2025 Medicare Tax Rates & Thresholds

Regular Medicare Tax

1.45%
Employee rate (2.9% total with employer)
Applied to all wages - no limit

Additional Medicare Tax

0.9%
Employee only - no employer match
On income over threshold

Income Thresholds

Single: $200,000
Married Joint: $250,000
Married Separate: $125,000

Medicare Tax Calculator

Enter your income information to calculate Medicare taxes

Income Information

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Your total annual wages from W-2
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Spouse's annual wages for joint threshold
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Self-employment, investment income, etc.

Employment Details

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Year-to-Date Information (Optional)

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Wages earned year-to-date
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Regular Medicare tax withheld YTD
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Additional Medicare tax withheld YTD

Medicare Tax Planning

Planning Tip: Additional Medicare Tax has no employer match and may require estimated tax payments if not enough is withheld.

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Expected bonus or commission income
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Extra Medicare tax to withhold per paycheck

Complete Medicare Tax Guide 2025

Master Medicare taxes with our comprehensive guide covering regular Medicare tax, Additional Medicare tax, and advanced planning strategies.

Medicare Tax Fundamentals

Regular Medicare Tax (2025):
  • Employee rate: 1.45% of all wages
  • Employer rate: 1.45% of all wages
  • Combined rate: 2.9% of all wages
  • No wage base limit (unlike Social Security)
Additional Medicare Tax (2025):
  • Rate: 0.9% on income over thresholds
  • Single filers: $200,000 threshold
  • Married filing jointly: $250,000 threshold
  • Married filing separately: $125,000 threshold
Key Differences from Social Security:
  • No wage base cap (Social Security caps at $176,100)
  • Additional Medicare Tax has no employer match
  • Applies to all earned income types
  • Self-employed pay both employee and employer portions

Net Investment Income Tax (NIIT)

NIIT Overview:
  • Rate: 3.8% on net investment income
  • Same income thresholds as Additional Medicare Tax
  • Applies to investment income, not wages
  • Separate from Medicare tax but related
Income Subject to NIIT:
  • Interest, dividends, and capital gains
  • Rental and royalty income
  • Income from passive activities
  • Income from trading securities
Income NOT Subject to NIIT:
  • Wages, salaries, and self-employment income
  • Distributions from qualified retirement plans
  • Tax-exempt municipal bond interest
  • Income from active business participation

Withholding and Estimated Taxes

Employer Withholding Rules:
  • Regular Medicare: Withheld on all wages
  • Additional Medicare: Starts when wages exceed $200,000
  • Withholding based on individual wages, not household income
  • No consideration for spouse's income in withholding
Estimated Tax Considerations:
  • May need estimated payments if under-withheld
  • Married couples often under-withhold due to combined income
  • Self-employed must make quarterly payments
  • Consider safe harbor rules to avoid penalties
Form W-4 Adjustments:
  • Request additional withholding on Line 4(c)
  • Useful for married couples with combined high income
  • Can specify dollar amount per paycheck
  • Review annually and after major life changes

Special Situations

Multiple Employers:
  • Each employer withholds based on wages paid
  • May result in under-withholding of Additional Medicare Tax
  • Consider additional withholding or estimated payments
  • Reconcile total tax owed when filing return
Self-Employment Income:
  • Pay both employee and employer portions (2.9%)
  • Additional Medicare Tax applies to net SE income
  • Make quarterly estimated tax payments
  • Can deduct employer portion as business expense
Railroad Retirement:
  • Subject to Medicare tax but not Social Security
  • Additional Medicare Tax applies to railroad wages
  • Tier 1 and Tier 2 taxes separate from Medicare
  • Special withholding and reporting rules

