What Is MED on a Pay Stub? Medicare Tax Rate, FICA, and Wage Rules
Last updated: July 20, 2026
Quick answer
MED on a pay stub means Medicare tax. It is the Medicare portion of FICA withheld from an employee’s Medicare-taxable wages. In 2026, the regular employee rate is 1.45%, the employer generally pays a separate matching 1.45%, and there is no annual Medicare wage cap. Your stub may label the same tax MED, Medicare, FICA MED, MED/EE, or Fed MED/EE.
MED usually appears in the tax or withholding section beside OASDI, Social Security, or federal income tax. It is a payroll tax, not the premium for a medical insurance plan. If your pay statement uses an unfamiliar variation, the amount and its location can help you identify it.
What do MED, MED/EE, and MED/ER mean?
Payroll systems shorten tax names in different ways. The labels below are common, but an employer’s payroll legend remains the final source for any company-specific code.
| Label | Usual meaning | Does it reduce employee net pay? |
|---|---|---|
| MED or Medicare | Employee Medicare tax | Usually yes |
| FICA MED or FICA-MED | Medicare portion of FICA | Usually yes |
| MED/EE, MED EE, or Fed MED/EE | Employee share of Medicare tax; EE commonly means employee | Usually yes |
| MED/ER, MED ER, or Fed MED/ER | Employer share; ER commonly means employer | Usually no; it may be shown for information |
| HI | Hospital Insurance tax, another name for Medicare tax | Usually yes when listed as an employee tax |
| ADDL MED or Fed Addl Med | Additional Medicare Tax | Yes, when applicable |
Do not guess at unusual codes. Labels such as MED R, PT MED, or a code that combines MED with FSA may be employer-specific. Check the pay-stub legend or ask payroll what the code includes before treating it as Medicare withholding.
Is MED the same as FICA?
MED is part of FICA, but it is not all of FICA. The Federal Insurance Contributions Act covers two payroll taxes: Social Security and Medicare. A pay stub may show them on separate lines because the rates and wage-limit rules are different.
| Feature | MED / Medicare | OASDI / Social Security |
|---|---|---|
| Standard employee rate | 1.45% | 6.2% |
| Standard employer rate | 1.45% | 6.2% |
| 2026 wage cap | No wage cap | $184,500 |
| Possible additional employee tax | 0.9% above applicable thresholds | No comparable additional tax |
The regular employee portions equal 7.65% when 6.2% Social Security and 1.45% Medicare both apply. Learn more in the ePaystubs guides to FICA on a pay stub and OASDI on a pay stub.
What is the Medicare tax rate in 2026?
The regular Medicare tax rate in 2026 is 1.45% for the employee and 1.45% for the employer. The combined regular contribution is 2.9%, but only the employee’s share is normally subtracted from the employee’s pay. The employer pays its share separately.
The IRS confirms that the 2026 Medicare rate remains 1.45% for each side and that Medicare has no wage base limit in Publication 15 (2026).
How to calculate MED on a pay stub
For a standard employee deduction, multiply the pay period’s Medicare-taxable wages by 0.0145:
Medicare-taxable wages × 0.0145 = regular employee MED withholding
The current deduction is $2,000 × 0.0145 = $29. The YTD number is a running total, so it should not be compared with only one pay period. If current and YTD columns are confusing, see current versus YTD on a pay stub.
What are Medicare-taxable wages?
Medicare-taxable wages are the earnings and taxable benefits to which Medicare tax applies after payroll follows the federal wage rules. This figure may equal gross pay, but it does not always.
- Do not calculate MED from net pay. Net pay is what remains after taxes and deductions.
- Do not assume every “pre-tax” deduction reduces Medicare wages. For example, employee 401(k) elective deferrals are generally still included in Social Security and Medicare wages.
- Some qualifying benefits can be excluded from Medicare wages when federal rules allow it.
- Tips, bonuses, sick pay, or taxable fringe benefits may be part of Medicare wages depending on the facts.
If the pay stub does not show a Medicare wage base, ask payroll for the amount used in the calculation. On Form W-2, Medicare wages and tips are reported in Box 5, while Medicare tax withheld is reported in Box 6. The 2026 IRS instructions for Forms W-2 and W-3 explain the Box 5 reporting rule.
Why is Medicare taken out of my paycheck?
Employers generally must withhold the employee portion of Medicare tax from wages covered by FICA. The tax helps finance Medicare Hospital Insurance. It can apply even when an employee is younger than Medicare eligibility age or has private health insurance because MED is a payroll tax, not an insurance premium chosen through an employer benefit plan.
You usually cannot opt out simply because you do not use Medicare. Limited exemptions can exist under federal law for particular workers or services, so an employee who believes an exemption applies should ask payroll or a qualified tax professional to review the exact facts.
Am I being charged Medicare twice?
Seeing FICA/EE and MED/EE on separate lines does not automatically mean Medicare was deducted twice. Some payroll systems use FICA/EE for the Social Security employee amount and MED/EE for the Medicare employee amount, even though Medicare is technically part of FICA.
Use the amounts to check what each line represents:
- A line close to 6.2% of Social Security-taxable wages is likely the employee Social Security amount.
- A line close to 1.45% of Medicare-taxable wages is likely the regular employee Medicare amount.
- An ER line generally reports an employer-paid amount and should not reduce net pay.
- If two employee deductions both equal about 1.45% of the same wage base, ask payroll for a line-by-line explanation.
Best verification: Compare gross pay, each taxable-wage base, current deductions, YTD deductions, and net pay. A label alone may not reveal how the payroll system calculated the line.
