% to 40% of patients and a variable prevalence across BC subtypes. Testing is thus crucial to ensure appropriate treatment selection. The development of PI3K-targeted agents may revolutionize the treatment landscape for HR+, HER2- metastatic breast cancer (mBC, and due to the recent approval of inavolisib, clinicians must be apprised of both the clinical evidence and best practices regarding the use of this agent. This activity has been designed to review the role of the PI3K-AKT-mTOR pathway in breast cancer, the importance of testing when making clinical decisions, and the role of PI3K-targeted therapies in HR+, HER- mBC.

CME credits: 0.75 Valid until: 07-10-2026 Claim your CME credit at https://reachmd.com/programs/cme/The-Future-of-PI3K-Inhibition-in-HR-HER2-Breast-Cancer/37339/ The PI3K-AKT-mTOR pathway is a crucial signaling network dysregulated in many cancers, promoting cell survival, growth, and proliferation, and often implicated in resistance to cancer therapies. Inhibition of this pathway by PI3K inhibitors disrupts a complex network of cellular processes that contribute to breast cancer, markedly reducing cell proliferation, promoting apoptosis, inhibiting angiogenesis, and ultimately preventing tumor formation and progression. In hormone receptor–positive (HR+), activating PIK3CA mutations occur in approximately 35% to 40% of patients and a variable prevalence across BC subtypes. Testing is thus crucial to ensure appropriate treatment selection. The development of PI3K-targeted agents may revolutionize the treatment landscape for HR+, HER2- metastatic breast cancer (mBC, and due to the recent approval of inavolisib, clinicians must be apprised of both the clinical evidence and best practices regarding the use of this agent. This activity has been designed to review the role of the PI3K-AKT-mTOR pathway in breast cancer, the importance of testing when making clinical decisions, and the role of PI3K-targeted therapies in HR+, HER- mBC.

CME credits: 0.75 Valid until: 07-10-2026 Claim your CME credit at https://reachmd.com/programs/cme/PI3K-Pathway-Inhibitors-Safety-and-Tolerability-Profiles/37338/ The PI3K-AKT-mTOR pathway is a crucial signaling network dysregulated in many cancers, promoting cell survival, growth, and proliferation, and often implicated in resistance to cancer therapies. Inhibition of this pathway by PI3K inhibitors disrupts a complex network of cellular processes that contribute to breast cancer, markedly reducing cell proliferation, promoting apoptosis, inhibiting angiogenesis, and ultimately preventing tumor formation and progression. In hormone receptor–positive (HR+), activating PIK3CA mutations occur in approximately 35% to 40% of patients and a variable prevalence across BC subtypes. Testing is thus crucial to ensure appropriate treatment selection. The development of PI3K-targeted agents may revolutionize the treatment landscape for HR+, HER2- metastatic breast cancer (mBC, and due to the recent approval of inavolisib, clinicians must be apprised of both the clinical evidence and best practices regarding the use of this agent. This activity has been designed to review the role of the PI3K-AKT-mTOR pathway in breast cancer, the importance of testing when making clinical decisions, and the role of PI3K-targeted therapies in HR+, HER- mBC.

CME credits: 0.75 Valid until: 07-10-2026 Claim your CME credit at https://reachmd.com/programs/cme/Case-in-Point-Applying-PI3K-Combinations-in-Early-Recurrent-HR-HER2-mBC/37336/ The PI3K-AKT-mTOR pathway is a crucial signaling network dysregulated in many cancers, promoting cell survival, growth, and proliferation, and often implicated in resistance to cancer therapies. Inhibition of this pathway by PI3K inhibitors disrupts a complex network of cellular processes that contribute to breast cancer, markedly reducing cell proliferation, promoting apoptosis, inhibiting angiogenesis, and ultimately preventing tumor formation and progression. In hormone receptor–positive (HR+), activating PIK3CA mutations occur in approximately 35% to 40% of patients and a variable prevalence across BC subtypes. Testing is thus crucial to ensure appropriate treatment selection. The development of PI3K-targeted agents may revolutionize the treatment landscape for HR+, HER2- metastatic breast cancer (mBC, and due to the recent approval of inavolisib, clinicians must be apprised of both the clinical evidence and best practices regarding the use of this agent. This activity has been designed to review the role of the PI3K-AKT-mTOR pathway in breast cancer, the importance of testing when making clinical decisions, and the role of PI3K-targeted therapies in HR+, HER- mBC.

