Medicare tax in 2026 is 1.45% on all wages — there is no wage base cap. An additional 0.9% applies once wages exceed $200,000 for single filers, $250,000 for married filing jointly, or $125,000 for married filing separately (ACA §9015, IRC §3101(b)(2)). Those thresholds are set by statute and are not inflation-adjusted. Combined, the maximum Medicare rate is 2.35% on wages above the applicable threshold.
Your employer withholds the 0.9% when your wages from that employer cross $200,000 in a calendar year — not based on your actual filing status or combined household income. Any difference is reconciled when you file Form 1040.
Use the paycheck calculator to see Medicare tax withheld from your paycheck.
Regular Medicare Tax: 1.45% on All Wages
Unlike Social Security, Medicare has no wage cap. Every dollar of covered wages is subject to 1.45%. Your employer matches this with another 1.45%, for a total of 2.9% — but the employer share does not reduce your take-home pay.
| Annual Wages | Medicare Tax (1.45%) |
|---|---|
| $40,000 | $580 |
| $70,000 | $1,015 |
| $100,000 | $1,450 |
| $184,500 | $2,675 |
| $200,000 | $2,900 |
Additional Medicare Tax: 0.9% Above the Threshold
The Additional Medicare Tax adds 0.9% on wages above the threshold for your filing status:
| Filing Status | Threshold |
|---|---|
| Single | $200,000 |
| Married filing jointly | $250,000 |
| Married filing separately | $125,000 |
| Head of household | $200,000 |
Example — single filer earning $220,000:
| Component | Calculation | Amount |
|---|---|---|
| Regular Medicare (1.45%) | $220,000 × 1.45% | $3,190 |
| Additional Medicare (0.9%) | ($220,000 − $200,000) × 0.9% | $180 |
| Total Medicare tax | — | $3,370 |
Example — married filing jointly, $270,000:
| Component | Calculation | Amount |
|---|---|---|
| Regular Medicare (1.45%) | $270,000 × 1.45% | $3,915 |
| Additional Medicare (0.9%) | ($270,000 − $250,000) × 0.9% | $180 |
| Total Medicare tax | — | $4,095 |
Example — married filing separately, $135,000:
| Component | Calculation | Amount |
|---|---|---|
| Regular Medicare (1.45%) | $135,000 × 1.45% | $1,958 |
| Additional Medicare (0.9%) | ($135,000 − $125,000) × 0.9% | $90 |
| Total Medicare tax | — | $2,048 |
Notice that MFS filers hit the Additional Medicare Tax at a much lower threshold ($125,000) than MFJ filers ($250,000). Filing separately can trigger this tax for each spouse independently if either has wages above $125,000.
How Employers Withhold the Additional Medicare Tax
Employers do not know your filing status or your spouse’s income. By law, an employer starts withholding the extra 0.9% when your wages from that single employer exceed $200,000 in the calendar year — regardless of whether you are single, married, or filing separately.
This creates two common mismatches:
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Under-withheld (most common for couples): A couple each earns $160,000. Neither employer withholds the Additional Medicare Tax, but the couple’s combined $320,000 exceeds the $250,000 MFJ threshold. The couple owes $70,000 × 0.9% = $630 extra at filing. They can avoid a surprise by requesting additional withholding on Form W-4 or making an estimated tax payment.
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Over-withheld (MFS filers): A married-filing-separately filer who earns exactly $200,000 has the 0.9% withheld on none of their wages by their employer (the employer threshold is $200,000 — it triggers only above that). But the MFS threshold is $125,000, so they owe 0.9% on $75,000 = $675 at filing.
Self-Employed Workers and Additional Medicare
Self-employed workers pay the Additional Medicare Tax at the same thresholds. If you also have W-2 wages, those wages count first toward the threshold, and then your self-employment net earnings are stacked on top.
Example — $80,000 self-employment profit plus $150,000 W-2 wages, single:
The $150,000 W-2 wages fill up all but $50,000 of the $200,000 single threshold. Additional Medicare Tax applies to $50,000 of W-2 wages (withheld by employer starting when W-2 wages cross $200,000 — none withheld here since W-2 stays under $200k). For SE earnings, the threshold is reduced by W-2 wages already counted: $200,000 − $150,000 = $50,000 remaining. Net SE earnings = $80,000 × 0.9235 = $73,880. Additional Medicare on SE = ($73,880 − $50,000) × 0.9% = $23,880 × 0.9% = $215.
Medicare vs. Social Security: Key Differences
| Feature | Social Security | Medicare |
|---|---|---|
| 2026 employee rate | 6.2% | 1.45% |
| Wage base cap | $184,500 | None |
| Additional rate | None | 0.9% over threshold |
| Employer match | 6.2% | 1.45% (not the 0.9%) |
For a combined view of how both taxes affect your paycheck, see FICA tax explained. For the Social Security wage base and how it is calculated, see Social Security tax 2026. If you earn income as a freelancer or sole proprietor, see self-employment tax explained for how the SE version works.
Consult a tax professional if your household situation — multiple jobs, self-employment alongside W-2 income, or a high-income MFJ return — makes the Additional Medicare Tax calculation complex.