Options and real estate wedlock - a beginner level trade on a real estate backed asset

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There's nothing Intellectual about being an ER doc. Scan, admit, discharge, get yelled at. Pretty much a waste of an MD. I remember really liking my corporate finance class in college. I shoulda done that.

At least we actually do something useful with our lives. Noble service.

If I had to be a soulless corporate jackwit that did nothing but push papers and go to meetings, making sure I wore suits for some reason, I wouldn't be able to look myself in the mirror and call myself a good man.
 
There's nothing Intellectual about being an ER doc. Scan, admit, discharge, get yelled at. Pretty much a waste of an MD. I remember really liking my corporate finance class in college. I shoulda done that.

Agree fully!

I genuinely think a majority of it can be done with a well-trained PA, perhaps an AI copilot, and a remote ER doc to call who is overseeing 10 EDs with an eICU type set up.

Is there a company who is doing this that I can invest in?

Probably UNH
 
Agree fully!

I genuinely think a majority of it can be done with a well-trained PA, perhaps an AI copilot, and a remote ER doc to call who is overseeing 10 EDs with an eICU type set up.

Is there a company who is doing this that I can invest in?

Probably UNH


Avel covers a ton of rural midwestern ED's with PAs on site.

I will say though all the sites I know that use it are not planning on renewing their contracts since its expensive and rarely used most shifts.
The vast majority of patients can be treated with simple protocols and the rest are basically immediately transferred to regional hospitals with specialists to manage their condition. Realistically speaking the main benefit would be crashing patients that need someone to oversee the resuscitation like for severe traumas but those cases are rare and maybe happen once a month at rural sites.
 

Avel covers a ton of rural midwestern ED's with PAs on site.

I will say though all the sites I know that use it are not planning on renewing their contracts since its expensive and rarely used most shifts.
The vast majority of patients can be treated with simple protocols and the rest are basically immediately transferred to regional hospitals with specialists to manage their condition. Realistically speaking the main benefit would be crashing patients that need someone to oversee the resuscitation like for severe traumas but those cases are rare and maybe happen once a month at rural sites.

Your math supports the idea that we will need FAR FEWER ER docs in this AI-driven future. So many are going to get priced out. The new sheriff of sodium video on it was fantastic and described a bleak picture.
 
and UNH dropping another 10%.

I got lucky yesterday and reduced position size by 25%.

Going back in really big when the market opens.

Capitulation going on in my opinion. Time to load the boat 🤣
we want 200s!!!
Scared On Fire GIF by SpongeBob SquarePants
 
Current positions:

ANF
AMZN
BRK.B
CCL
CLS
CRDO
LX
META
NUTX
NVDA
OLO
PYPL
UBER
VRNA

Largest positions are AMZN and NVDA. I've got 5K shares of NVDA. I bought half of it at $105 and doubled down at $96. I actually told my sister to buy some at $100. I am beyond tickled pink to see it touch 130 today. Very tech heavy obviously. I have about 10% in cash right now and have been looking for lower priced stocks under $10 such as recent picks OLO and LX (Steven Cress recommendations from recent SA article). I also bought some TIGR and got stopped out this morning. I have to be very careful with NVDA at this point and am trying not to be too greedy as all it would take is one China set back to send it down. If I'm perfectly honest, I should reduce the position right now. It's a little stressful because stops don't work very well with NVDA due to the intrinsic volatility and usually if I have a stop loss, it's not uncommon for it to trigger on market open only to see buyers rush in and the stock come up significantly within the first hour so I've been taking a Minervini approach to stops and setting them daily on NVDA or at the very least mentally.

AMZN is up about 19% from purchase and NVDA is up around 30%. Biggest winner has been CLS and I'm sad that I didn't have the guts to go in bigger especially after I had such success with it last year. Last year alone I think my gain/loss ratio was upwards of 93% successful swing trades on CLS. It's up 41% so far. Second best performer has been CRDO. I got that one from Seeking Alpha and it's up 38% but a small position. Have been trying to get back into PLTR but I just can't catch it.