CME credits: 0.75 Valid until: 07-10-2026 Claim your CME credit at https://reachmd.com/programs/cme/Triple-Threat-Key-Data-on-Simultaneous-Estrogen-CDK4-6-and-PI3K-Inhibition-in-mBC/37335/ The PI3K-AKT-mTOR pathway is a crucial signaling network dysregulated in many cancers, promoting cell survival, growth, and proliferation, and often implicated in resistance to cancer therapies. Inhibition of this pathway by PI3K inhibitors disrupts a complex network of cellular processes that contribute to breast cancer, markedly reducing cell proliferation, promoting apoptosis, inhibiting angiogenesis, and ultimately preventing tumor formation and progression. In hormone receptor–positive (HR+), activating PIK3CA mutations occur in approximately 35% to 40% of patients and a variable prevalence across BC subtypes. Testing is thus crucial to ensure appropriate treatment selection. The development of PI3K-targeted agents may revolutionize the treatment landscape for HR+, HER2- metastatic breast cancer (mBC, and due to the recent approval of inavolisib, clinicians must be apprised of both the clinical evidence and best practices regarding the use of this agent. This activity has been designed to review the role of the PI3K-AKT-mTOR pathway in breast cancer, the importance of testing when making clinical decisions, and the role of PI3K-targeted therapies in HR+, HER- mBC.

CME credits: 0.75 Valid until: 07-10-2026 Claim your CME credit at https://reachmd.com/programs/cme/Double-Take-Pivotal-Data-Evaluating-PI3K-Inhibitor-Endocrine-Therapy-Regimens-in-mBC/37333/ The PI3K-AKT-mTOR pathway is a crucial signaling network dysregulated in many cancers, promoting cell survival, growth, and proliferation, and often implicated in resistance to cancer therapies. Inhibition of this pathway by PI3K inhibitors disrupts a complex network of cellular processes that contribute to breast cancer, markedly reducing cell proliferation, promoting apoptosis, inhibiting angiogenesis, and ultimately preventing tumor formation and progression. In hormone receptor–positive (HR+), activating PIK3CA mutations occur in approximately 35% to 40% of patients and a variable prevalence across BC subtypes. Testing is thus crucial to ensure appropriate treatment selection. The development of PI3K-targeted agents may revolutionize the treatment landscape for HR+, HER2- metastatic breast cancer (mBC, and due to the recent approval of inavolisib, clinicians must be apprised of both the clinical evidence and best practices regarding the use of this agent. This activity has been designed to review the role of the PI3K-AKT-mTOR pathway in breast cancer, the importance of testing when making clinical decisions, and the role of PI3K-targeted therapies in HR+, HER- mBC.

CME credits: 0.75 Valid until: 07-10-2026 Claim your CME credit at https://reachmd.com/programs/cme/Understanding-Endocrine-Resistance-in-HR-HER2-mBC/37323/ The PI3K-AKT-mTOR pathway is a crucial signaling network dysregulated in many cancers, promoting cell survival, growth, and proliferation, and often implicated in resistance to cancer therapies. Inhibition of this pathway by PI3K inhibitors disrupts a complex network of cellular processes that contribute to breast cancer, markedly reducing cell proliferation, promoting apoptosis, inhibiting angiogenesis, and ultimately preventing tumor formation and progression. In hormone receptor–positive (HR+), activating PIK3CA mutations occur in approximately 35% to 40% of patients and a variable prevalence across BC subtypes. Testing is thus crucial to ensure appropriate treatment selection. The development of PI3K-targeted agents may revolutionize the treatment landscape for HR+, HER2- metastatic breast cancer (mBC, and due to the recent approval of inavolisib, clinicians must be apprised of both the clinical evidence and best practices regarding the use of this agent. This activity has been designed to review the role of the PI3K-AKT-mTOR pathway in breast cancer, the importance of testing when making clinical decisions, and the role of PI3K-targeted therapies in HR+, HER- mBC.

CME credits: 0.75 Valid until: 07-10-2026 Claim your CME credit at https://reachmd.com/programs/cme/PI3K-Pathway-inhibition-in-HR-HER2-mBC-Mechanistic-Insights/37329/ The PI3K-AKT-mTOR pathway is a crucial signaling network dysregulated in many cancers, promoting cell survival, growth, and proliferation, and often implicated in resistance to cancer therapies. Inhibition of this pathway by PI3K inhibitors disrupts a complex network of cellular processes that contribute to breast cancer, markedly reducing cell proliferation, promoting apoptosis, inhibiting angiogenesis, and ultimately preventing tumor formation and progression. In hormone receptor–positive (HR+), activating PIK3CA mutations occur in approximately 35% to 40% of patients and a variable prevalence across BC subtypes. Testing is thus crucial to ensure appropriate treatment selection. The development of PI3K-targeted agents may revolutionize the treatment landscape for HR+, HER2- metastatic breast cancer (mBC, and due to the recent approval of inavolisib, clinicians must be apprised of both the clinical evidence and best practices regarding the use of this agent. This activity has been designed to review the role of the PI3K-AKT-mTOR pathway in breast cancer, the importance of testing when making clinical decisions, and the role of PI3K-targeted therapies in HR+, HER- mBC.

