SECURE Act 2.0: What Doctors Need to Know About the 2026 Retirement Plan Changes — A Tax & Compliance Update

As your CPA advisors, we understand that doctors face unique financial pressures — from managing a demanding clinical schedule to overseeing the business side of a medical or dental practice. Retirement planning is a critical part of protecting your long‑term financial health, and several major changes under the SECURE Act 2.0 will take effect in 2026 that directly impact how you save.

Whether you are a physician, dentist, specialist, or practice owner, these updates affect your contribution limits, catch‑up opportunities, and payroll compliance. Below is a clear breakdown of what you need to know.

1. Updated 2026 Elective Deferral Limits

Beginning in 2026, the IRS will increase the amount employees — including doctors — can defer into employer‑sponsored retirement plans. If your practice offers a 401(k), 403(b), or 457(b), the new limits will be:

• 401(k), 403(b), 457(b): $24,500
• SIMPLE IRA: $17,000
• Total defined contribution plan limit: $72,000

For many doctors who already maximize contributions, these increases create additional room for tax‑advantaged savings.

2. Standard Catch‑Up Contributions for Age 50+

Many doctors begin saving aggressively later in their careers due to medical school, residency, or early practice start‑up costs. The catch‑up rules help close that gap.

In 2026, the standard catch‑up limits increase to:

• 401(k), 403(b), 457(b): $8,000
• SIMPLE IRA: $4,000

These amounts are added on top of the regular deferral limits.

3. The New “Super Catch‑Up” for Ages 60–63

This is one of the most valuable opportunities for late‑career doctors.

Beginning in 2025 and continuing into 2026, individuals aged 60–63 may contribute the greater of:

• $10,000, or
• 150% of the standard catch‑up limit

For 2026, this equals:

• 401(k)/403(b)/457(b): $11,250
• SIMPLE IRA: $5,250

For doctors in their peak earning years, this enhanced contribution window can significantly accelerate retirement savings.

4. Mandatory Roth Catch‑Up Contributions for High‑Earning Doctors

This is the change most likely to affect physicians and dentists.

Starting January 1, 2026, any employee who:

• Is age 50 or older, and
• Earned more than $150,000 in wages in the prior year

must make all catch‑up contributions on a Roth (after‑tax) basis.

This applies to:

• Standard catch‑up contributions
• Super catch‑up contributions (ages 60–63)

Why this matters for doctors:

• Most physicians and dentists exceed the $150,000 threshold.
• Pre‑tax catch‑up contributions will no longer be allowed for high earners.
• Payroll systems must be updated to classify Roth catch‑ups correctly.
• Retirement plan documents may require amendments.
• Practices that fail to update their plans risk losing the ability to accept any catch‑up contributions until corrected.

5. Key Planning Considerations for Doctors and Practices

✔ Review your 2025 compensation

This determines whether you’ll be subject to the Roth catch‑up requirement in 2026.

✔ Confirm your retirement plan supports Roth catch‑up contributions

Some plans — especially older 401(k) structures — may not currently allow Roth catch‑ups.

✔ Coordinate with payroll and HR

Medical and dental practices often rely on third‑party payroll providers; ensure they are prepared for the 2026 changes.

✔ Evaluate cash flow for increased contributions

Doctors ages 60–63 may want to maximize the super catch‑up opportunity.

✔ Review plan design with your CPA and plan administrator

This is especially important for practices with Safe Harbor plans, profit‑sharing contributions, or defined benefit/defined contribution combination plans.

Final thoughts from your CPA team

The SECURE Act 2.0 introduces some of the most significant retirement plan changes in years — and doctors will feel the impact more than most professions due to high compensation levels and complex practice‑based plan structures.

Our goal is to help you:

• Maximize tax‑advantaged retirement savings
• Ensure your practice remains fully compliant
• Avoid payroll and plan administration issues
• Strategically plan for 2026 and beyond

If you’d like us to review your retirement plan or model how these changes affect your personal tax strategy, we’re here to support you.