Overall portfolio performance as of yesterday:

Screenshot 2025-05-13 at 11.07.40 AM.png


This morning I'm updating stop losses to lock in gains on the appropriate stocks. Lessons learned from times past where I get so elated during bull runs that I forget to update stops and would wake up to huge reversals that would wipe out a weeks worth of gains.

I still expect chop come July but we'll see. Trump seems to keep grinding out these trade deals (or at least demonstrating progress) and that's definitely changing market sentiment.

Looks like some rotation back into tech. XLK 15% last month. Best performing sector next to XLY/XLI, consumer discretionary and industrials respectively. Rotation out of consumer staples/utilities XLP/XLU last 5 days. SPY at 9% gain last month. Interestingly IWC Micro Caps led for the past month at 16%. Another indication of investor confidence in economic recovery and risk appetite.

Nasdaq is now trading above 200SMA. SPY needs to close above it today to do same. Russell trading below. While Nasdaq is trading above 200SMA, only 38% of nasdaq listed stocks are trading above their individual 200SMA showing a clear indication that many individual stocks are still in long term downtrends.
 
Your math supports the idea that we will need FAR FEWER ER docs in this AI-driven future. So many are going to get priced out. The new sheriff of sodium video on it was fantastic and described a bleak picture.

If the nurses and midlevels want to run everything already, why do I need to physically be in the department? I'll just remotely supervise. Pay attention kids, reason number 2849 to save up and quit.
 
The vast majority of patients can be treated with simple protocols
30 years ago, I worked on the ambulance with a paramedic that had been a medic when he was in the US Army. He told me he had a book as a medic that told him everything he could do. I can't say for sure, but, I think I recall him telling me that the book said he could close lacs 10cm or less. 10.1, it went to the the aid station. That's Army for you. But, the protocols were clear. "Do this now. Don't do that." So, it was very precise cookbook medicine. And, you know what? Just like EM, it usually works.
 
Watching gold. Obviously expecting dip with recent market sentiment but if it re-tests 19.41 and holds, would be a good hedge against any upcoming volatility. Alternatively, could enter now since it's pulled back nicely and place 19.41 stop but futures are green tomorrow and bulls look in control for the moment so I think it could pull back further. Watching GFI. Got stopped out of it recently.

Man, I just noticed the UNH drop. Ugh. Glad I got stopped out of that one but feel for any of you still holding. I do think it's still a good long term hold though, it will no doubt recover at some point. It looks like it's retesting lows from Feb '21 on the weekly. I doubt it goes below this point. If it closes below 320, I'd get out because next leg down is a 10% drop.

My Watchlist:

NFLX - I might re-enter though I consider NFLX horribly overvalued. Crazy momentum though.
PM - swung this a few weeks ago for a small profit
ALIZY
ATGE - Swung this for 19% profit last week. I'd like to re-enter if it continues to pull back.
GOOGL - Got stopped out on the bad Apple press about declining safari searches but I'm long GOOGL so will probably re-enter soon.
BBSEY - high risk...but kind of a decent set up and I like Brazilian....stocks
STX - been chasing this one, I'd love a big pull back so I could get entry
TIMB - Communications stock. Brazilian....
BLBD
 
My target for entry now is $250.

largest volume day in 20 years. 58 million shares bought and sold - Average daily vol is 7-8 million.

Very very close to capitulation if this wasn't it already. $300 and $270-280 (pre-covid highs) will give significant support as well. So the way down to 250 isn't as easy as you'd think.

RSI for weekly and monthly graphs is very over sold - Again buyers should start coming out.

Todays volume was in fact almost double the volume post Q1 sell off of ~25% or so. So you can see buyers already entering into the mix given a 17.7% drop for 58M volume while previously it only needed 30M volume for a 25% price drop.

Up 2% in premarket. Selling will likely exhaust soon and the buying pressure will increase. A rapid rise may in fact give rise to FOMO as well and buyers may start flocking in.

i think the bottom is near. Tripled my position size today. Bottom is somewhere between 270-310 (at least the short term bottom before a bounce - even if a dead cat bounce). But there should be a bounce atleast soon. Even if a long term downtrend persists.
 