When your health fails, families often bear the emotional and financial cost. In this episode of Protect Your Assets, David Hollander dives into long-term care planning, from real-life caregiving challenges to understanding the true cost of in-home and facility care. Learn how to evaluate caregivers, what long-term care can cost in California, and how veterans or their spouses may qualify for the VA’s Aid and Attendance benefit to help pay for care. David also breaks down key RMD strategies for retirees age 73 and older, including how a QLAC can reduce taxable income and delay distributions. Plus, a brief market update and what to watch for as year-end approaches. You can send your questions to questions@pyaradio.com for a chance to be answered on air. Catch up on past episodes: http://pyaradio.com Liberty Group website: https://libertygroupllc.com/ Attend an event: www.pyaevents.com Schedule a complimentary 15-minute consultation: https://calendly.com/libertygroupllc/scheduleacall/ See omnystudio.com/listener for privacy information.

When your health fails, families often bear the emotional and financial cost. In this episode of Protect Your Assets, David Hollander dives into long-term care planning, from real-life caregiving challenges to understanding the true cost of in-home and facility care. Learn how to evaluate caregivers, what long-term care can cost in California, and how veterans or their spouses may qualify for the VA’s Aid and Attendance benefit to help pay for care. David also breaks down key RMD strategies for retirees age 73 and older, including how a QLAC can reduce taxable income and delay distributions. Plus, a brief market update and what to watch for as year-end approaches. You can send your questions to questions@pyaradio.com for a chance to be answered on air. Catch up on past episodes: http://pyaradio.com Liberty Group website: https://libertygroupllc.com/ Attend an event: www.pyaevents.com Schedule a complimentary 15-minute consultation: https://calendly.com/libertygroupllc/scheduleacall/ See omnystudio.com/listener for privacy information.

Jim and Chris discuss listener questions on Social Security spousal benefits, a listener PSA on IRMAA repayment silence, IRMAA reduction eligibility and planning considerations, and a PSA on how 60-day rollover Roth conversions affect year-end RMD calculations.(7:45) A listener points out a possible error from a recent episode and looks for clarification whether delaying benefits […] The post Social Security, Roth Conversions, RMD Calculations: Q&A #2540 appeared first on The Retirement and IRA Show.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Charles Kahi, MD Computer-aided detection systems (CADe) are transforming adenoma detection and enhancing colonoscopy quality. Dr. Peter Buch sits down with Dr. Charles Kahi to unpack the latest American Gastroenterological Association (AGA) guideline, evidence from randomized controlled trials, and the practical implications of integrating AI tools into clinical practice. Dr. Kahi is a Professor of Medicine at Indiana University School of Medicine, and he helped develop the AGA Living Clinical Practice Guideline on Computer-Aided Detection-Assisted Colonoscopy, which was published in Gastroenterology in 2025.