Does Medicare tax have a wage cap?
No. Regular Medicare tax does not stop at an annual wage ceiling. In 2026, Medicare withholding generally continues on all covered Medicare wages, while Social Security withholding stops after Social Security wages reach the $184,500 wage base.
This difference explains why a high-earning employee may see OASDI disappear later in the year while MED continues. It also explains why Medicare wages in W-2 Box 5 can be higher than Social Security wages in Box 3.
What is Additional Medicare Tax?
Additional Medicare Tax is an extra 0.9% employee tax on Medicare wages, self-employment income, and Railroad Retirement Tax Act compensation above the threshold for the taxpayer’s filing status.
| Filing status | Tax-liability threshold |
|---|---|
| Married filing jointly | $250,000 |
| Married filing separately | $125,000 |
| All other filing statuses | $200,000 |
The employer’s withholding rule is different from the employee’s final tax-liability threshold. An employer must begin withholding the extra 0.9% in the pay period when wages it pays to that employee exceed $200,000 for the calendar year, regardless of filing status. The employer does not match the additional tax. The employee reconciles the final amount on the federal income tax return. See IRS Topic No. 560 for the filing-status rules.
Additional Medicare Tax example
If one employer pays an employee $205,000 of Medicare wages during the year, the employer generally withholds the extra 0.9% on the $5,000 above its $200,000 withholding trigger. That additional withholding is $45, separate from regular Medicare withholding. The employee’s final liability can differ after filing status, a spouse’s wages, or income from another job is considered.
Why is my MED deduction not exactly 1.45% of gross pay?
A difference does not always mean payroll made an error. Check these possibilities:
- Wrong comparison amount: Medicare-taxable wages may differ from gross pay.
- Additional Medicare Tax: An extra 0.9% may have started after wages from that employer exceeded $200,000.
- Current versus YTD: A cumulative MED total was compared with one pay period’s wages.
- Payroll adjustment: The employer corrected an earlier underwithholding or overwithholding.
- Rounding: Payroll may round each pay-period calculation to the nearest cent.
- Combined or company-specific code: The line may include more than the regular employee Medicare amount.
If the number still does not reconcile, ask payroll for the Medicare-taxable wage base, rate, adjustment, and whether the line is employee-paid or employer-paid.
How to check MED on your pay stub
- Find MED, Medicare, FICA MED, MED/EE, or a similar code in the tax section.
- Confirm whether the label is EE (employee) or ER (employer).
- Locate the current Medicare-taxable wages, not net pay or a YTD amount.
- Multiply current Medicare-taxable wages by 0.0145.
- Check for a separate ADDL MED line, a payroll adjustment, and normal cent rounding.
- Repeat the review with the YTD wage and YTD tax columns if you are checking a year-to-date total.
- Ask payroll to explain any remaining difference in writing.
For a broader walkthrough of earnings, taxes, deductions, and net pay, use the guide to reading a pay stub.
Frequently asked questions
What does MED EE mean on a paycheck?
MED EE normally means the employee’s Medicare tax withholding. EE commonly stands for employee. The regular 2026 employee rate is 1.45% of Medicare-taxable wages.
What does MED ER mean on a pay stub?
MED ER normally means the employer’s Medicare contribution. ER commonly stands for employer. It may appear for information, but it should not normally reduce the employee’s net pay.
Is MED the same as health insurance?
No. MED is Medicare payroll tax. A health, medical, dental, HSA, or FSA deduction is a separate employee-benefit item, even if both appear in a health-related section.
Can I remove MED from my paycheck?
Most covered employees cannot opt out of Medicare withholding. If you believe a specific legal exemption applies, ask payroll or a qualified tax professional to review your worker status and the type of services performed.
Why did OASDI stop but MED continued?
Social Security has an annual wage base, while Medicare does not. In 2026, OASDI generally stops after Social Security wages reach $184,500, but regular MED continues on covered Medicare wages.
Does a 401(k) contribution reduce Medicare tax?
Employee elective deferrals to a 401(k) generally remain included in Social Security and Medicare wages even when they reduce federal income-tax wages. This is one reason a paycheck’s taxable-wage figures can differ.
Where does MED appear on Form W-2?
Form W-2 reports Medicare wages and tips in Box 5 and Medicare tax withheld in Box 6. Box 6 can include both regular Medicare tax and any Additional Medicare Tax withheld.
Do self-employed people pay Medicare tax?
Self-employed individuals generally pay the employee and employer portions through self-employment tax. The regular Medicare component is generally 2.9% of applicable net earnings, and Additional Medicare Tax may also apply.
Create a clear, accurate pay stub
Need to document real payroll details? Create a pay stub online with separate earnings, Medicare, Social Security, deductions, and YTD fields. Use accurate payroll information and verify all tax calculations before issuing the record.
Sources and references
- IRS Publication 15 (2026), Employer’s Tax Guide — 2026 Social Security and Medicare rates, wage-base rules, and employer withholding requirements.
- IRS Topic No. 751, Social Security and Medicare Withholding Rates — standard FICA components and rates.
- IRS Topic No. 560, Additional Medicare Tax — filing-status thresholds and employer responsibilities.
- 2026 General Instructions for Forms W-2 and W-3 — Medicare wages in Box 5 and Medicare tax in Box 6.
Editorial note: This article provides general educational information and is not legal, tax, accounting, or payroll advice. Payroll labels vary by employer and software. Use current IRS guidance and consult payroll or a qualified professional for advice about a specific record.