New portfolio. After yesterday's big positive day, vix closing below 20, yesterday I went back to 129 days to expiration (september) on almost all positions. Today I took a massive thrashing because of UHC (I had 12 contracts at $270 strike to start the day). I dropped my strike and kept increasing position size ultimately ended with 35 contracts $230 strike. Short term pain for long term gain.

I figured out and learned something new - I was not fully utilizing my account properly, now I am.

Not only do i have options contracts open worth a couple million that have given me 60k premium for some 4 months. I also have 680k sitting in SGOV returning 4.5% risk free (30k annual at current yield - but expected to drop as fed drops rates).

This portfolio satisfies both margin maintenance requirements (positive 18k currently), while having a positive cash balance (96K) meaning im not charged any interest on margin. And it also gives me the luxury of liquidating SGOV at any time to free up 1/3 x 680k (~200K) of buying power to avoid any capital calls or to protect myself in any bad situation.

It's actually something really cool and I'm going to explain it here.

I have 810k cash in the account (account value + Options premium).

I've purchased $680k + 30k of VT - So 100k positive cash in account (no margin being used. No interest to pay) - Risk free Dividend yield from SGOV.

SGOV + VT - Each $1 spend there only uses 30% buying power for margin maintenance excess to avoid margin call for naked puts. So 680 + 30k = 710k = 30% buying power used is 215k

Current options contracts require $582k of cash sitting on the side. So 582 + 215 = 797; Leaves about 18k maintenance excess.

So not only can I get returns from premiums, but I should keep getting massive risk free and state income tax free dividends from SGOV. This risk free return I was leaving on the table previously. And because SGOV only uses 30% for maintenance, It still leaves plenty of available capital to play options with.

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@cyanide12345678

You have 680k in Treasury bond... Why?

META share was at < $500 three wks ago. You would have been up more 25% now.

That's what I'm trying to explain. My portfolio margin account has 2 different buckets - CASH and margin maintenance excess. Both need to be positive.

If I have 100% options positions, I'm ONLY using margin maintenance excess and have 800k+ available cash just sitting as cash doing nothing. Yes, I can open more contracts and use ALL my maintenance excess, but THAT puts me at higher risk with a larger number of naked puts. Even the current puts are probably worth 3M in nominal value in an account with 800k cash. That's plenty of leverage, I dont want more positions.

Opening naked puts uses $0 in cash, it just requires cash sitting on the sidelines.

Buying SGOV on the other hand uses cash. So buying 680k in treasuries uses 680k cash. BUT it only uses 30% of maintenance excess (~200k) - Leaving lots of capital for all contracts.

So now I'm in the sweet spot - Using almost all of my maintenance excess, and using almost all of my cash. While I could buy something like VT or SPY with that cash, but then that's riskier than ever. Then that's just ridiculous leverage which can kill me in a down market. Not only would I hit capital calls from the naked puts side, but I'll hit capital calls from equity losing value on the cash side.

Trust me I take plenty of risk, and I'm not adding more to it.

Current positions yield 60K from options premium in 128 days and 10k in cash from SGOV. So 70k return if things go according to plan in 129 days (9% return IF THINGS GO WELL in 4.3 months).
 
wow i didnt realize so many ER docs are traders until I stumbled upon this thread, ive been riding HIMS and HOOD all year occasionally selling calls on them which has limited some of my upside.
UNH looks ripe for a scalp rn
 
if anyone is interested in forming an actual groupchat that we can share plays in live/discuss id be very interested
 
I'm going to be very honest here: I was not positioned well for a rapid correction and am sitting on a lot of cash. Looking for gems.

This is what I would do, which i think is a very reasonable risk adjusted way to play this.

Assuming you still have a relatively negative outlook.

Sell Jun 27th 2025 Put $560 strike. You get $500 in premium for 45 days per $55500 of cash buying power. That's a 7.2% annualized return waiting on a 4.6% discounted entry price point. Cash covered. No leverage risk.

I would also see if Etrade or whatever brokerage you use lets you keep that cash sitting in SGOV or VUSXX and get an extra 4.4% annualized return on your cash thats sitting that as well.

If it doesn't let you do that, then you upgrade to a portfolio margin account. $560 put would use 15% of actual cash needed - So $8400. This would leave $55500 - 8400 = 47100 free to do whatever with. Then you buy $45000 of SGOV with that giving you $500 in premium + 253 in dividends in 45 days resulting in a 1.35% return in 1.5 months - 9% annualized return.