Medicare isn't always as free as you think. In this episode, we'll explain IRMAA—the income-based surcharge that can raise your premiums and shrink your Social Security check. Learn what triggers it, who's most at risk, and a few smart planning moves to help keep more money in your pocket.   Helpful Information: PFG Website: https://www.pfgprivatewealth.com/ Contact: 813-286-7776 Email: info@pfgprivatewealth.com   Disclaimer: PFG Private Wealth Management, LLC is an SEC Registered Investment Advisor. Information presented is for educational purposes only and does not intend to make an offer or solicitation for the sale or purchase of any specific securities, investments, or investment strategies. The topics and information discussed during this podcast are not intended to provide tax or legal advice. Investments involve risk, and unless otherwise stated, are not guaranteed. Be sure to first consult with a qualified financial advisor and/or tax professional before implementing any strategy discussed on this podcast. Past performance is not indicative of future performance. Insurance products and services are offered and sold through individually licensed and appointed insurance agents.   Episode Transcript Think Medicare is free once you hit 65. Well, not quite. If your income's too high, there's a hidden surcharge that can quietly shrink your social security check by thousands a year. It's called IRMAA, and we're going to talk about that today here on Retirement Planning Redefined. Hey everybody, welcome into the podcast. Thanks for hanging out with John and Nick and myself as we talk, investing, finance and retirement. And guys, we're going to talk about Aunt Irmaa this week instead of Uncle Sam. Seems like there's these two relatives that got their hand in your pocket. I've always been taught to call IRMAA, the Aunt Irmaa that comes by and pinches your cheeks really hard instead of the cool one that gives you candy when you're a kid. So we're going to talk about IRMAA, and what it is and why it exists and all that good stuff this week. How you doing, John?   John: I'm doing all right. How are you?   Speaker 1: Hanging in there. Doing pretty good. Looking forward to chatting with you guys about this, learning a little bit about what is IRMAA and what does it do to us. And Nick, my friend, how are you?   Nick: Pretty good. Staying busy in the red zone for wedding planning and all that kind of stuff. And we are in football season so-   Speaker 1: There you go.   Nick: ... I've had to adjust my sleep schedule a little bit.   Speaker 1: Exactly. So between planning and football, you're burning the candle at both ends.   John: Monday is a little slower for Nick-   Speaker 1: Little slower. Gotcha.   John: ... the last three weeks, especially with the Bills, how good they look.   Speaker 1: Yeah, for sure. Yeah, my Lions look pretty good on Monday night this pastime.   Nick: You sure do.   Speaker 1: Yeah. Well, let's get into the conversation a little bit, guys. What is IRMAA and why does it exist? Whoever wants to start?   Nick: All right, I'll go ahead and start. So essentially IRMAA is an acronym that refers to essentially an income related monthly adjustment for the cost of Medicare part B and D. So essentially back in '03, as the plans both Medicare and social security continually get reevaluated due to the pressure that they're under from the standpoint of expenses and flows in, they decided to put this into place where to kind of tier it where people that were earning income currently, so if you're single earning income greater than 106,000 or married filing jointly earning income greater than 212,000, the premiums for part B start to go up. So this is something that we've dealt with quite a bit with clients.   It's based upon modified adjusted gross income, which nobody knows what that means, but it is a term that everybody's heard or most people have heard. As a reminder part A, there is no premium charge as long as you worked you or your spouse or former spouse work 40 quarters. This applies to the part B and part D. And it's not a penalty from the perspective of how they look at it. It's not like you're doing something wrong. It's more along the lines of almost just like tax brackets where lower income, lower bracket, the same thing on this, lower income, lower premium.   Speaker 1: Gotcha. Yeah. And that interesting piece that catches people is that it's a two year ago look back. So they're going to adjust it based on what you made two years back. So as you move into retirement, that could feel a little... You're like, wait a minute, why is this going up? But they're looking at maybe the last couple of years.   Nick: Yeah, for sure, and there is a form that people can fill out. We oftentimes help people fill them out. I think we've done it twice in the last two weeks where you can basically contest it. So especially if you've just retired and you were previously high income and they look back those two years, you can let them know that, "Hey, moving forward, this is going to be my income, it's going to be reduced."   Speaker 1: Gotcha.   Nick: Explain why, and oftentimes you can get it amended moving forward.   Speaker 1: Okay. And John, so hit us with some numbers here. So who's at risk paying the most? Obviously, there's some data in here and Nick explained that the more you make, but what's some of those guidelines?   John: Yeah. So just looking at the base levels here, single father who's modified adjusted gross income is over 106,000. Then they're going to be at risk of basically, we know it's not a penalty, but basically paying more for part B.   Speaker 1: Right.   John: And if you're married filing jointly, it's over 212,000. And the more you make, there's different phases of it where you might pay $74 and then it'll go up a little bit more as the modified adjusted gross income is up.   Speaker 1: Yeah, we'll talk about that here in just a second. So obviously it's not hard to get to 212 for a lot of couples, so this could impact a lot of people obviously.   John: Yeah, so no, we do see this coming up quite a bit lately, and where we see it is when someone hits RMD age, where if they've been sending so much money into pre-tax buckets and all of a sudden it's, hey, you have a 50, $60,000 RMD, you have two social securities, and with the cost of living adjustments the last five or six years, some of these social security payments are getting pretty large compared to what they were about six or seven years ago, with the run-up in the market, these are getting really large. So that's where we start to really see it come into play is high income earners have been saving a lot into their pre-tax accounts, and all of a sudden, it's time to pull out of those. You can be forced into this.   Speaker 1: Gotcha. Yeah.   Nick: A couple other areas I would say too is if there's a situation where for whatever reason there's one spouse and a married filing jointly situation where one spouse is still working, other spouse is retired, and we've seen people, especially if they do it before they come and speak with us where they look and see like, "Oh, I should only pay the one 70 a month for part B," and not realizing that there is this test and the retired spouse goes on Medicare instead of going on their spouse that's still working's plan, health plan and not realizing that the income is going to take them over the threshold and they're going to pay more on part B than they would have if they were just a part of the plan at the work. And then...   Speaker 1: It's kind of sizable too, right? I mean, you're talking-   Nick: Oh, yeah.   Speaker 1: ... it could be some big chunks of money here.   Nick: Yeah, for sure. I mean, especially if you get to... So single 167 to 200K is almost an additional $300 a month for part B and 57 on part D. So that's another $4,000 a year on an expense aside. Married filing jointly at that same amount, 334 to 400, and we'll see issues like this too, where maybe there's a small business owner or self-employed or maybe them in one or two employees and their premiums, they had been running through the business and they attempted to switch over to Medicare at 65 and/or fed some issues with people almost being, not necessarily forced, but almost forced that way with their policies when they are over the age of 65, if it's a small or a one person individual plan and not realizing that, again, that their premiums are going to be substantially higher than they expected. So it definitely happens more than people realize.   