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Planning Your CRNA School And Living Expenses With Natalie A. Kratzer, ChFC®, CLF®, CLTC®, FIC (she/her)

CRNA S2 90 | CRNA School Expenses

Preparation is key to success. And what better way to prepare for CRNA school than to be financially ready? To make sure you know what you are getting into, Thrivent’s Financial Advisor, Natalie Kratzer, sits with Jenny Finnell as she goes into detail with everything you need to know about CRNA school and living expenses. Natalie goes through different financial assistance options you can take advantage of and provides specific information that will help you make the best decision. She shares valuable insights on how self-assessment and recognizing your spending leaks can help you cut back on expenses as early as your application stage.

Learn how to map out your CRNA journey from the moment you apply until you land that job and start earning back the hard work that you put in. Tune in!

Get access to planning tools, mock interviews, valuable CRNA Faculty guidance, and mapped-out courses that have been proven to accelerate your CRNA success! Become a member of CRNA School Prep Academy here! https://www.crnaschoolprepacademy.com/join

Book a mock interview, personal statement, resume, and more at http://www.NursesTeachNurses.com

Join the CSPA email list here! https://www.cspaedu.com/podcast-email

Send Jenny an email or make a podcast request! Hello@CRNASchoolPrepAcademy.com

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Planning Your CRNA School And Living Expenses With Natalie A. Kratzer, ChFC®, CLF®, CLTC®, FIC (she/her)

The question in this episode is, how to pay for CRNA school? We have a very special guest, Natalie Kratzer. Welcome, Natalie.

Thank you. Good to be here.

It’s been too long, I will say. For those of you who are CSPA members and you recognize Natalie’s name, she has been working with us since the beginning. In fact, back in 2019, I originally reached out to Natalie because I had been mentoring students inside our Facebook Community. A common pain point was, how do I pay for CRNA school? How do I pay back all these loans? Am I going to be in debt for the rest of my life?

It’s funny because I was like, “I can share my story and my experience but I am by no means a financial consultant.” I did that but I was like, “I know I need someone who has more expertise and who can help in this area because I want to make sure that I’m not misleading anyone or guiding them down the wrong path.” I know that you know as well as I do that who you take advice from is critical in your success and a lot of things in life. No one means harm by giving you misadvice but it’s the natural result that not everyone knows everything.

They can speak from their own experience but sometimes that’s a very limited viewpoint. Natalie brings a wealth of knowledge to you guys. She has a sister-in-law who’s a CRNA and that’s how she has become very passionate about her work. She pretty much exclusively works with CRNAs and SRNAs only. She also works with New York College and works with those students. She knows your story, what you’re up against, and what the financial looks like after school. Again, we’re going to discuss how to pay for CRNA school, some of the things maybe to watch out for, and some of the common questions that Natalie gets from SRNAs and nurses who are pursuing this career path, so welcome.

Thank you so very much. It has been so much fun watching CSPA grow and become the most amazing way for nurses to truly understand what this journey looks like, to get into school and become a CRNA. I’m so glad to be a part of it.

Honestly, I’m so grateful to have you too. You’re right. You’ve been helping  from the beginning and it’s been almost three years coming in 2023.

Crazy, isn’t it?

It’s crazy. Let’s go ahead and get into the good stuff. In this episode, we’re going to discuss some common questions that students tend to ask. We do financial quarterly webinars that Natalie hosts inside CRNA School Prep Academy for our students. If you are a CSPA student, you will have access to this quarterly webinar. Make sure to mark your calendar. We will announce the 2023 schedule here relatively soon.

Students can attend these webinars and ask her questions. That’s amazing that you have a financial consultant to talk to prior to school, so don’t hesitate to ever ask questions. Let’s get into how you pay for CRNA school and all of the living expenses that go with it.

That’s the extra little piece you added on there and often gets people. There’s tuition, some of the other fees and expenses that come along with school itself, the program, but then there are all those living expenses as well. As Jenny shared in the intro, every single one of you is coming to school in a different circumstance with a different set of baggage but everybody is so different. That’s where it can be dangerous to take somebody else’s word for it. Even if on the surface they look similar to where you are coming from, you don’t know what’s going on in the background with their finances, how they grew up with the money, or any of those kinds of things.

It’s very important to take it for what it is for you, your family, and your situation. I broke this out into two different sections. There are the traditional ways to pay for school, so we’ll start with that, then there are some of the more non-traditional ways as well. In traditional ways, the very first one that almost everybody thinks of is Federal Student Loans, which has been a major hot topic in the news here as of late.

Federal student lending is very different at the graduate school level than for undergraduates. If I had $1 for every time I heard a nurse say, “I have no idea what I’m doing with regard to loans,” you are not alone if you don’t know. It’s like a whole different animal at the grad level. I’m going to keep this a little bit high level because we want to give you all the parts. There are two basic types of Federal student graduate loans.

The 1st is the Unsubsidized Direct Loan and the 2nd is the Grad PLUS Loan. These loans are very easy for a student to get. You’re completing the FAFSA, the Free Application For Student Aid, and that is basically all you have to do in order to get eligibility for that type of lending. There’s no credit check, you don’t need a co-signer, and things of that nature aren’t going to cause any hiccups for you. There are a few extra little things here and there. You do need to be a US citizen and some things like that come into play depending again on your situation.

The piece with the federal student lending that sometimes makes people go, “Do I want to go that route?” is that they do have set interest rates. Those reset every July 1st and that interest rate then stays put for the whole following year. They also come with origination fees. It’s almost like a fee to be able to take the loan itself and that fee gets added to your principal. When the interest starts accruing, it’s accruing on not the amount that you took but the amount that you took plus that origination fee.