Not bad for cash secured position with no leverage. Assuming you'd rather own SPY at 5% discount to today rather than where its at and you won't be bummed about annualized gain of 9% if SPY continued to go up.
 
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NUTX trade went well. I entered right above my stop loss. Got lucky with earnings which honestly, I was more focused on the chart set up and didn't even realize earnings was so close. I would have sold the entire position if I was awake earlier at market open knowing it would pull back after that first hour. I think I'll hold it overnight and see what happens. 37% gain.

Bought PM, ALIZY, GFI. As I thought, GFI pulled back even more this am and is right on support so provides me an extremely tight stop. Thought about NFLX but it's just so pricey now. Ah well.

Added VCISY to watchlist.

That's it for me today.
 
Man, UNH is such an incredible value. I'm not re-entering until it build some upwards momentum after reaching a clear bottom but damn is that stock a bargain. That P/E is mouth watering. It broke down through 320 and it seems to be next leg down could be 299 and 289. I kind of feel like it should be very close to a bottom but will see. I'll be checking this one daily. Will absolutely take another position when the time is right.
 
That's what I'm trying to explain. My portfolio margin account has 2 different buckets - CASH and margin maintenance excess. Both need to be positive.

If I have 100% options positions, I'm ONLY using margin maintenance excess and have 800k+ available cash just sitting as cash doing nothing. Yes, I can open more contracts and use ALL my maintenance excess, but THAT puts me at higher risk with a larger number of naked puts. Even the current puts are probably worth 3M in nominal value in an account with 800k cash. That's plenty of leverage, I dont want more positions.

Opening naked puts uses $0 in cash, it just requires cash sitting on the sidelines.

Buying SGOV on the other hand uses cash. So buying 680k in treasuries uses 680k cash. BUT it only uses 30% of maintenance excess (~200k) - Leaving lots of capital for all contracts.

So now I'm in the sweet spot - Using almost all of my maintenance excess, and using almost all of my cash. While I could buy something like VT or SPY with that cash, but then that's riskier than ever. Then that's just ridiculous leverage which can kill me in a down market. Not only would I hit capital calls from the naked puts side, but I'll hit capital calls from equity losing value on the cash side.

Trust me I take plenty of risk, and I'm not adding more to it.

Current positions yield 60K from options premium in 128 days and 10k in cash from SGOV. So 70k return if things go according to plan in 129 days (9% return IF THINGS GO WELL in 4.3 months).

This is one of the great parts about options. Learning to be "capital efficient" with your entire portfolio.

I have a whole separate portfolio where I purely sell options, and it's been fascinating optimizing not only the capital efficiency, but also being theta neutral (optimizing the greeks).

Spending the time learning all of this has been the most efficient use of my free time, huge ROI over index investing.

I also believe that passive indexing will no longer be the best way to generate returns, and that it will become the HURDLE RATE that one must beat to have REAL returns over 30 years.

A "VOO and chill" portfolio today will disappoint 10 years from now, mark my words.
 
Man, UNH is such an incredible value. I'm not re-entering until it build some upwards momentum after reaching a clear bottom but damn is that stock a bargain. That P/E is mouth watering. It broke down through 320 and it seems to be next leg down could be 299 and 289. I kind of feel like it should be very close to a bottom but will see. I'll be checking this one daily. Will absolutely take another position when the time is right.

8% lower after hours.
 
Man, UNH is such an incredible value. I'm not re-entering until it build some upwards momentum after reaching a clear bottom but damn is that stock a bargain. That P/E is mouth watering. It broke down through 320 and it seems to be next leg down could be 299 and 289. I kind of feel like it should be very close to a bottom but will see. I'll be checking this one daily. Will absolutely take another position when the time is right.