Speaker 1: Yeah. Well, John, you talked about what triggers it, a lot of the times being RMDs, people moving into that. What are some other things that might trigger IRMAA?   John: Yeah. So what we've seen in the past where people run into trouble, and this is where if you listen to our podcast, we always talk about being able to prepare for unexpected events and having a balance. But let's say someone has most of their money in pre-tax and their dream home comes up and they really want to buy it and they got to jump through some hoops to potentially get it. They can afford it, but the majority of the money is in the pre-tax account and they got to pull it out, maybe a down payment or whatever it might be that could put your income up more than you expected. The unforeseen medical expenses where all of a sudden things are going along great, and emergency happens, you need to pull 20, 30 grand out to cover some medical expenses. That happened. I mean, oddly enough, I just had someone I think have to pull out almost 40, 50 grand for dental expenses unexpectedly, which as everyone knows typically not covered by any type of insurance, even if you have dental insurance, it's not covering that-   Speaker 1: Right. Right.   John: ... what you need that for. So things come up, family emergencies. Another scenario I've seen in the past, just trying to give people some examples of things to consider before they make any moves that are permanent. Home sales, let's say if you had a second property, you've been depreciating it and all of a sudden it's like, "Yeah, it's time to sell this," or you're forced to sell it. There could be some pretty large capital gains that would actually put you above these thresholds as well.   Speaker 1: Yeah. So basically it's income generating items, right? That's what's going to trigger it. So I guess the opposite being said, Nick, is that things like Roth IRA withdrawals for example, wouldn't trigger it, right? Because it's tax, it's not against your income.   Nick: Yeah, Roth IRA withdrawals, HSA distributions, income that you might receive from a reverse mortgage and then a life insurance policy loan are all things that could be helpful. One thing I'll say additionally is in line with this and with some of the reasons that will cause this. We've had clients quite a bunch recently where they've got substantial non-qualified money, so non-retirement money and they're looking to get a new home and/or they're in the process of selling their current home, looking at the new home, trying to avoid costs associated with mortgage, et cetera. And instead of selling the holdings, which oftentimes, especially over the last 3, 4, 5 years have substantial gains built in that then have this cascading effect that would impact this and that sort of thing where we've been using essentially what's called a pledge asset line or a line of credit on non-retirement accounts.   So they can take a loan bridge that period of time, get the access to the funds, have to pay interest, but it's non-taxable transaction, and then use that money, do it, wait for the sale of the original property and then just pay back the loan. And that's a perfect example of where with IRMAA where that could be an unforeseen consequence of somebody just maybe doing a traditional way, "Hey, I've got this money here, I'm just going to cash out. Yeah, I'll have to pay taxes." But that's in their case or their thought process, they might prefer that versus having to get a mortgage or paying a bunch of extra fees and expenses associated with the mortgage or having to go through the process of underwriting, et cetera, and this additional impact on IRMAA for a year.   Speaker 1: Gotcha.   Nick: So yeah, it's just one of those things where it's almost like a multiplier effect that falls down and just kind of a snowball going downhill.   Speaker 1: Well, let's talk a few strategies guys as we wrap up this week on ways to maybe avoid or at least lower IRMAA, again, if it's income related. Obviously, John, you talked about the RMDs. Obviously, conversion could be one way to do that, a Roth conversion. Yeah?   John: Yeah. And this goes back to the stressing, making sure that you have a plan in place to adjust to any situation. So what we find is let's say someone retires 62, 64 when we're doing the plan, we can estimate their taxes, what they're going to be now and in the future. And if we see a period where it's like five or six, seven years before RMD age is like, "Hey, we could start doing some Roth conversions here," and what we'll do is we'll estimate how much of a conversion to do to make sure they don't jump up into a higher tax bracket. So what that will do, ultimately, it'll give them a little bit more tax-free income so we don't trigger the IRMAA and then also it will lower their RMD. So IRMAA doesn't get triggered by that. So again, that's a great way to try to avoid any future IRMAA surprises basically.   Speaker 1: Yeah. Yeah. And Nick, what's some other ones besides that? I mean, obviously, that's going to be probably a bigger one for many people, but I mean like tax loss harvesting, things of that nature.   Nick: Yeah. So if you have non-qualified assets and you're working with somebody that manages your account and/or you're handling it yourself, you want to make sure that you're taking advantage of tax loss harvesting in that account. Inevitably, any portfolio is going to have some winners and losers at the end of the year. If you can sell off some of the losers to offset previously recognized gains and/or get yourself some losses on paper to use to offset future gains, that's something that you can absolutely do. The qualified charitable deduction, being able to send money directly from your IRA qualified charitable distribution to reduce your taxable portion of the RMD that you have to take can be a great tool as well.   So you just want to... We always talk about with clients that it's really essential, should we have the time, you really want to have the three buckets of assets to generate income and retirement, those being pre-tax Roth and unqualified assets. And this is kind of a perfect example. I had a conversation with a client earlier, them just wrapping their mind around, hey, a distribution from a non-retirement account doesn't necessarily mean that it's taxable. And oftentimes those are some of the most flexible accounts and could provide quite a bit of a lot of different options on how to take income and reduce some of these hidden expenses like IRMAA.   Speaker 1: Yeah. So, I mean, it's a sneaky one that can get some folks, and again, we want to make sure we're being as efficient as possible with anything, and that's why a good strategy for your situation is important. I mean, these things can exist to affect all of us, but how you handle it, how you work with it, and based on your income and so on and so forth, and how you're pulling money and where you're pulling money and when you're pulling money can go a long way. So it's something worthwhile to make sure you're sitting down and having a conversation about that hidden Medicare penalty, if you will. However, you want to look at it. It's still something that frustrates people.   So if you need some help, get yourself onto the calendar. Don't let it sneak up on you and eat into your income. Reach out to Nick and John and have a chat today at pfgprivatewealth.com, that's pfgprivatewealth.com or call them at 813-286-7776. That's 813-286-7776. Or again, just go to pfgprivatewealth.com, schedule that 15-minute chat, have that 15-minute chat and subscribe to the podcast on whatever app you enjoy using, Apple, Spotify, so on and so forth. Guys, thanks for hanging out and breaking it down. Always appreciate it. We'll see you next time here on Retirement Planning Redefined with John and Nick.  