That can be the part where it feels a little yucky sometimes. Now, we’ve been in this administrative forbearance and it feels like forever now. We are thinking that the most recent extension will be it, and that is supposed to sunset here starting in January of 2023. At that point, interest will start accruing. I’ll bring this up here in a little while as well. Some of you may be familiar from undergrad if you had subsidized loans.

Subsidized loans don’t accrue interest while you’re in deferment. That doesn’t exist for graduate school loans. For graduates, it will all be accruing again outside of this administrative forbearance that we’re in. That’ll start right away. To give you an idea of rates in 2022 for the Federal Direct are 6.54% and the origination fee is 1.057%. For the Grad PLUS, it’s a whole percent higher at 7.54% for the interest rate and the origination fee is quite a bit higher at 4.228%. That’s the one that a lot of times, when we can with planning that we’re doing with students, we’re trying to often avoid that one where and when we can. It feels nasty.

Honestly, 6.54%, when I went, it was over 8%. I know it’s been lower than that even in the past years and the fact that the students who have been in school for the last few years have had no interest is amazing. A backstory, I paid for my undergrad. I had close to $90,000 of undergrad debt when I went into CRNA school. I had paid for them. The minimum payments were paid, mind you, because I was making $55,000 a year. I couldn’t afford to pay more than the minimum.

I did that for three years by the time I started school, and then I deferred them. About a year after graduation, I went and looked at my loans and realized I owed over 100% of the loans that I’d been paying on because all the interest came back. Essentially, all the payments I made were gone. I remember crying because I was like, “Three years of paying on my loans completely knocked out in one year of having interest accrue.” The thing is, if you don’t have a choice, you don’t have a choice but you’re right. You have to pay attention to the interest rate. Six percent may not seem big but when you’re talking $50,000 to $60,000 plus, it is significant.

It adds up fast. The same with the origination fee. It builds and builds upon itself. Sticking with the traditional ways to pay for school, private loans are another option that is out there. Now, I will say private loans are not going to have some of the benefits that we’ve seen with this administrative forbearance here over the last few years. I know a few students who have been kicking themselves a little bit because they’re like, “I took a private loan and my private loan didn’t get the deferral that everybody has been seeing.” It’s the 0% that we’ve seen for the last few years.

Private loans will not have some of the benefits like we've seen with this administrative forbearance here over the last few years. Click To Tweet

At the same time, their rates are probably locked in a lot lower because, as you said, for the last few years, rates have been so much lower. It’s not been at zero but when the forbearance ends, they’re going to be at maybe 3% instead of 6% or 7%. Private loans are definitely an option. In almost every case, you will need a co-signer. A private lender is not going to approve you all by your lonesome without income.

With the majority of programs, you’re probably not working or working extremely minimally, so you’re going to want a very strong co-signer. What I mean by strong is a good credit score and a good debt-to-income ratio. Those are your two biggies. When it comes to a co-signer, a lot of people automatically think that needs to be a mom, dad, or spouse. I would say those are probably the typical people but there are also other loved ones or strong people in your life who are willing to invest in you in that way.

When I say invest in you, sometimes people think that there is a straight-up monetary thing that they need to be doing. Probably not for a co-signer because the co-signer, if you happen to default on those loans, is who the lending institution is going to come back to. Let’s be real. Most of you are going to graduate with good jobs, so the possibility of you defaulting is probably very slim to none.

I always say if you can, take a look at the private loans. I was looking with a student. She’s in year two and some circumstances changed for her. She decided she was going to take some loans where she wasn’t going to initially. She is married, so she’s got a good strong co-signer. We were taking a look at a health profession private loan. There’s a handful of those out there from different lenders.

There are variable rate offers as well as fixed rate offers. Again, those are the things you’re going to want to talk to a professional about to understand what’s the difference between those. Given both options that they were looking at from this one lender, it could have been as low as 4% up to 9% and change without origination fees.

Even if it’s the same 7.54% that the Grad PLUS is at, there’s no origination fee attached to that, so it is cheaper. With private student lending, you’re still going to have that deferral while you’re in school, so you don’t have any of those kinds of issues where you need to start making payment right away or anything like that.

On one of my private loans, I remember I had this letter saying, “You have to start making payments.” I’m like, “Wait, no.” I dropped below whatever they considered a full-time student in school but they didn’t understand that I was in clinical. It was not a big deal. It stressed me out at that time but I called my program director and I’m like, “I need help.” The program director himself wrote a letter stating that I was technically full-time because of the residency, so they put me back in deferral. No problem but it was stressful nonetheless.

I’ve always used a lot of private loans because, as you said, as long as you have good credit they’re affordable. My husband worked in school. He must have but I don’t remember. These are the things that I don’t remember but I know we mostly took out private loans. I took out all the government loans I could get but we also took out private loans. When I was done, my private loans were the best interest rates.

They were 2.5% or 3% and my government loans were 8%. I didn’t think about this until a year and a half after school, which was a mistake. I finally reconsolidated all my government loans into private loans to cut my interest rate in half and set it on a five-year payment plan. I set it and forget it and they’re gone now.

You make up a good point that reminded me of something I wanted to share. You said it on the side. One thing with private lending sometimes students don’t understand is that the private lender is going to talk to your financial aid department. It’s not like a whole separate thing over here. Your financial aid department is still going to say, “Yes, private student lender, they are here. They are a student and they do qualify for lending when it’s a true student loan.” Sometimes people will take other kinds of loans to pay for school. That would be outside of that but when you’re doing a private student loan, they are going to communicate back and forth. I like for people to understand how that works.

