MED on a pay stub is Medicare tax: 1.45% of your Medicare wages, withheld every payday to fund Medicare, the federal health insurance program mainly for people 65 and older. Your employer pays the same again. Unlike Social Security, it has no yearly cap, so it comes out of every paycheck all year.
Medicare usually sits next to Social Security in the taxes section, because the two together make up FICA. If the line looks a little smaller than 1.45% of your gross pay, that is normal; the reason is below.
How Medicare is worked out on one paycheck
Medicare is not figured on gross pay. It is figured on Medicare wages, which are gross pay minus a few pre-tax deductions. Here is one real calculation, made with our pay stub generator for an invented dental hygienist paid hourly every two weeks:
| Line | Why | Amount |
|---|---|---|
| Gross pay | 72 hours x $38.00 | $2,736.00 |
| Health insurance, pre-tax | A cafeteria plan premium: comes off before Medicare is figured | −$112.00 |
| Medicare wages | What the Medicare rate is applied to | $2,624.00 |
| Medicare withheld (1.45%) | The line on the stub, often printed as MED | $38.05 |
| 401(k), 6% of gross | Lowers federal income tax wages, but not Medicare wages | −$164.16 |
| Federal taxable wages | What federal income tax is figured on | $2,459.84 |
The health insurance premium is paid through a cafeteria plan, so it comes off before Medicare. The 401(k) contribution does not: retirement deferrals avoid federal income tax now, but they are still Medicare wages. That is why this hygienist’s federal taxable wages are lower than their Medicare wages.
The same rules decide Social Security wages, so on most stubs the Social Security and Medicare wage figures match. They only part ways once a high earner passes the Social Security wage base of $184,500 for the year, where Social Security stops and Medicare carries on.
What the Medicare line can be called
Payroll systems use different labels for the same tax. The amount is the giveaway: if a line is 1.45% of your Medicare wages, it is Medicare.
| What the stub says | What it is |
|---|---|
| MED, MEDI, MEDCR, MEDICARE | The employee's Medicare tax withheld this pay period |
| FICA-MED, FICA MED, MED/EE, MEDICARE EE | The same tax, labelled as part of FICA or as the employee (EE) share |
| MED/ER, MEDICARE ER | The employer's matching share, shown for information; it is not taken from your pay |
| ADDL MED, MED SURTAX | Additional Medicare Tax, withheld only on wages over the yearly withholding threshold |
| OASDI, SS, FICA-SS | Social Security, the other half of FICA, which is a separate line |
A line marked ER is the employer’s share. Some stubs show it so you can see the full cost of your job, but it is not deducted from your pay and should not be counted in your deductions total.
Why Medicare never stops, and when it goes up
Social Security stops for the year once your wages reach its wage base. Medicare has no wage base, so 1.45% comes out of every dollar of Medicare wages, from the first paycheck in January to the last in December.
It can go up. Once one employer pays you more than $200,000 in a calendar year, it must also withhold Additional Medicare Tax of 0.9% on the amount above that. Your stub may show it as a separate line or fold it into the Medicare line. Additional Medicare Tax explains who actually owes it.
Your employer pays Medicare too
For every dollar of Medicare withheld from you, your employer pays a matching dollar, so the full Medicare tax on your wages is 2.9%. The employer deposits both halves with the IRS along with your Social Security and income tax, and reports them every quarter on Form 941.
There is one exception to the match: the employer pays nothing extra for Additional Medicare Tax. That part is the employee’s alone.
Medicare on your W-2: boxes 5 and 6
Your Form W-2 repeats the year’s totals. Box 5 is your Medicare wages and tips, and box 6 is the Medicare tax withheld. Box 6 should equal the year-to-date Medicare figure on your last pay stub of the year.
Box 5 is often higher than box 1, your federal taxable wages, for the reason shown in the example: 401(k) deferrals count in box 5 but not in box 1. W-2 box 12 codes shows where those deferrals are reported.
Is Medicare tax ever refunded?
Usually not. Medicare tax withheld at 1.45% is not refunded when you file, even if you owe no income tax. It pays for Medicare itself, not toward your income tax bill. The exception is Additional Medicare Tax withheld when your household ends up under its threshold, which is credited back on your return.
If you think too much Medicare was taken, check the Medicare wages first. A wrong figure usually means a pre-tax benefit was coded incorrectly, and only your employer can correct it on payroll and on the W-2.
If you work for yourself
Independent contractors do not have Medicare withheld, because no employer is paying them. They pay both halves themselves as part of self-employment tax when they file. W-2 vs 1099 compares the two arrangements.
To see the Medicare line on a stub for your own pay, our pay stub generator calculates it from your gross pay and pre-tax deductions, with year-to-date totals. For the Social Security half of FICA, see OASDI on a paycheck.
Sources: IRS Publication 15 (2026); IRS Questions and answers for the Additional Medicare Tax; General Instructions for Forms W-2 and W-3. Checked October 26, 2026.
