The MED line on your pay stub is Medicare tax: a flat 1.45% of your wages that your employer withholds every pay period to fund Medicare, the federal health insurance program for people age 65 and older and certain younger people with disabilities. Your employer pays a matching 1.45% out of company funds, so the combined rate going to Medicare is 2.9%, but only your half shows up as a deduction on your stub.1Social Security Administration. Social Security and Medicare Tax Rates Some payroll systems label the same line “Medicare” or “FICA Med” instead of MED.
How to Check the Math on Your Stub
The employee rate is 1.45% of gross wages with no annual cap. Unlike Social Security, which stops once your earnings hit a yearly ceiling, Medicare tax keeps applying to every dollar you earn all year long.2Internal Revenue Service. Topic No. 751, Social Security and Medicare Withholding Rates
A quick example: on gross pay of $2,000 for the period, the MED deduction should be $29.00 ($2,000 × 0.0145). Your stub usually shows two numbers on the MED line: the amount for that period and a year-to-date total. The YTD figure is worth watching as the year goes on, both to catch payroll errors and to see when a higher-rate withholding kicks in (more on that below).
Why the Number Might Not Be Exactly 1.45% of Gross
If you run the calculation and it comes out a little low, pre-tax benefits are usually the reason. Medicare tax is charged on your Medicare-taxable wages, not on your total gross pay. Contributions to a Section 125 cafeteria plan reduce the wages subject to Medicare tax, including employer-sponsored health insurance premiums, health savings account contributions, and dependent care assistance.3Internal Revenue Service. FAQs for Government Entities Regarding Cafeteria Plans
Not every pre-tax item escapes Medicare tax, though. Group-term life insurance coverage above $50,000 and adoption assistance benefits remain subject to Medicare tax even when paid pre-tax.3Internal Revenue Service. FAQs for Government Entities Regarding Cafeteria Plans To verify the number on your stub, multiply your Medicare-taxable wages (gross pay minus qualifying pre-tax deductions) by 0.0145.
At year end, Box 5 of your W-2 shows total Medicare wages and Box 6 shows total Medicare tax withheld. The YTD total on your final stub of the year should match Box 6. If it doesn’t, ask payroll to fix it before you file.4Internal Revenue Service. General Instructions for Forms W-2 and W-3 (2026)
The Extra 0.9% for High Earners
If your wages cross a certain line, an Additional Medicare Tax of 0.9% applies to the portion above that line. Your employer does not match this piece; it comes entirely out of your pay.5Office of the Law Revision Counsel. 26 USC 3101 – Rate of Tax
The thresholds depend on how you file:6Internal Revenue Service. Questions and Answers for the Additional Medicare Tax
- Single or head of household: $200,000
- Married filing jointly: $250,000 combined
- Married filing separately: $125,000
These numbers are fixed in the statute. They aren’t adjusted for inflation and have stood at the same levels since the surtax took effect in 2013.
Withholding Doesn’t Always Match What You Owe
Your employer only sees your wages from that one job, and it starts withholding the extra 0.9% once those wages pass $200,000 in the calendar year, no matter your filing status.6Internal Revenue Service. Questions and Answers for the Additional Medicare Tax Your actual liability follows your filing-status threshold, so the two can diverge.
A married-filing-jointly couple earning $240,000 combined won’t see any surtax withholding, and they don’t owe any because $240,000 is under the $250,000 joint threshold. A married-filing-separately taxpayer earning $180,000 also won’t see any surtax withholding, but does owe 0.9% on $55,000 ($180,000 minus the $125,000 threshold). In that second case, you either request extra withholding on Form W-4 or pay it at tax time.
Two jobs create the same problem. Earn $120,000 at one and $110,000 at another, and neither employer withholds the surtax because neither job alone hits $200,000. Combined, you’re $30,000 over the single-filer line and owe 0.9% on that overage. You reconcile the whole thing on Form 8959, which is attached to your Form 1040 and either credits you for over-withholding or calculates what you still owe.7Internal Revenue Service. 2025 Instructions for Form 8959 – Additional Medicare Tax
If You’re Self-Employed
When you work for yourself, there’s no employer half. You pay both sides of Medicare tax, which comes to 2.9% of your net self-employment income, calculated on Schedule SE.8Office of the Law Revision Counsel. 26 USC 1401 – Rate of Tax The 0.9% Additional Medicare Tax applies to self-employment income above the same filing-status thresholds, and the IRS looks at your wages and self-employment income together in deciding whether you’ve crossed the line.
You can deduct half of your self-employment tax as an adjustment to gross income without itemizing. That deduction covers the standard portions but not the 0.9% Additional Medicare Tax.9Office of the Law Revision Counsel. 26 US Code 164 – Taxes
Who Doesn’t Pay Medicare Tax
Almost every worker with traditional wages pays this tax, and you can’t opt out. A few narrow exceptions exist.
Foreign students temporarily in the U.S. on F-1, J-1, or M-1 visas are generally exempt from Medicare tax during their first five calendar years. The exemption covers on-campus employment and authorized practical training, and it ends once the student becomes a resident alien or changes to a non-exempt status.10Internal Revenue Service. Foreign Student Liability for Social Security and Medicare Taxes
Students working for the college or university where they’re enrolled may also qualify. The job has to be secondary to the education, and the student needs to carry at least a half-time course load. Career employees and professional staff receiving benefits like retirement contributions or paid vacation don’t qualify, even if they’re taking classes.11Internal Revenue Service. Student FICA Exception
Workers covered by a totalization agreement, a treaty that coordinates social insurance between the U.S. and another country, may be exempt while paying into the other country’s system.5Office of the Law Revision Counsel. 26 USC 3101 – Rate of Tax
If You Suspect Your Employer Isn’t Sending It In
The MED withholding on your stub is money the employer holds in trust for the federal government. If a stub shows the deduction but you have reason to think the funds aren’t being deposited, you can check your Social Security earnings record at ssa.gov to see whether the wages are being reported, or contact the IRS directly. When employers collect the tax and fail to pay it, the IRS can pursue the business and individually assess responsible people through the Trust Fund Recovery Penalty.12Internal Revenue Service. Employment Taxes and the Trust Fund Recovery Penalty