CRNA S2 90 | CRNA School Expenses
CRNA School Expenses: One thing with private lending that sometimes students don’t understand is that the private lender will talk to your financial aid department.

That’s a great point; I was shocked that they knew that I dropped below because they clearly were communicating with my college that, “Jenny is now only taking eight credit hours.” I’m like, “I have all the clinical.” They do chat often. People always ask this question too, what should I have in savings prior to starting school?

We joke a little bit in our world and the financial planning world that there are so many it-depends answers. This is for sure an it-depends answer because cash is another way to be able to pay for school. I do have a decent amount of students who come to us. They have been able to, through whatever circumstances, save a boatload of money or they’ve chosen one of those programs that is much further down on the expense scale for the actual program itself.

Sometimes, I’ve got people who are like, “No, I’m not going to take any loans. Here we are, I’m going to pay for it.” It depends on what your circumstances are leading up to. A few things that I run into with students leading up to school: The travel money is not what it was a few years ago, so that looks very different for my students now than it did years ago. That can limit. You can pick up extra shifts to try and save but again, you can only do so much. If you have a family and kids, you can cut back. You can limit but there’s only so far you can go.

Even if you’re in application mode or pre-application mode, I recommend taking a look at your spending. Nobody likes the word budget but take a look at your spending and figure out where is your money going. It can be extremely eye-opening to start recognizing and realizing, “I didn’t realize we were spending that much more on this specific thing.

Starbucks and Amazon get picked on all the time, but it is a thing. Everybody has their place where, we call them spending leaks, where the money seems to keep dripping out. Take a look at what that is for you and then how you save. You spend less money than what’s coming in the door. It’s not rocket science but it is hard. Do what you can to save as much as you can. A big piece to that too is what are you coming in with in terms of debts? As you shared, you had the undergrad debt in a decent chunk hanging out there.

Oftentimes, we’ll all have different circumstances. We may have people who went through a divorce and divorces are expensive. We may have people who got stuck with a house and couldn’t sell it. That wasn’t a thing for a few years but we’re starting to get back to that again. There are all these different things. I 100% believe that if you’ve got any higher interest rate loans hanging out there, ignore undergrad student loans for a minute if you’ve got credit cards, cars, or any of those bills that are not going to stop when you go to school.

Credit card company doesn’t care that you went to school. They’re still going to be looking for their payment. Those often have those high-interest rates where, if those sit for three years and you’re making minimums, talk about getting nasty. It’s worse than what you described as your undergrad debt. Take care of those first and foremost then look to figure out if you can save.

It doesn’t make a whole lot of sense to put money in the bank that you’re saving. We’re starting to see interest go up a little bit on high-yield savings and things like that. I think high-yield savings are averaging right around 2.15% now. Somewhere in that ballpark. That’s nothing if you’ve got 22% interest on a credit card. I encourage you to take care of the debts first then come back and focus on the savings. Undergrad outstanding loans and things can go back and forth. Your story is a great example of like, “It would’ve been nice if you could have paid that off before school.”

Take care of the debts first and then come back and focus on the savings. Click To Tweet

As you said, you couldn’t. That wasn’t a reality at that time for you and your situation. A lot of people are in that same boat. Of all the things that you have to let go and not pay off prior to school, undergrad loans are that thing because those are going to be deferred once you’re a full-time student again. It’s great if you can pay them off but, of all the things, leave those. If you think about, “Do I save money or pay off my undergrad student loans,” some people will be in different camps on this but I look at the interest rate.

What’s the cost of the money that you’re borrowing? If your undergrad loans have okay interest rates compared to what we talked about with the rates and the origination fee on graduate school loans, it might make more sense for you to put a little extra money in the bank so you’re taking less graduate school loan and let your lower interest rate undergrad loan grow on you a little bit. Does that make sense?

That makes sense. The way I always felt, and we didn’t have a lot, I managed to save close to $10,000. We didn’t have kids. We had a dog. He was high maintenance. He had a lot of vet bills. He was immunocompromised. He was always at the vet and I had an old car. I had a twelve-year-old Nissan Sentra that I called Old Betty. She was routinely failing. She’s a rough bucket. She sat out at Ohio State for five years but we did our best. We cut the cable. We never bought food or went out to eat unless we got taken out to dinner by my in-laws or my parents for like, birthdays.

We cut back as much as we could that way but the reason why I think some cash is nice is because the unexpected will happen. You should have credit cards but as you said, “Don’t carry balances on those credit cards that you can’t pay off because the interest rate is astronomically high.” For me, the cash was my fund of like, “What am I going to do? I have this $2,000 charge. I have to have a way to pay the credit card.”

I kept the cash as reserves if I had to make a charge. The beauty of a credit card is it gives you an entire extra month to pay for it. It gives you more time and then you earn points. I love my credit card because, in some way, to cut back, I get some money back at the end of the year. It could be a couple of hundred dollars but that’s still a couple of hundred dollars. We kept some cash but I’ll tell you, I was only in school for 27 months and I blew through that $10,000.

Part of it was I committed to being in a wedding. She was my best friend. In fact, Deanna, who helps with CSPA, I was her maid of honor. I cannot say no to my best friend. We’ve been friends for over two decades. It was that important to me. I spent money that I shouldn’t have spent to go to an out-of-state wedding and all that other stuff. All that being said, I had to make choices on how I spent that money. When I was done with school, I remember my first paycheck wasn’t going to be until the end of October and I graduated in August.