Advanced Medicare Tax Planning Strategies

High-Income Tax Reduction Strategies

Pre-Tax Retirement Contributions (2025):
  • 401(k) limit: $23,500 ($31,000 if 50+)
  • 403(b) and 457(b): Same limits as 401(k)
  • SEP-IRA: Up to 25% of compensation or $70,000
  • Solo 401(k): Up to $70,000 ($77,500 if 50+)
Health Savings Account (HSA) 2025:
  • Individual coverage: $4,300 contribution limit
  • Family coverage: $8,550 contribution limit
  • Catch-up (55+): Additional $1,000
  • Triple tax advantage: Deductible, grows tax-free, tax-free withdrawals
Other Pre-Tax Deductions:
  • Health insurance premiums (if self-employed)
  • Dependent care FSA: Up to $5,000
  • Commuter benefits: Up to $315/month
  • Life insurance premiums (group term up to $50,000)

Income Timing and Deferral

Deferred Compensation Plans:
  • Non-qualified deferred compensation (NQDC)
  • Defer income to lower-tax years
  • Reduce current year Medicare tax exposure
  • Consider employer financial stability
Bonus and Stock Option Timing:
  • Time bonus payments across tax years
  • Consider ISO vs. NQSO exercise timing
  • Evaluate restricted stock vesting schedules
  • Plan around Medicare tax thresholds
Business Income Planning:
  • Time business income and expenses
  • Consider installment sales for large gains
  • Evaluate like-kind exchanges (1031)
  • Plan equipment purchases for depreciation

Investment and NIIT Planning

Tax-Efficient Investing:
  • Hold investments longer than one year for capital gains rates
  • Use tax-loss harvesting to offset gains
  • Consider municipal bonds for high earners
  • Maximize tax-deferred and tax-free accounts
Asset Location Strategies:
  • Hold tax-inefficient investments in tax-deferred accounts
  • Keep tax-efficient investments in taxable accounts
  • Use Roth accounts for high-growth investments
  • Consider asset allocation across account types
Real Estate Strategies:
  • Active participation can avoid NIIT on rental income
  • Real estate professional status eliminates NIIT
  • Consider opportunity zones for capital gains deferral
  • Use depreciation to offset rental income

Business Structure Optimization

S-Corporation Election:
  • Reasonable salary subject to Medicare tax
  • Distributions not subject to self-employment tax
  • Must pay reasonable compensation to owner-employees
  • Consider state tax implications
Partnership Structures:
  • Limited partners generally not subject to SE tax
  • General partners subject to SE tax on all income
  • Consider LLC with multiple members
  • Evaluate guaranteed payments vs. distributions
Employee vs. Independent Contractor:
  • Employees: Employer pays half of Medicare tax
  • Contractors: Pay full self-employment tax
  • Consider total compensation package
  • Ensure proper classification to avoid penalties

Medicare Tax Calculator FAQ

The regular Medicare tax rate is 1.45% for employees (2.9% total with employer match). There's also an Additional Medicare Tax of 0.9% on income over $200,000 for single filers, $250,000 for married filing jointly, and $125,000 for married filing separately.

No, there is no wage limit for Medicare tax. Unlike Social Security tax which caps at $176,100 in 2025, Medicare tax applies to all wages and self-employment income with no maximum limit.

Additional Medicare Tax is an extra 0.9% tax on wages, compensation, and self-employment income above certain thresholds. Only the employee pays this tax - there is no employer match. It applies to high earners to help fund Medicare.

Self-employed individuals pay both the employee and employer portions of Medicare tax (2.9% total) on their net self-employment earnings. They also pay Additional Medicare Tax of 0.9% on income over the thresholds, just like employees.

Employers must begin withholding Additional Medicare Tax when an employee's wages exceed $200,000 in a calendar year, regardless of filing status. If you're married and file jointly with combined income over $250,000, you may owe additional tax when filing your return.

Generally, no. Medicare tax is not refundable like excess Social Security tax can be. However, if too much Additional Medicare Tax was withheld based on your actual filing status and income, you may get a refund when you file your tax return.

Medicare taxes apply to wages, salaries, tips, bonuses, and self-employment income. They do not apply to investment income, rental income, or retirement distributions. However, high earners may pay Net Investment Income Tax (3.8%) on investment income.

You can reduce Additional Medicare Tax by maximizing pre-tax deductions like 401(k) contributions, HSA contributions, and health insurance premiums. These reduce your taxable wages and may keep you below the Additional Medicare Tax thresholds.