HR Mavericks

Eddy’s HR Mavericks Encyclopedia

Medicare Tax
What do you know about Medicare tax… really? Take a simplified dive into the complex world of Medicare tax where blind spots will be uncovered and you’ll find yourself equipped with proactive action steps and newfound know-how.

What Is Medicare Tax?

Medicare tax is a payroll tax that helps fund the Medicare program, which provides health insurance coverage primarily to individuals aged 65 and older. It is part of the Federal Insurance Contributions Act (FICA) taxes, along with Social Security tax. Medicare tax is separate from income tax and is withheld from an individual's wages or self-employment income.

Employer vs Employee Medicare Tax

Medicare tax is divided into two components: the employer's portion and the employee's portion. Both the employer and the employee contribute a certain percentage of the employee's wages towards Medicare tax.

2023 Medicare Tax Rates and Thresholds

These rates and thresholds are subject to change, so it's advisable to refer to the latest IRS publications or consult with a tax professional for the most up-to-date information. Per the IRS as of 2023, the Medicare tax rates are as follows:

2023 Medicare Tax Rates

  • Employer medicare tax rate. Employers are responsible for paying 1.45% of the employee's wages as Medicare tax.
  • Employee medicare tax rate. Employees are required to contribute 1.45% of their wages as Medicare tax.
  • Combined medicare tax rate. Employer and employee contributions combined equal 2.9%.
  • Additional medicare tax rate. If an employee’s income exceeds the income threshold (explained below), an additional 0.9% of employee income goes toward medicare tax.

2023 Medicare Tax Thresholds

If an individual's wages, compensation or self-employment income exceeds the applicable threshold for their filing status, they become liable for additional Medicare tax. The regular Medicare tax rates of 1.45% for both employer and employee contributions still apply to all covered wages. If income exceeds these thresholds, employees are required to pay additional Medicare tax.
  • Married filing jointly. $250,000.
  • Married filing separately. $125,000.
  • Single. $200,000
  • Head of household (with qualifying person). $200,000.
  • Qualifying widow(er) with dependent child. $200,000.

How to Calculate Medicare Tax

Calculating Medicare tax involves determining the employee's wages and applying the appropriate tax rates. The Medicare tax rate for both the employer and the employee is 1.45%. Multiply the employee's wages by this rate to calculate the Medicare tax amounts for both the employee and the employer. As described above, if the employee's wages exceed the threshold amounts based on their filing status, an additional Medicare tax of 0.9% applies. To calculate the additional Medicare tax, subtract the threshold amount from the employee's wages and multiply the excess by the additional tax rate. The total Medicare tax liability is the sum of the employee Medicare tax, employer Medicare tax and additional Medicare tax (if applicable). It is important for employers to withhold and remit the employee's portion of Medicare tax and pay their own portion. Employers should consult IRS publications and guidelines for accurate calculations and to ensure compliance with Medicare tax regulations. Seeking assistance from a tax professional can provide further guidance on specific situations or complexities related to Medicare tax calculations.

How to Withhold and Report Medicare Taxes

It is crucial to consult the most recent IRS publications, instructions and forms related to Medicare tax withholding and reporting. Depending on your specific circumstances, you may need to consider additional exceptions. Seeking guidance from a tax professional ensures accurate compliance with the regulations. The following steps provide a general guideline and a great place to start.

Step 1: Obtain an Employer Identification Number (EIN)

Before hiring employees, obtain an Employer Identification Number (EIN) from the IRS for your organization. You can apply for an EIN online through the IRS website. This unique identifier will be used when reporting taxes and identifying your business.

Step 2: Determine Employee Medicare Tax Withholding

Calculate the amount of Medicare tax to withhold from each employee’s wages by following the instruction above (See section titled: “How to Calculate Medicare Tax”).

Step 3: Deposit and Report Medicare Taxes

Deposit the total Medicare taxes withheld from employees, along with the employer's share, using the Electronic Federal Tax Payment System (EFTPS) or another approved deposit method. Deposit schedules may vary based on the size of your payroll. Report the Medicare taxes on Form 941, the Employer's Quarterly Federal Tax Return. Form 941 is used to report income tax, Social Security tax, and Medicare tax withheld from employees, as well as the employer's share of these taxes. The form should be filed quarterly by the last day of the month following the end of the quarter.