We luckily had good credit. I had a Discover card that I opened that was 0% interest for eighteen months. With some credit cards, you can write yourself a check. I wrote myself a check, “Jenny Finnell, $10,000. Maxing out and it’s eighteen months. Here you go Mr. Chase Bank, cash it.” They did and we lived off that $10,000 until I got my first paycheck. Essentially, my first few paychecks were like, “Let’s pay off this credit card.”

You’re right. One of the things my team and I do with students who work with us one-on-one is a thing we call The Semester Breakdown. We literally lay out the nine semesters, some programs are structured slightly differently, or your quarters and we say, “What’s the cost for this semester? What do we think your living expenses are going to look like? Are you going to have clinical travel and housing that we need to figure out? What are all the things?”

We figure out what assets we have to be able to pay for it. Do we have savings? Are we going to be able to take private loans? Do we have the lucky ones who have maybe gifts coming from family or whatever it may be? We start to map that out. As what you explained, we tell our students all the time, “We don’t want you to get to the end of the program and have nothing.” It’s because you’ve got to take boards and get credentialed. Those things take forever and you have your time until the first paycheck gets into your bank. This is why Jenny and I do what we do now. We want people to learn from the mistakes we’ve seen.

CRNA S2 90 | CRNA School Expenses
CRNA School Expenses: We don’t want you to get to the end of the program and have nothing because you have to take boards and get credentialed, which takes forever.

Don’t do as I say or don’t do as I do. What is it?

Do as I say, not as I did. Those are all things that we need to look at. I realized we didn’t share some of the non-traditional ways to pay for school. I’ll talk super high level but as we’re laying that map out for people, we’re plugging those things in as they come up. One thing is there are lots of programs and/or hospital systems and/or anesthesia groups out there that are offering money to students very early on in their programs. I call them front-loaded sign-on bonuses where you’re committing before school starts or maybe a year into school to go work for that program later. It’s not something you do lightly.

Thanks for saying that. Talk to CRNAs at work there, by the way.

Do not go blindly into that one. That can be a great way. I’ve got students that are getting stipends every month. I have one student. He’s going to graduate with more money and savings than he started the program by way of some scholarships he got, the stipends, and some sign-on bonuses. It’s amazing. The military is another option that can be very similar. It’s not for everybody. That’s a commitment that you’re making but for sure, that can provide an amazing income stream to you. The program can be very incredible from a financial standpoint. Again, know what you’re walking into.

The last one that I didn’t mention is using home equity. It’s starting to look a little different with this current rising interest rate environment that we’re in. I do often have students, usually, it’s ones who are coming into a program after working more than a couple of years. Most of those are people who’ve had a home for maybe 10 to 15 years and have been able to plow a lot of money towards their mortgage.

Over the last couple of years, we’ve seen equity go up significantly in most areas around our country. You now have quite a bit of money that you can access via your house and that equity that you’ve built up. That can be another way to take a look at alternative ways to get money to pay for school. Again, it looks a little different. Those home equity lines of credit or HELOCs, the rates on those now are not what they were six months ago even. Do your homework, talk to experts, and make sure you know what you’re walking into and how it compares to the other options. That can be another great way to consider paying for school if you have that means.

Make sure you know what you're walking into and how it compares to the other options. Click To Tweet

Those are all great. I’m glad you pointed all those out. I took a stipend when I was in school. As Natalie spoke to, I was about a year into my program and I had a job. If you find out about these things, you’re probably like, “How do I know this?” It’s word of mouth going to clinical and talking to CRNAs and other students. I’ve always spoken about how important networking is. This is a small community.

You can pretty much find anyone anywhere in the entire country by asking someone if they know someone who knows someone. That’s key to finding these little contracts. That being said, I did not take that stipend without first talking to CRNAs who work there and SRNAs who rotated there. It was a hospital that I didn’t rotate at ever. I requested to rotate there and I did get to rotate there because I wanted to see it before I committed.

I knew that they would be able to do what I wanted, which was to do open heart after I graduated. I took that knowing if they would be able to support me in the way I needed and it was a great decision. I equally know people who went into the same stipend and broke that contract because they weren’t happy there. Trust me when I say they’ll come after that, with interest sometimes too.

Have somebody read those contracts who knows and can understand employment contracts. I’ve seen some very interesting ones over the last several years in particular. You’re absolutely right. Some of them want the money paid back in a super crazy short amount of time with a boatload of interest and others are a little more forgiving but know what you’re walking into. Great advice, Jenny.

They’d have lawyers that come after you for sure. It can get ugly. We talked about cash savings and I mentioned I saved about $10,000. The next question I would love to hear your thoughts on is, how much would you say you would see on average students enter CRNA school with cash savings?

I would say the average may be a little higher than what you were able to do. Probably around $40,000 or $50,000 is average. I certainly have clients who walk in with nothing. None at all. It scares me a little bit but we figure it out. I have others who, as I said earlier, walk in with such an amount that they can pay for the program in its entirety with cash. It is all over the place but I agree with how you shared your story.

I prefer when students can walk in with some liquid cash on hand at least as an emergency fund if nothing else. There are a lot of “rule of thumb” things that you might see on the internet, TikTok, or whatever. They go out the window for you all once you’re a student because you’re in such a different situation. I’ve said that so many times about the planning we do for our SRNAs. If a colleague of mine who had no idea about the SRNA experience was sitting next to me and listening to the advice I was giving, they’d be like, “What is she talking about?”

It’s so different. We have to plan very differently for the short-term little hiccup on the career journey. Also, make sure that we’re ready because we know what it’s going to look like for the most part after school and once that paycheck starts coming in. It’s all sorts of different things but that rule of thumb for emergency savings is typically 3 to 6 months’ worth of your expenses. I’d say that’s still an okay goal for you planning for school.

