That Medicare line on your pay stub is a flat 1.45% of your gross wages — every paycheck, every dollar, no cap and no exceptions for most workers. On a $2,000 biweekly paycheck it's $29.00; on a $4,000 paycheck it's $58.00. Unlike Social Security, which stops once your wages pass $184,500 in 2026, Medicare keeps coming out all year long.
Here's what that line actually is, how to check the math on your own stub, why some high earners see a second Medicare line appear mid-year, and what the money pays for.
Medicare tax is half of FICA, the federal payroll tax. Your stub might label it "Medicare," "Med," "HI" (hospital insurance), or fold it into a single "FICA" line next to Social Security. However it's labeled, the rate for employees in 2026 is 1.45% of your Medicare wages — which for most people is just your gross pay.
The money goes into the Medicare hospital insurance trust fund, which pays for Part A hospital coverage for Americans 65 and older. Your employer matches your 1.45% dollar for dollar, so 2.9% of your wages reaches the fund in total — you just never see the employer's half on your stub.
One thing that confuses people: Medicare tax is figured on each paycheck independently. There's no standard deduction, no allowance, no W-4 setting that changes it. If you earned $2,000 this pay period, $29 comes out. That's the whole calculation.
Because the rate never changes, verifying your Medicare line takes ten seconds: multiply your gross pay by 0.0145.
$1,200 biweekly paycheck (about $31,200 a year): $1,200 × 1.45% = $17.40. Over 26 paychecks that's $452.40 a year. Small per check, but it adds up to real money by December.
$2,885 biweekly paycheck ($75,000 a year): $2,885 × 1.45% = $41.83 per check, or about $1,087.50 a year. For comparison, the Social Security line on the same check is $178.85 (6.2%) — Medicare is the smaller of the two FICA lines, but it's the one that never goes away.
$5,769 biweekly paycheck ($150,000 a year): $5,769 × 1.45% = $83.65 per check. By late in the year this earner's Social Security line will hit the $184,500 wage base and drop to zero, but the Medicare line keeps printing $83.65 on every stub through December 31.
If your number doesn't match 1.45% of gross, the usual explanation is pre-tax deductions. Money you put into a traditional 401(k) still gets hit with Medicare tax — 401(k) contributions dodge income tax, not FICA. But health insurance premiums paid through a cafeteria plan and HSA contributions made through payroll do reduce your Medicare wages, so your taxable base can be a bit lower than your gross. Check whether your stub prints a separate "Medicare wages" figure; that's the number to multiply.
A part-time example: a retail worker paid $640 weekly (about $33,280 a year) sees $640 × 1.45% = $9.28 of Medicare tax each week. That feels trivial until you annualize it: $482.56 a year, roughly three-quarters of a week's pay, gone to a line most people never look at. The percentage is identical at every income level — that's the point of a flat tax — but the share of your budget it represents is very different at $33,000 than at $150,000.
Earn enough and a second, smaller Medicare deduction appears. Once your wages with one employer pass $200,000 in a calendar year, that employer must start withholding an additional 0.9% Medicare tax on every dollar above $200,000. Your total Medicare rate on those later paychecks becomes 2.35%.
On a stub this shows up under names like "Addl Med," "Additional Medicare," or "Medicare Surtax." Example: you're paid $10,000 biweekly and cross $200,000 in year-to-date wages in November. From that point on, each $10,000 check carries $235 of Medicare tax instead of $145 — an extra $90 per check that wasn't there in October. Nothing is broken; payroll is following the rule.
Two quirks worth knowing. First, the $200,000 threshold is per employer and based only on what that employer paid you. Two jobs paying $150,000 each means neither one withholds the extra 0.9% — but you still owe it on the $100,000 over the line when you file. Second, the employer does not match the extra 0.9%. It's employee-only, which is why your stub can show a Medicare rate your employer isn't mirroring.
Both lines are FICA, but they behave differently, and the differences explain most pay-stub surprises:
Rate: Social Security is 6.2%, Medicare is 1.45% (plus the 0.9% kicker over $200,000).
Cap: Social Security stops at $184,500 of wages in 2026. Medicare has no cap at all.