In Case You Missed It...

In this episode of Behind the Wealth, we dig into two common retirement questions that often come up in conversations with clients and listeners. First, we look at Roth conversions in light of the “Big Beautiful Bill” that extended lower tax rates. Many people rushed to convert before the Tax Cuts & Jobs Act was set to expire—so do conversions still make sense now? We'll discuss the considerations, trade-offs, and planning angles to think about before making any moves. Next, we tackle the question: “I'm 42—how much should I have saved?” We walk through recent data on retirement account balances by age, highlight why averages and medians can be misleading, and explain why comparing yourself to benchmarks may not give you the full picture. Instead, we'll share what actually matters: building a personal plan that reflects your lifestyle, income sources, expenses, and retirement goals. Whether you're weighing tax strategies or measuring your savings progress, this conversation is about helping you think more clearly about your own financial story. Securities and advisory services offered through LPL Financial, a registered investment advisor, member FINRA/SIPC. The opinions voiced in this show are for general information purposes only and are not intended to provide specific advice or recommendations for any individual. To determine which investments may be appropriate for you, consult with your attorney, accountant, and financial or tax advisor prior to investing. Premier Investments & Wealth Management and LPL Financial do not provide tax advice, please consult your tax professional. Economic forecasts set forth may not develop as predicted and there can be no guarantee that strategies promoted will be successful. There is no guarantee that a diversified portfolio will enhance overall returns or outperform a non-diversified portfolio. Diversification does not protect against market risk. All performance referenced All performance referenced is historical and is not a guarantee of future results. All indices are unmanaged and cannot be invested into directly. There is no assurance that the techniques and strategies discussed are suitable for all investors or will yield positive outcomes. The purchase of certain securities may be required to effect some of the strategies. Investing involves risks including possible loss of principal. Consult your tax professional about eligibility to Roth and Traditional IRA contributions. Contributions and earnings in a Roth IRA can be withdrawn without paying taxes and penalties if the account owner is at least 59 ½ and has held their Roth IRA for at least five years. Traditional IRA account owners have considerations to make before performing a Roth IRA conversion. These primarily include income tax consequences on the converted amount in the year of the conversion, withdrawal limitations from a Roth IRA, and income limitations for future contributions to a Roth IRA. In addition, if you are required to take a minimum distribution (RMD) in the year you convert, you must do so before converting to a Roth IRA. This information is not intended to be a substitute for specific individualized tax advice. We suggest that you discuss your specific tax issues with a qualified tax advisor.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Alexa Weingarden, MD PhD Probiotic use in gastroenterology remains a complex and evolving topic, shaped by variable evidence and growing patient demand. Dr. Peter Buch sits down with Dr. Alexa Weingarden to review current data, discuss distinctions between probiotic-related therapies, and explore the clinical utility of microbiome testing. Dr. Weingarden is an Assistant Professor of Gastroenterology, Hepatology, and Nutrition at the University of Minnesota Medical School.