Again, not everybody is going to be able to do that, especially depending on your rep. I love these stories. Many CSPA students have these stories. “I applied because they told me to get the application in and all of a sudden, I got an interview and acceptance. I never expected it.” Sometimes, that can be hard to turn down if you got that offer. I know, Richard, I’ve heard him talk so many times about this too. He and I are very much on the same page.

It doesn’t make sense to wait and delay that CRNA income for another whole year. For most people, probably not. I’ve had a small handful where when we dug in, again based on certain family situations and things, it made sense for them to defer but for most people, the cost of waiting is much more expensive than the cost of buckling down, figuring it out, and getting through it.

For most people, the cost of waiting is much more expensive than the cost of buckling down, figuring it out, and getting through it. Click To Tweet

That was like our situation. We didn’t have a lot of money. I graduated when the last recession took place, which was in 2008 or 2009. My poor husband didn’t have a job for the most part. I graduated and I was like, “I’m your sugar mama. I didn’t plan for this to work out that way.” It was hard. We paid for our own wedding. Back then, we paid $30,000 that we had to pay off. We couldn’t get any family help, so we had that. We did the best we could but 3 to 6 months would be amazing.

Honestly, now that I know what I’ve seen back when the pandemic happened and the ORs were shut down for however long. I remember thinking, “Why, Jenny?” It’s because we had the ability to set aside months of income. Nobody in their wildest dreams ever thought that their job is going to be like, “You can’t come in today.” “What? We’re necessary.” It was like, “No, you’re not. It’s carpal tunnel. You’re not necessary.”

It was crazy to me to feel like I never, in my wildest dreams, thought as a CRNA I would ever not be needed. I worked at a surgery center but a lot of my colleagues who were at level-one trauma centers sped up. They didn’t take a pay cut at all but I worked at a surgery center. That was different. I think 3 to 6 months, whether you’re in CRNA school or not, is a good standard to set in general.

If you can’t, do the best you can. It’ll be okay. As Natalie said, somebody has got to strap in for the ride and you can figure it out. Also, one thing that I noticed when I was in school, it was hard because you see your classmates who do have more money. As I said, one of my classmates and a good friend of mine, I don’t know what her parents call it. What do parents have funds for their children? I don’t even have one of those.

Probably a 529 plan.

It was like a savings account or something. Anyways, she was getting funds from that.

Like a trust fund or something?

A trust fund. Thank you. I couldn’t think of the term. My other friend had been a nurse for over ten years so she had good savings. They were going and buying all these things and Starbucks. I’m thinking, “I got nickels. I can’t do that.” It’s hard when you play the comparison game. You’re like, “They can afford it, I should afford it,” but it’s not the case.

Keep it in mind, just because some of your classmates are in a different situation, as hard as it is to say, “I want to go out and go to dinner with you guys and go to the sushi restaurant but that’s not my budget.” Maybe go hang out and get a drink but then go home. It does stink when you can’t participate in certain things because you can’t afford them, but that’s the reality. Sometimes, you’re going to see your classmates not have the same situation as you. You’re going to have to smile and get through it.

I hate to say this but sometimes the people who you see spending money don’t have it either. They’re getting themselves into deeper, uglier, and murkier waters sometimes because they don’t have the ability to do what you said and create a boundary for themselves. Thankfully, most of you are too busy to have to make those decisions anyway when you’re in school.

When I was in school, I tried. It was called Stitch Fix. It was like the big fad back then. I think it’s still around but I was like, “I don’t have time to shop anymore. I’m going to have it sent to my doorstep.” That was a huge mistake. After the second box, I canceled. I was like, “I do not have the money for this and this is dangerous.” It is so hard, especially for nurses who have been working for 4 or 5 years and they’re so used to their spending habits.

That’s the hard part.

It’s like you created this habit. You’re used to being able to spend $500 a month on play money, concerts, dinners, buying new tops, new clothes, new hats, and new shoes. Sometimes you’re going to put on your shoes and it’s worn out before you use the next pair.

I don’t think she’d mind me sharing this. My sister-in-law and my brother used to say, “We lived on frozen meatballs and pancakes for three years.” You figure out where you can back off. Not to continue beating this dead horse but many were travel nursing and you didn’t have to think about the money. It was coming in and you were fine for the most part.

Look at your spending as soon as you know CRNA is even a thing. If it's even in your plan at all, start to back your spending down slowly. Click To Tweet

That’s why I say take a look at the spending as soon as you know CRNA is even a thing. If it’s even in your plan at all, start to back yourself down slowly. It feels so much better when you can ease into it as opposed to that slamming into the wall like, “There’s no money coming in. What do I do now?” Especially for single people. I have quite a few who are able to move back in with mom and dad or move in with a brother or somebody like that. For those who are completely on their own, it can be very jarring. Start early and figure out what are the things that don’t mean as much to you as getting to CRNA. I say it that way.

The other thing too with that is any of the things you’re spending or income from a spouse or somebody else during school, anything you spend money on, it better be important enough to you to know that you’re paying interest on that money because you’re taking out a loan. It didn’t cost this much. It cost this much because it had an origination fee maybe and it’s accruing interest for three years. I hate to harp on the budget thing but it’s important.

Mint is a good app if you’re not familiar with Mint. It’s pretty popular these days. It allows you to see where your money is going and what you’re spending your money on in categories, which is nice. I agree, easing into it is better. I was still in couponing mode. For me, it didn’t feel like a big deal of cut because we were already penny-pinching, couponing, and cognizant of what we were spending because we didn’t have a lot of money prior to starting school.