Step 4: Annual Reporting

At the end of the year, provide employees with Form W-2, Wage and Tax Statement. Form W-2 summarizes their wages, tips and tax withholdings, including Medicare taxes. Ensure that the Medicare tax withheld is correctly reported on the Form W-2 before giving it to employees. File Form W-3, Transmittal of Wage and Tax Statements, along with copies of all employees' Form W-2 with the Social Security Administration (SSA) by the end of February. Form W-3 summarizes the information from all individual W-2 forms.

Step 5: Additional Medicare Tax

As described above, if an employee's wages exceed the threshold for the additional Medicare tax, you are required to withhold an additional 0.9% tax on the excess amount. This tax is separate from the regular Medicare tax. Report this additional Medicare tax on Form 8959, Additional Medicare Tax. Include the amount withheld when reporting on Form 941.

Medicare Tax Regulations and Requirements

Medicare tax requirements outline the obligations and responsibilities that employers must fulfill regarding the administration, withholding, reporting and payment of Medicare taxes. It's important for employers to understand and fulfill these Medicare tax requirements to ensure compliance with the law and avoid penalties or other legal consequences. Here are some key Medicare tax requirements for employers.

Withholding Medicare Taxes

Employers are required to withhold the employee's share of Medicare taxes from their wages. This includes the current Medicare tax rate for both the employer and the employee as well as additional medicare tax if applicable based on the employee’s tax filing status and wages.

Paying Employer's Share

Employers are responsible for paying their share of Medicare taxes as the employer’s share is separate from the employee’s portion and should be budgeted and accounted for accurately.

Reporting and Depositing Medicare Taxes

Employers must report Medicare taxes on Form 941. Additionally, Medicare taxes, along with other payroll taxes, must be deposited periodically using an approved deposit method. The deposit schedule varies based on the size of the payroll. (see “Step 3: Deposit and Report Medicare Taxes” above)

Forms W-2 and W-3

Employers must provide employees with Form W-2, Wage and Tax Statement, which summarizes their wages, tips, and tax withholdings, including Medicare taxes. This as well as form W-3, Transmittal of Wage and Tax Statements, must be filed with the Social Security Administration (SSA) by the end of February.


Employers are required to maintain accurate records of wages, tips and tax withholdings, including Medicare taxes, for each employee. These records should be kept for at least four years and made available for review if requested by the IRS.

Compliance With IRS Publications

Employers should refer to IRS publications, such as Publication 15 (Circular E), Employer's Tax Guide, and Publication 51 (Circular A), Agricultural Employer's Tax Guide, for detailed information on Medicare tax requirements and compliance guidelines.

Best Practices for Managing Medicare Tax

Managing Medicare tax effectively involves adhering to best practices to ensure compliance and accurate handling of tax obligations. Here are some best practices for managing Medicare tax.

Stay Informed and Up-to-Date

To stay informed about changes regarding Medicare tax, employers should check the IRS website regularly. While a general guideline is to review the site at least once a quarter or during major tax law changes, specific circumstances may require more frequent monitoring. Situations that may prompt more regular checks include announced changes by the IRS, annual updates at the beginning of the year, payroll system updates, legislative changes, and consultation with tax professionals or payroll experts for guidance on Medicare tax updates and changes. Action Step: Create a calendar event or reminder to review the IRS website quarterly.

Maintain Accurate and Complete Records (Don’t Toss Them!)

Maintain thorough and accurate records of employee wages, tips and tax withholdings, including Medicare taxes. These records must be maintained for at least four years as required by the IRS. Action step: Verify the position/employee responsible for ensuring records are consistently updated and organized. Reach out to offer support and take suggestions on how to make this responsibility more streamlined (it may be in need of an update).

Monitor Thresholds

Regularly monitor employees' wages to determine if they exceed the threshold amount for additional Medicare tax. Adjust withholding accordingly if employees cross the threshold. Action step: If you have an active part in payroll, check the features and documentation of your specific payroll software to determine if it includes the ability to monitor wages for Medicare thresholds. Ensure these features are set and active.

Conduct Periodic Reviews

These reviews typically take the form of internal audits or engaging external experts to ensure accuracy and thoroughness. The frequency of internal audits or engaging external experts to ensure accuracy regarding Medicare tax can vary depending on the size of the organization, the complexity of payroll operations, and the level of risk tolerance. However, as a general guideline, it is recommended for employers to conduct internal audits at least once a year. This allows for a comprehensive review of payroll records, tax calculations, and reporting procedures to identify any errors or discrepancies. Action step: Verify when the last periodic review took place. Get one in the books if the year mark is approaching.
Kayla Farber

Kayla Farber

Kayla is the Chief Innovation Officer at Hero Culture, where the passion is to create company cultures of retention using the power of personality.
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