# Medicare tax withholding calculator / additional Medicare tax (2026)

Additional Medicare tax is 0.9% of FICA wages above a filing-status threshold. It is employee-only; there is no employer match. For 2026 the thresholds remain $200,000 (single and head of household), $250,000 (married filing jointly), and $125,000 (married filing separately). This page starts at $200,000 California, single, so the extra line is live.

Ordinary Medicare is 1.45% on all FICA wages. Additional Medicare is extra 0.9% only on the slice above the threshold. A single filer at exactly $200,000 is at the line; one dollar more starts the extra. Payroll must withhold additional Medicare once wages at that employer pass $200,000 in the year, even if a joint return would be under $250,000 — that mismatch is a refund-or-bill issue on the return, not something this paycheck sketch fully solves.

The $150k how-much-is page does not hit this line for a single filer. This URL exists because people search “additional Medicare tax on my paycheck.” Social Security is separate and still caps at $184,500 in 2026, so a $200,000 wage has already finished the 6.2% OASDI slice.

Compare California $200,000 with Texas $200,000: additional Medicare is federal. State tax differs. Reviewed October 2, 2026.

## Sample estimates

### $200k CA single (additional Medicare on)

- Gross: $200,000.00
- Federal income tax: $36,734.00
- Social Security: $11,439.00
- Medicare: $2,900.00
- State income tax: $14,370.42
- Net / take-home: $131,956.58 (effective tax 34.0%)
- Per paycheck net: $131,956.58 (1 periods)

### $200k TX single (same extra Medicare, no state PIT)

- Gross: $200,000.00
- Federal income tax: $36,734.00
- Social Security: $11,439.00
- Medicare: $2,900.00
- State income tax: $0.00
- Net / take-home: $148,927.00 (effective tax 25.5%)
- Per paycheck net: $148,927.00 (1 periods)

Label: engine estimates, not pay stubs.

## FAQ

### Who pays additional Medicare tax?

The employee. There is no employer match on the 0.9% additional Medicare tax.

### What is the 2026 threshold?

$200,000 single or head of household, $250,000 married filing jointly, $125,000 married filing separately. Unchanged from prior years in this engine.

### Does a 401(k) avoid additional Medicare?

Usually no. Traditional 401(k) deferrals stay in FICA wages. The health/FSA/HSA-style line can reduce FICA wages.

## Related

- [What is FICA on a paycheck](https://takehomecash.com/what-is-fica-on-paycheck/index.md)
- [How much is $150k after taxes](https://takehomecash.com/how-much-is-150k-after-taxes/index.md)
- [W-4 extra withholding](https://takehomecash.com/w4-extra-withholding/index.md)