As I spoke to you, my car was fourteen years old when I was done with school. My husband is the same thing. He had a paid-off car. Again, we’re already frugal prior, so it didn’t feel like a giant slap in the face prior to school. Although, the Stitch Fix thing. I occasionally have little moments like that where I’m like, “I could be cool,” and I’m like, “I’m not cool. I can’t do that. Not yet. Maybe someday,” then you hold out.

I love the fact that you mention that everyone’s situation is different. Let’s maybe talk about what other factors they should consider when considering how much cash they should have. You mentioned travel expenses and whether they can live with mom. I lived with my parents for a few days out of the week for the first few months of the program so I was traveling 2 hours each way to go to class 4 times a week. Instead of getting a hotel, I shacked up with mom and dad again when I was in my twenties. It was nice. They made me food.

I think looking at things like where can I cut back? Is there the ability to move in with mom and dad? Are there abilities to room with somebody else from the program? I even have 2 clients who are going to 2 different programs that are in the same town but they knew each other from ICU experience. They’re rooming together because they’re like, “We’re both right here and we can save.” Any of those things that you can look at, yet again, I’ve got plenty of students who are coming to the program with kids.

It’s a little hard in a room with mom and dad or a room with a roommate when you got kiddos. Also, the fur babies. Considering the cost of the program and the cost of living where your program is, I know, Jenny, you have that amazing resource that talks about the lower-cost programs that are out there. Look at those things and think through, is this in an area where I have people I can live with?

Is this in an area where I’m not going to have to commute as far? The ability to graduate and survive the program is much more important than the name that’s on the degree. I know you’ve said that before and I still feel funny saying it. You got to be able to pass boards. That’s the bottom line. If your program costs $120,000 or $30,000, it doesn’t matter.

I’m glad you brought that up because so many people hype up, “That school has ranked. That school is this.” They have the name and the prestige. It does not matter. You are a CRNA. What matters more to any hospital system or any CRNA you’re going to work with, is who are you and how would I work with you. Are you going to show up? Are you going to offer me a break? Are you going to be a team player? That matters. I don’t care whether you went to Puerto Rico, Akron, Yale, or Harvard. Be cognizant of that. I’m not saying don’t go to a top-name school if that’s in your dream to do or if you can afford it. Whatever makes sense.

Don’t pick it solely based on that and take on way more debt than you would’ve otherwise just because of the name. I love all that. I know we already touched on whether you should be off undergrad before you go back to school. I think that that depends. As you said, you have to look at the numbers. What makes sense interest rate-wise? For me, it made sense to defer because I had too much anyways. I equally think that despite some debt, you should still have some cash because you could accumulate debt unexpectedly on a credit card that you want to be able to pay. I’m guilty of this and I’m not saying you should do it. I’m saying it’s a survival mode and I can survive.

I equally watched my parents do this. I love you, mom and dad. My mom would bounce checks to different banks so other checks wouldn’t bounce. I’m not saying do that but I did that with my credit cards. It’s funny how much you take from your own childhood. What you see and what you learn, you bring into your adult world. I know it’s not okay but I did it even in my undergrad years to survive whereas back then, it was easy to get credit. I’d open a credit card, do the 0%, 18 months, and charge it up. Open a new credit card, transfer the balance, and away I went.

I’m not saying that’s what you should do but at the end of the day, the reason why you need cash is because you don’t want to get yourself in that situation. It can get ugly really fast, especially if you don’t have good credit. It’s hard to recover credit too. Let’s change the mood for our last question because this is another thing that I know you get asked a lot too. Before I get off topic, I thought of something I just remembered.

If you’re looking for a job in school, I’m not saying you want to work full-time but I have an amazing opportunity that I want to take this moment to spread now. One of the reasons why I started NTN or Nurses Teach Nurses is because one of the things we had been doing inside CRNA School Prep Academy was I was essentially hiring current students to mentor by doing mock interviews, essay edits, and resume edits because I’m one person.

There are over 2,000 of you inside CSPA. I could not handle you all. I love you but I couldn’t do it. I’m one person. I was like, “Why not have the students do it? They clearly made it. They know what it takes to be successful in your resume and essay interview.” It has worked out beautifully to where now we open Nurses Teach Nurses. You can go apply, become a service provider and mentor and give back. Most students find this incredibly rewarding. It’s flexible. You can do an hour here, an hour there.

Some of these students are earning $1,000 a month in school. Maybe they’re doing eight mock interviews. It’s 1 or 2 a week, whatever they can fit in. It’s an hour of their time versus committing to an eight-hour shift at the hospital. It’s huge. I’m saying go check out Nurses Teach Nurses. Let’s get into the last question, which is, what are your options for health insurance while in CRNA school?

Again, everybody is coming into this with different circumstances. I’ll give the overall rundown on all the possibilities that could exist depending on where you’re at. Some of you are coming in super young. If you are age 26 or under, you could still have the ability to be on mom or dad’s insurance through their employer, which can be huge. The one thing that can be a little challenging is oftentimes if I’m seeing students come into the program with that ability at some point during the program, they’re aging out of that.

If that is you, I always recommend getting the details on when you’re going to get booted from that. With some employer plan insurance, it could be the month in which you turn 26, the day you turn 26, or the end of the year in which you turn 26. Know what it is so you can be prepared but that’s for sure an option.