Yes I have dreams of hitting this hard. A couple of things: big funds are dumping their shares in record numbers. Fidelity (FMR) had like 30M shares and they sold millions. Same as T Rowe Price, GS, etc. it takes a while for them to sell their intended amount and move on. So there might be more selling. Their stock price has been cut in half but I don’t necessarily see their revenue, earnings, FCF etc. also all being cut in half. They might go down 30-40%, but but represents some upside as UNH returns to prior earnings. They guided down at earnings and then a few weeks later didn’t even guide…and I suspect there will be no further surprise news coming from them until next earnings July 18. I don’t think there will be a V shaped recovery until then..I do think there will be chop. I seriously doubt (although possible) that there will be pre announcement risk prior to next earnings. Lastly option premium is markedly elevated and IV percentile is 100%. Selling here is a good idea.

A few different strategies could be just selling June OTM puts and even DCA into them. Like the 260-280 range. Pick whatever you like. Another good thing would be to sell strangles like the June 260p 370c which is a 16 delta strangle. Right now that nets you $9 and you have protection against 19% down and 24% above. Lastly can do risk reversals if you want some upside and thise are best in high IV like now. Sell a put, buy a call. Can also do call spread risk reversals. Sell a put and buy a call spread. What I might do actually is a combo of things including sell puts, sell a strangle, and buy longer dated call. Can sell a June Strangle and buy a Sept 370c and that would only cost like $4, and you have an extremely high amount of upside protection if the stock moves higher. It should be noted that in my belief there will be no IV crush until July earnings. IV will compress some but will probably have IV percentile of like 70% or higher until July. I think they threw the kitchen and the bath out all at the same time, however that phrase goes.

I will be DCAing into this too. It’s impossible to bottom tick this so just be happy DCAing into it. Only new systemic risk that can come from this over the next few months is massive fraud is uncovered or there are big time govt health care changes.

The stock has basically been cut in half but I don’t think business operations have. God man I lost 40K selling those 400p and 390p. I want my ****ing money back!!
 

8% lower after hours.
Ah yes fraud would be a problem as I wrote. Although I don’t know if this is new news?

Unh responded saying no such notification of criminal investigation already.

Wsj has also updated their article stating that the doj is looking at potential criminal investigation. Whereas the first article stated that a criminal investigation was underway.

Also United has been under doj scrutiny atleast since feb. and wsj had a very similar piece on them in feb as well. Even the article itself says they’ve been under investigation since last summer. So it’s not necessarily new news - not unless a criminal case is filed.
 
Unh responded saying no such notification of criminal investigation already.

Wsj has also updated their article stating that the doj is looking at potential criminal investigation. Whereas the first article stated that a criminal investigation was underway.

Also United has been under doj scrutiny atleast since feb. and wsj had a very similar piece on them in feb as well. Even the article itself says they’ve been under investigation since last summer. So it’s not necessarily new news - not unless a criminal case is filed.
From a Twitter post:

"In March, a court-appointed special master recommended that a judge effectively dismiss a whistleblower case against UnitedHealth after concluding the government hadn’t presented evidence that patient diagnoses submitted for payment were inaccurate."
 
we could definitely see a dead cat bounce in UNH tomorrow if it opens around 280. Might bounce 10-15 points.
Mind you...dead cat bounces usually just rest on the floor after it bounces. Gotta be quick.
 
Down to that 289 level premarket. Probably recovers at market open. If not, next leg down 271-273 and then extremely strong support at 210-212. Lots of volume fueling these legs down. Short interest up 6.5%

Futures red. Updated all my stop losses on the 30m chart.
 
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Down to that 289 level premarket. Probably recovers at market open. If not, next leg down 271-273 and then extremely strong support at 210-212. Lots of volume fueling these legs down. Short interest up 6.5%

Futures red. Updated all my stop losses on the 30m chart.
Have to load the boat at these levels. With that high of short levels and the moat UNH has built, the rebound will be violent. Not a matter of if but when. Could see low 200s but long term think this level is more than safe
 
Have to load the boat at these levels. With that high of short levels and the moat UNH has built, the rebound will be violent. Not a matter of if but when. Could see low 200s but long term think this level is more than safe

It was 1-2% short just a few weeks ago.

That’s an extra 45 million shares sold in a few weeks on a company that’s not even going bankrupt

Q1 which had the same issues of increased utilization had an adjusted earnings per share of 7.2.

It’s going to be a hell of a bounce with that rsi. I was looking back, i couldn’t find another instance of being this oversold ever.

