Open enrollment isn’t just a benefits paperwork exercise — it’s a tax planning opportunity. For orthopedic surgeons and other high-income physicians, the way you structure your health insurance, HSA, healthcare FSA, and dependent care FSA elections can materially impact your tax bill and long-term wealth. This article breaks down the 2026 limits, HDHP eligibility rules, and practical strategies to optimize your benefits before you lock in elections for the year.

The first half of the year is already written. For surgeons who own their practice, that makes midyear the most underused planning window on the calendar. In one Saturday, you can run a simple “halftime report” on five numbers—income, tax liability pacing, retirement contribution progress, practice overhead, and personal spending rate—and make small adjustments while they’re still cheap. This framework helps surgeon‑owners avoid fourth‑quarter scrambles, smooth cash flow, and turn more of a surgeon‑level income into lasting wealth.

June looks quiet on the calendar, but it is one of the most important months for surgeon practice owners to reassess taxes and cash flow. In about 30 minutes, you can review income pacing, estimated payments, retirement plan funding, and household liquidity before the June 15 deadline. That midyear “audit” turns vague concern into one clear decision, so the rest of 2026 feels planned instead of reactive.

Most surgeons get second opinions in the OR, not in their financial lives. This article shows how a coordinated review of entity structure, retirement plan design, tax strategy, and investments can uncover six‑figure opportunities hiding between your CPA, advisor, and attorney.

For years, “just do the backdoor Roth” was default advice for high‑earning surgeons. But after 2025’s OBBBA changes, that rule of thumb can quietly cost you money. This article walks through a simple three‑branch framework to decide when Roth still wins, when traditional and cash balance contributions create more value, and how your state‑to‑state tax trajectory can flip the answer. Before you fund another backdoor Roth on autopilot, model both paths and let the math—not the calendar—drive the decision.