Another option maybe goes without saying that sometimes people forget, if you are married, look at your spouse. Even if you’re not married but you have a significant other and you two are cohabitating and have lots of integration, a lot more employers are offering domestic partner health insurance. I’m seeing it more, which is wonderful and beautiful. That could be an option as well. It may mean you have to go get something notarized or you have to have a bill with both of your names on it. Check with the HR department to know what hoop you have to jump through but it’s definitely an option.

A lot of programs do have student health insurance plans. Some don’t have that as an option at all. Some do, some are good, and some are a little cringy. Do the math. Figure out what it’s going to cost you. Don’t look at the overarching cost. They usually put it as a per semester. It’s going to be X. Divide that out by the number of months because I have seen some that are well over $400 a month.

CRNA S2 90 | CRNA School Expenses
CRNA School Expenses: Do the math. Figure out what it will cost to determine whether or not that student health insurance is reasonable. Don’t just look at the overarching cost.

That’s a lot of money for a health insurance plan that may or may not be half decent. Know what your deductible is, know what the co-insurance is, and know what the actual cost per month is to be able to determine whether or not that student health insurance is reasonable. It will be easy. All you’re going to say is, “I signed up for this.” Also, most times, they wrap it into your tuition so it gets paid immediately. You don’t get a bill so it doesn’t feel like it costs $400 a month because you’re not writing a check for $400 a month or whatever but it’s still costing you that much.

Yet again, as I said earlier, that is now money that is getting accrued interest while you’re in school because it got paid for by loan. It can be good. I have seen some that are quite wonderful. They’ve got low deductibles and they’re not horribly expensive. The other thing with student health insurance is that a lot of times they’re going to want you to go to the clinic on campus. Again, some of you have different situations. For older students, not that it’s just older students who have health issues but if you have any health issues existing already, that may not be your ideal to go to a campus clinic.

When you’re nineteen and in undergrad, it’s not usually as big a deal as when you’re a grown adult. It feels very different. Check out all those details. Depending on what state you’re going to be living in or where your program is, Medicaid could be a good option. The challenge with Medicaid is that every state is different in how they qualify you whether it’s even there, adults can be eligible, or just children. Do some research to understand what the options are in the state where you’re going to be.

If you do have Medicaid available as a possibility, it could be that they’re going to be looking at income as a qualifying factor or income and savings as a qualifying factor. Those are all going to be the things that you want to check out. Again, understand what the hoops are and what the criteria are. If you’re in a state where Medicaid is an option, there could also be some other helpful things. The SNAP Program or food stamps, you may be eligible for.

I always say these are programs that you paid into, especially if you’ve lived in that state most of your working years. If you’ve paid into those programs, they’re there for you. That’s what these are there for. There’s also heating. I can’t remember what they’re called. In every state, they will call it something different but there could be stipends that you could get towards costs for heating your home as well. Look into all the options that are out there depending on where you live. Medicaid can be a great possibility because it’s free.

CRNA S2 90 | CRNA School Expenses
CRNA School Expenses: Look into all the options that are out there. Depending on where you live, Medicaid can be a great possibility because it’s free.

Do they go off taxes? When you apply to it, they’d probably go by your previous year’s taxes but if you have no income and you started school, I feel like it would be unfair to judge you based on the previous year’s income.

Thankfully, most do not go based on tax year or tax files. You don’t want to apply while working though. You don’t want to hit that button until you are no longer working. Wait until you’re no longer working and you no longer have income going forward. That’s what they’ll take a look at.

That’s good to know.

The last option that we typically throw out there, again, is not for everybody but it’s this concept of a health share program. These have popped up a little more commonly here over the last few years. It’s not health insurance. I always say it’s like old school. I have one of my clients. She calls it the farmer plan because of this analogy that I use.

It’s like when communities here in the states were first developing. It was almost all farm communities like a lot of them. What would farmers do, they would all throw a little bit of money into the kitty. If something happen to a family member or they had a bad crop that year, whatever the situation was, then the farmers collectively would say, “The money from the kitty goes to this guy or gal.”

That’s how a health share program works. You pay a little bit of “premium” each month. If you were going to the doctor because you had a cold or something like that, you’re going to be a cash payer. You’re going to say, “I don’t have health insurance. I’m a cash payer.” If you have a situation where you have a very significant issue arises, whether it’s because of an accident, an illness, or whatever it may be, typically, with most of the programs that I’ve seen, $500 is the amount. As long as whatever has happened to you is accumulating bills over $500, you’re going to end up getting reimbursed for the cost of your issue, test, surgery, or whatever it may be. Those can be handy.

I’ll throw out a few names. There are a bunch of these but Christian Healthcare Ministries is one I see a lot, OneShare Health, MPowering Benefits, and Altrua HealthShare. There’s a whole slew of them. Do pay attention though because some of them are affiliated around sometimes religion. Check out what their criteria are. Some are around other types of criteria, so check them out. Make sure you understand what boxes you’re checking or attesting to before you commit to those. They can be a nice option if you’re not in a Medicaid state and you don’t have health insurance through your school.

I could share my experience. We went through a slew in the few years with private healthcare. I dropped PRN. PRNs don’t get healthcare insurance and my husband works for CSPA. Essentially, I’m a small business owner, which mostly is what we do. We finally have it good because now we have employees and things like that.

Back before I had employees, we were bouncing healthcare insurance and it was so hard to get someone who genuinely wanted to help you and it would tell you all the things. It was incredibly frustrating. What I had found and be careful is when you pick a plan, like what hospitals? I had the hardest time. Cleveland Clinic for example. They were like, “Who’s this? We don’t know what this is.” Nobody knew of these carriers, so you would spend hours on the phone trying to fight over your bill that should have been paid but they’re like, “We don’t take this.”