Too bad i pulled the trigger on 35 contracts 2 days ago, it’s going to be a painful day, but im going back to leaps on UNH and dropping my $230 strike to $195.

At some point this insanity will end and selling will exhaust. Just need patience.
 
$UNH

Was 600 literally 2.5 weeks ago. Is the business that bad?

Fundamentally almost nothing has changed for the business.

It’s still a cash cow, just hitting increased expenses this year from higher levels of care and will reprice next year - the entire insurance industry will be repricing next year to account for the increased care, it’s just an industry wide issue.

They’re already working on cost control and have aimed to lay off 30,000 people by May 1st.

They get multiple annual cms audits of their financials and charts, so it’s not like they have no checks or balances and are some fraudulent company.

It’s literally a blue chip stock amongst the dow jones. Very few companies have the earnings and balance sheets to end up a part of the Dow

The last possible shoe left to drop is the dow dropping unh 🤣
 
Cvs literally went through this last year because of aetna - aetna was essentially at 95% medical care cost compared to their revenue and aetna lost them big money.

They repriced, stock went back to 60s from 40s. I went big when it was 40s.

Patience.
 
Sold LX for 6% gain. Bought KINS, AGESY, TTWO, BSX.

I wish Tradingview would quit changing stuff. They switched the screener to the right menu bar and it deleted all my screeners so I have to set them all back up. I hate having the screener over there. So annoying.
 
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I will keep buying until the bottom. Hopefully my covered calls don't burn me on the way up.

Strike dropped, loaded up.

Dont ask me how much i lost today on my existing position that i had to roll.

The new position despite the dropped strike from sep $230 to jan $160 more than makes up for all previous losses.

100k premium for current position.

I don’t mind waiting a little longer especially with the new de-risked strike price.
 

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I will keep buying until the bottom. Hopefully my covered calls don't burn me on the way up.

Unless you wanna get out of UNH, you’ll probably just make more notnselling that 270c. You actually might get assigned

Wait a few days. Wait until next week. Then sell June regular way 350c or so.
 
Unless you wanna get out of UNH, you’ll probably just make more notnselling that 270c. You actually might get assigned

Wait a few days. Wait until next week. Then sell June regular way 350c or so.
The calls expire tomorrow. Was a free 44XX for a nice meal and some gas money. Essentially betting no ‘good’ news for tomorrow
 
The calls expire tomorrow. Was a free 44XX for a nice meal and some gas money. Essentially betting no ‘good’ news for tomorrow

Not necessarily free, just limits your gain to $17/share in two days. Not bad - 17k in 2 days gain, if it happened i wouldn’t be upset over it. Could repeat by selling puts if your shares get assigned, just wheel it and enjoy the premium

I would make sure not to have naked calls though. Your screenshot had 11 calls and 1000 shares.
 
Not necessarily free, just limits your gain to $17/share in two days. Not bad - 17k in 2 days gain, if it happened i wouldn’t be upset over it. Could repeat by selling puts if your shares get assigned, just wheel it and enjoy the premium

I would make sure not to have naked calls though. Your screenshot had 11 calls and 1000 shares.
You’re not wrong. Would kick myself if a huge dead cat bounce occurs or DOJ drops their suit tomorrow 😅 I’ll risk it for the premium though. I’m just betting I didn’t catch the bottom because I know I don’t have that luck.
 
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As @cyanide12345678 said above, there is another shoe left to drop. I don't what it is but I fell like that stock can even get to ~$150/share

Dude....if you keep on lowering your price target to buy, you will never end up owning UNH (or any stock for that matter).

The key thing to see today is that volume is 10x what it normally is (on the daily, going back as long as trading view can post daily charts) which is what we see during capitulation. This has only happened a few times over the past 40 years. I showed the daily and weekly chart. On the weekly chart, only a few instances in the 90's was there higher volume. The other thing to see is that UNH has gone up consistently after those other few blips.

Kind of reminds me of META a few years ago when it got to 180. I thought it was going to 100 then. And I never bought, at all, until I started buying calls around 450. Stupid of me.

Daily Chart

UNH Daily.jpg


Weekly Chart

UNH Weekly.jpg
 
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