Guest: Alexis Leonard Sickle cell disease management traditionally involves two primary treatment approaches: disease-modifying therapies and curative strategies. While disease-modifying therapies can help reduce complications associated with the disease, they do not correct or fix them, which is why curative strategies are appealing to some patients and physicians. Join Dr. Alexis Leonard as she discusses the current management landscape for sickle cell disease, including disease-modifying treatments, curative strategies, and potential gene therapies. Dr. Leonard works in the Department of Hematology at St. Jude's Hospital in Memphis, Tennessee.

What would you do if your company sold, your stock was cashed out, and you suddenly found yourself with $5 million in hand? In this episode, Nic and I dive into the reality of experiencing a once-in-a-lifetime windfall and all the opportunities — and challenges — that come with it.   We explore the first critical steps you need to take before making big financial decisions, from understanding the tax implications to planning for long-term income and security. Whether you're dreaming of retiring tomorrow or just trying to figure out what Uncle Sam's cut will be, this conversation will give you a grounded perspective on how to approach sudden wealth wisely.   Timeline Summary [0:45] – Setting the stage: your company sells, your stock cashes out, and a $5M windfall arrives [3:22] – Why this might be the biggest financial event of your life [6:18] – The first place to start: navigating taxes before spending [9:40] – Real-world examples: from tech startups to natural food brands [12:55] – Breaking down what a $5M payout can actually mean for your future income [16:10] – Retirement readiness: could you really stop working today? [20:45] – Building a strategy to make wealth last a lifetime   Links & Resources Learn more at [https://YourRetirementCoach.com](https://yourretirementcoach.com/) Connect with Nic on LinkedIn: https://www.linkedin.com/in/nicyeomans/ Schedule a consultation: https://www.yourretirementcoach.com/free-consultation   If you enjoyed this episode, please rate, follow, and leave a review. It really helps spread the word so more listeners can find Coffee with Your Retirement Coach!  

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: David Levinthal, MD, PhD Cyclic vomiting syndrome (CVS) is often underdiagnosed in adults due to its episodic nature and symptom overlap with other conditions. Dr. David Levinthal joins Dr. Peter Buch to explore key diagnostic criteria, key differences between CVS and cannabinoid hyperemesis syndrome (CHS), and evidence-based treatment strategies. Dr. Levinthal is the Director of the UPMC Neurogastroenterology and Motility Center and an Associate Professor of Medicine at the University of Pittsburgh School of Medicine.

Jim and Chris discuss listener questions on IRMAA reductions and Roth-conversion effects, widow filing status and IRMAA, in-kind stock Roth conversions and RMD transfers, annuity RMD interactions, and 60-day rollover mail timing. (7:45) George asks whether an approved SSA Form 44 that reduced 2025 IRMAA will also govern next year, how a large 2026 Roth […] The post IRMAA, Widow Status, Roth Conversions, Annuity RMDs, and Rollovers: Q&A #2538 appeared first on The Retirement and IRA Show.

Don't run out of money before you run out of life—build a written retirement income plan you can count on.Large, poorly timed withdrawals and RMD surprises can wreck a portfolio—separate income from growth and let a tax plan, not emotions, drive your decisions.

How much you need to retire quiz: https://bit.ly/Adam-OlsonAvoid Retirement Taxes So Well It Feels Like Cheating8319121.1Most retirees unknowingly hand over 20–30% of their retirement income to taxes every year. But the truth is—smart retirees often pay less than 5%. The difference comes down to retirement tax strategies that are 100% legal, yet so effective they feel like cheating.In this video, I'll reveal how to avoid retirement taxes and build a tax-free retirement plan using strategies that go far beyond conventional advice. You'll learn:✅ The hidden retirement tax mistakes most people make, including RMD tax planning traps, Social Security tax strategies, Medicare IRMAA surcharges, and state income tax surprises that eat away at your savings.✅ Why traditional retirement tax advice often fails—and how tax-efficient retirement planning can save you thousands every year.✅ The power of the Roth conversion strategy to eliminate required minimum distributions and create lifetime tax-free retirement income.✅ How geographic arbitrage (moving to a tax-friendly state like Florida, Texas, or Nevada) can instantly save 5–10% of your income.✅ The overlooked benefits of municipal bonds that generate completely tax-free income and don't trigger Social Security taxes or Medicare surcharges.✅ Why the Health Savings Account (HSA) retirement strategy is the only account with triple tax advantages—and how to use it for healthcare and tax-free wealth building.✅ My complete Red Zone Retirement Plan framework that coordinates Roth conversions, state tax planning, municipal bond ladders, and HSAs into a powerful tax-efficient retirement strategy.All of these tax strategies are fully legal, built into the tax code, and proven to reduce lifetime tax burdens. Done correctly, they can transform your finances and create the confidence of a near-zero-tax retirement.