Who matches: your employer matches both the 6.2% and the base 1.45%, but not the extra 0.9%.
This is why high earners sometimes see their take-home pay jump in the fall — the 6.2% Social Security line vanishes — while the Medicare line quietly stays. And it's why two people with the same salary can owe extra Medicare tax in April: the withholding threshold looks at one job at a time, but your tax return looks at all of them together. Our FICA tax calculator shows both lines side by side for your exact pay.
A single stub tells you the rate; the year-to-date (YTD) column tells you the story. Most stubs print both a current-period amount and a YTD total for Medicare. That YTD figure should track 1.45% of your YTD Medicare wages all year — and checking it twice a year catches the handful of payroll errors that actually happen: a bonus processed without FICA, a mid-year job change where the new payroll system started your wage counters wrong, or pre-tax deductions coded as post-tax.
The mid-year job change is the one that bites. Start a new job in July and your new employer begins counting toward the $200,000 additional-tax threshold from zero — correct for withholding, even if you earned $180,000 at the old job. The IRS sorts out the difference on your return, in whichever direction it falls. Meanwhile your Social Security wage base does not fully reset in the same helpful way: if two employers each withhold Social Security tax and together they take it on more than $184,500 of wages, the excess comes back to you as a credit when you file. Medicare has no equivalent refund for the base 1.45% — only the extra 0.9% gets reconciled.
One more annual check worth doing: if you hold two jobs and your combined wages pass $200,000 but neither employer withheld the additional 0.9%, consider bumping your W-4 extra withholding or making an estimated payment. The 0.9% on $50,000 of excess wages is $450 — small enough to forget, big enough to sting with an underpayment penalty attached.
Medicare tax isn't a savings account with your name on it, but it does build eligibility. Work and pay Medicare tax for about 10 years (40 quarters) and you qualify for premium-free Medicare Part A hospital coverage at 65. The quarters you earn are tracked by the Social Security Administration alongside your earnings record.
Your year-end proof lives on your W-2: Box 5 shows your total Medicare wages for the year and Box 6 shows the Medicare tax withheld. If you had two jobs and crossed $200,000 combined, Box 6 across both W-2s is what settles whether you owe more of the 0.9% or get some back. It's worth a glance every January — payroll mistakes happen, and Medicare wages in Box 5 should roughly equal your gross pay minus cafeteria-plan premiums and payroll HSA contributions.
Self-employed? There's no Medicare line on a pay stub because there's no pay stub. You pay both halves yourself through the self-employment tax — 2.9% Medicare on all net earnings, plus the same 0.9% over $200,000 — and half of it comes back as an income-tax deduction. The self-employment tax calculator breaks that out if you freelance.
Finally, keep perspective on the size of the line. For a median full-time worker, Medicare tax runs roughly $900–$1,100 a year — less than a month of take-home pay, spread across every check. You'll never negotiate it, deduct it away, or time it. The only real levers are structural: pre-tax health premiums and payroll HSA contributions shrink the wage base it applies to, and that's about it. Everything else about the Medicare line is just arithmetic you can now check yourself in ten seconds.
1.45% of your Medicare wages (usually your gross pay) per paycheck in 2026. That's $14.50 on a $1,000 check or $41.83 on a $2,885 biweekly check. Your employer pays another 1.45% that never appears on your stub.
Those are payroll abbreviations for the same tax. "HI" stands for hospital insurance, the Medicare program the tax funds. Some stubs combine Social Security and Medicare into one "FICA" line totaling 7.65%.
No. Unlike Social Security, which stops after $184,500 in wages (2026), Medicare tax applies to every dollar you earn with no annual cap. The rate actually goes up — by 0.9% — once your wages with one employer pass $200,000.
That's the Additional Medicare Tax: an extra 0.9% withheld on wages over $200,000 from a single employer. It raises your Medicare rate on those paychecks to 2.35%. Your employer doesn't match this portion.
No. Traditional 401(k) contributions reduce your federal income tax but are still subject to Medicare (and Social Security) tax. Health premiums paid through a cafeteria plan and HSA contributions through payroll do reduce your Medicare wages.