It’s like, “Who is this? They bill it wrong.” They would bill inappropriately because they never heard of it before. I’m like, “Oh my gosh.” It can be frustrating to get private insurance but we have been on a healthcare plan temporarily too. We’re a family so it was quite expensive like $1,000 a month for pretty much nothing. For one person, it’s $200 to $300. The cheapest I found was a couple of hundred dollars a month for private healthcare.

That was getting very minimal if you’re healthy. That’s the reality, unfortunately. Hopefully, Medicaid can pull through. That’d be a great option like Natalie said and hopefully, your school, your parent, or your spouse. Those are obviously the more ideal methods. Thank you, Natalie. This was incredibly insightful. I hope you guys reading enjoyed it. I hope this didn’t make you feel anxious because I know we spewed a lot of stuff.

Money is one of those things where it affects people differently. Some people shut up and close in and they’re like, “I can’t.” Other people are like, “It’s fine. It’s money.” This is where I’ve been shifting. Money is a replaceable asset. Time is not. I’m not saying I have it all figured out by any means but when I think about going to CRNA school, you are putting in time and money. It’s so you can have the lifestyle and the career that you want so you can spend your time the way you want with your family and your loved ones financially, take trips, or whatever it may be.

That time is irreplaceable. Money is a replaceable asset. I’m not saying going into debt irresponsibly but be realistic and run the numbers. I know for me, when I was making the decision back to CRNA school, I had set $90,000 in debt. Thinking about taking it on under $100,000 but then I researched and knew CRNAs in my area made about $150,000 to $160,000.

This was back in 2009. I had researched how much CRNA makes. Now I was making $55,000 as an ICU nurse in Ohio. I knew I’d be increasing my salary approximately by $100,000. Now more than ever, you’re increasing more than that because I’m telling you now, there are shooting up our pay like crazy. They increased my rate by $40 an hour without even asking.

I didn’t ask but it was the competition in the market, “We need you. Don’t go work for there, work for here. Here’s more money.” It’s like, “Okay.” It’s crazy now that we’re dealing with how short hospitals are for CRNAs. Making $180 an hour is not unheard of, even in a smaller rural area. There’s a place in Youngstown, Ohio that’s paying that for a W-2 employee. That’s pretty high for Ohio.

We’re not Manhattan or anything and it’s $180 an hour. I’m not saying that you’re guaranteed that but keep in mind that the money you put in CRNA school, whether that’s $200,000 plus, as long as you’re debt to income ratio is not over 100% when you’re done with school, in my opinion, it’s going to be okay to pay it off in a reasonable amount of time as long as you hook up with Natalie here and plan well for your financial future.

I was going to add that too, Jenny. You’re 100% right that everybody has these different emotions and feelings when it comes to all of this money stuff. My goal is to not make you more anxious. My team’s goal is to take the financial stress off. There are so many stressors for all of you when you’re in school. Our goal is to take the financial stressors off and to know that you’ve got a partner in the game.

You’ve got somebody who knows what’s coming up, can help you when the road turns, gives you a little twist, and get you back on a new roadmap. Please feel free to reach out to us and we can always share with you how we work with students and the planning that we do. I was sharing with Jenny, we were getting on here and how exciting it is to see the CSPA students graduating and moving into all these fun, new goals, and dreams, and seeing life on the other side of CRNA school. It makes my heart sing.

Natalie now has worked with full cohorts of CSPA at this point that she is all getting ready for the graduate of CRNA school. They’re going to continue to go on work with Natalie to plan for what their goals are for retirement. Natalie is a wealth of information. She’s a huge resource. I wish I would’ve had someone like you back in the day because it is stressful to juggle all this.

That’s not a stressor you should be focused on in. Schools should be focused on getting good grades, passing, and doing well in clinical versus, “How am I going to pay? This credit card is adding up, what am I going to do?” How can someone reach out to you? How can they connect with you if they want to learn how they can get going and start with you now?

We do have a phone number that you can text us at or call us, either way. That is (717) 954-0032. You can shoot us a quick text. My whole team gets that so we’re usually pretty good at getting back to you fairly quickly or you can check us out online. Google Natalie Kratzer Thrivent and you’ll find me and my team online. You can shoot us an email as well, Natalie.Kratzer@Thrivent.com or find us on social. I hang out in the community for CSPA on Facebook and all the other places too.

Thank you guys so much for tuning in. I highly recommend working with Natalie sooner than later, especially on what she said. If CRNA is your goal, the sooner you get started on the financial aspect of it, the less stressful your overall journey is going to be. Anytime that you hear this message is reaching you, if you’re worried about finances, reach out to Natalie. Thank you, Natalie, so much for your time. I appreciate you and I look forward to continuing to work together and work with our students. Thank you for all that you do.

Thank you. Good luck, guys.

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About Natalie Kratzer

CRNA S2 90 | CRNA School ExpensesWhether you’re just starting out in nurse anesthesia school, established in your career or are preparing for the retirement of your dreams, I am here to listen, understand and help guide you along your financial journey.

I have more than a decade of experience providing transparent, holistic advice to clients. This leads to long-lasting relationships amongst my clients and their families.

I am married to Greg, and we have a son named Finley. A graduate of Lower Dauphin High School and Lebanon Valley College, I reside with my family in the Hummelstown/Hershey area in Pennsylvania.

I am passionate about supporting the SOFA Foundation (Supporting Our Future Anesthetists) and the Diversity in Nurse Anesthesia Mentorship Program. I am also a proud contributor for CRNA School Prep Academy.

IG @NatalieKratzerthrivent

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