Don and Tom break down the overhyped expectations around recent market returns, referencing Jason Zweig's analysis of 230 years of stock market data. They emphasize that spending and saving habits matter more than chasing 15% returns, and explain why realistic planning using a 3–6% real return assumption over 30-year rolling periods is more prudent. They also tackle questions about RMD strategies from Vanguard IRAs and the TSP's F and G bond funds. The show ends with a tongue-in-cheek breakdown of NFL team valuations—yes, the Raiders rank surprisingly high. 0:04 Welcome, fatuousness defined, and realistic investing begins 0:52 Why you shouldn't expect 15% returns forever—even if you got them 1:52 What Jason Zweig's long-term data reveals about stock returns 2:51 Bogle warned us not to expect high returns—now what? 4:16 Spending and saving: more important than investing performance 5:08 Don's “prepaid gains” analogy for future expectations 7:00 Real market returns since 1793—spoiler: they're not 15% 8:58 Stocks might only beat inflation by 3%—and that's still a win 9:45 Start saving early: waiting until 50 is a losing game 10:18 How to plan with lower expected returns (realistic scenarios) 11:56 Use expected return to guide your savings rate (3% = save 20%) 13:45 “You weren't smart. You were lucky.” Now diversify. 15:31 Tom's wife dreads football season—Don celebrates Chiefs loss 18:42 Listener RMD question: Which ETFs get tapped at Vanguard? 19:29 Bonds are back: fixed income up ~6% this year 20:24 Rebalancing vs. just selling: how to handle RMDs smartly 21:04 Raiders rank #4 in NFL valuations… but why? 24:36 Top NFL team values: Cowboys rule, Cardinals drool 27:27 Arizona sports: low attendance, low valuations 28:59 TSP question: F fund vs. G fund—what to use, when 30:25 Don favors the G fund for simplicity and ballast 31:45 Tom and Don disagree—F fund might return more, but… 32:26 Don's vegetable-spiked coffee and Justin's final TSP allocation 34:13 Listener Barbara has multiple annuities—Don and Tom say, “Yikes” 35:47 Why you probably talked to a salesperson, not a fiduciary 37:04 The free Appella consultation is steak-free and no-pressure Learn more about your ad choices. Visit megaphone.fm/adchoices

How much you need to retire quiz: https://bit.ly/Adam-OlsonAvoid Retirement Taxes So Well It Feels Like Cheating8319121.1Most retirees unknowingly hand over 20–30% of their retirement income to taxes every year. But the truth is—smart retirees often pay less than 5%. The difference comes down to retirement tax strategies that are 100% legal, yet so effective they feel like cheating.In this video, I'll reveal how to avoid retirement taxes and build a tax-free retirement plan using strategies that go far beyond conventional advice. You'll learn:✅ The hidden retirement tax mistakes most people make, including RMD tax planning traps, Social Security tax strategies, Medicare IRMAA surcharges, and state income tax surprises that eat away at your savings.✅ Why traditional retirement tax advice often fails—and how tax-efficient retirement planning can save you thousands every year.✅ The power of the Roth conversion strategy to eliminate required minimum distributions and create lifetime tax-free retirement income.✅ How geographic arbitrage (moving to a tax-friendly state like Florida, Texas, or Nevada) can instantly save 5–10% of your income.✅ The overlooked benefits of municipal bonds that generate completely tax-free income and don't trigger Social Security taxes or Medicare surcharges.✅ Why the Health Savings Account (HSA) retirement strategy is the only account with triple tax advantages—and how to use it for healthcare and tax-free wealth building.✅ My complete Red Zone Retirement Plan framework that coordinates Roth conversions, state tax planning, municipal bond ladders, and HSAs into a powerful tax-efficient retirement strategy.All of these tax strategies are fully legal, built into the tax code, and proven to reduce lifetime tax burdens. Done correctly, they can transform your finances and create the confidence of a near-zero-tax retirement.