Understanding Medicare Taxes and Hidden Costs

Medicare is a vital program that costs almost a trillion dollars annually. The majority of this funding comes from taxes. But do you know how much Medicare tax you’re contributing, and are you aware of the hidden taxes that some high-income individuals have to pay? In this article, we’ll delve into the world of Medicare taxes, explaining how they work, including hidden Medicare taxes, and how you can navigate them.

The Basics of Medicare Taxes

The Basics of Medicare Taxes

Medicare is funded through taxes known as FICA (Federal Insurance Contributions Act) taxes. If you work for someone else, it’s called the Federal Insurance Contribution Act. If you’re self-employed, it’s known as the Self-Employment Contribution Act. Currently, the total tax rate for FICA is 15.30 percent.

  • Social Security Contribution: If you work for someone else, 6.20 percent of every dollar you earn goes towards Social Security. Your employer matches this contribution, resulting in a total of 12.40 percent.
  • Medicare Contribution: For every dollar you earn, you pay 1.45 percent towards Medicare, with your employer matching this amount, totaling 2.90 percent.

So, as a worker for someone else, you contribute 7.65 percent (6.20 percent for Social Security and 1.45 percent for Medicare) of your income, and your employer contributes the same.

If you’re self-employed, you pay the full amount—12.40 percent for Social Security and 2.90 percent for Medicare. These are the standard Medicare taxes that every working individual pays.

Social Security Tax Limit vs. Ongoing Medicare Taxes

Social Security Tax Limit vs. Ongoing Medicare Taxes

Social Security taxes have a limit. In 2023, this limit is $160,200. If you earn more than this, you won’t pay the 12.40 percent Social Security tax on income above that threshold. However, Medicare taxes are different. They have no upper limit.

Additional Medicare Taxes for High-Income Earners

For high-income earners, there’s an additional Medicare tax beyond the standard 2.90 percent. This additional tax is 0.90 percent and applies to individuals with high incomes.

How Additional Medicare Taxes Work

To calculate this additional Medicare tax, the IRS uses a form called 89.59. Let’s take an example:

  1. Let’s say your income is $400,000.
  2. The standard Medicare tax rate is 2.90 percent.
  3. So, you’ve already paid $11,600 in Medicare taxes on the base rate of 2.90 percent.

Now, you need to calculate the additional tax on the income that exceeds the threshold. For married couples filing jointly, the threshold is $250,000.

  1. Your income is $400,000.
  2. The threshold for married filing jointly is $250,000.
  3. The difference is $150,000.

You’ll pay an additional 0.90 percent tax on this $150,000.

  • $150,000 x 0.90 percent = $1,350

So, you owe an additional $1,350 in Medicare taxes due to your high income. This is in addition to the standard Medicare tax you’ve already paid.

The Hidden Medicare Tax

The Hidden Medicare Tax

Medicare Part A and Part B are essential components of the program. Part A premiums are typically zero for 99 percent of people who have contributed to Medicare taxes for at least 40 quarters (equivalent to 10 years). If you don’t have enough quarters, you may be able to use your spouse’s or ex-spouse’s work record.

Medicare Part B, on the other hand, has a premium that varies based on your income, and it’s not tied to the 40-quarter requirement.

Income-Related Monthly Adjusted Amount (IRMAA)

Medicare calculates Part B premiums using a modified adjusted gross income (MAGI) from two years prior. If your MAGI exceeds certain thresholds, you’ll pay additional premiums, effectively making it a hidden tax.

Here are the income thresholds for 2023:

  • Single filer: $97,000 or less, no additional premium.
  • Married filing jointly: $194,000 or less, no additional premium.

As your income exceeds these thresholds, your Part B premium increases. At the highest income levels, you could be paying significantly more.

Understanding IRMAA Levels

There are five IRMAA levels based on your income. Each level increases the Part B premium you pay:

  • Level 1: 25% of the cost to cover you.
  • Level 2: 35% of the cost.
  • Level 3: 50% of the cost.
  • Level 4: 65% of the cost.
  • Level 5: 75% of the cost.

At the highest income level, this hidden Medicare tax can be as high as $560 per month, in addition to the standard Part B premium.

Appealing IRMAA

Appealing IRMAA

If your income decreases significantly due to a life-changing event, you can appeal to your IRMAA. The following events qualify for an appeal:

  1. Marriage
  2. Divorce
  3. Death of a spouse
  4. Work stoppage (full retirement)
  5. Work reduction (semi-retirement)
  6. Loss of income-reducing property
  7. Loss of pension income
  8. Employer settlement payment

By providing documentation of these events, you can request that Medicare recalculates your IRMAA based on your current circumstances.

Remember, IRMAA can affect both your Part B and Part D premiums, so it’s essential to keep track of your income changes and appeal when necessary.

Understanding Medicare taxes and hidden costs is crucial for planning your retirement and managing your healthcare expenses effectively. By staying informed and taking appropriate actions, you can navigate the Medicare system with confidence.


Understanding Medicare taxes and hidden costs is vital for anyone planning their retirement and managing their healthcare expenses. Medicare is a substantial program funded primarily through taxes, and it’s essential to grasp how these taxes work and how they may affect your finances. We’ve covered the basics of Medicare taxes, including Social Security and Medicare contributions, as well as the key differences between them.

One critical point to remember is that Social Security taxes have an upper limit, while Medicare taxes do not. This means that even high-income individuals continue to pay Medicare taxes on their earnings.

Frequently Asked Questions (FAQs)

What are Medicare taxes, and how are they funded?

Medicare taxes are contributions made to fund the Medicare program, which provides health coverage to eligible individuals. These taxes are primarily funded through payroll taxes collected from workers and their employers.

What is the current Medicare tax rate?

The current Medicare tax rate is 2.90 percent of your earnings. If you work for someone else, you pay 1.45 percent, and your employer matches that amount. If you’re self-employed, you pay the full 2.90 percent.

Is there an income limit for Medicare taxes like there is for Social Security taxes?

No, there is no income limit for Medicare taxes. Unlike Social Security taxes, which have an upper limit on taxable earnings, Medicare taxes apply to all of your earned income, regardless of how high it is.

What is the additional Medicare tax for high-income earners?

High-income earners may be subject to an additional Medicare tax of 0.90 percent on income that exceeds certain thresholds. This tax is in addition to the standard 2.90 percent Medicare tax.

How can I calculate the additional Medicare tax on high income?

To calculate the additional Medicare tax on high income, subtract the threshold amount (e.g., $250,000 for married filing jointly) from your total income subject to Medicare tax and then apply the 0.90 percent tax rate to the resulting amount.

What is the Income-Related Monthly Adjusted Amount (IRMAA)?

IRMAA is a hidden Medicare tax that affects the premiums for Medicare Part B and Part D. It is based on your modified adjusted gross income (MAGI) from two years prior and can increase your Medicare costs if your income exceeds certain thresholds.

How do I appeal IRMAA if I experience a life-changing event?

If you experience a qualifying life-changing event, such as retirement or a significant reduction in income, you can appeal IRMAA. You’ll need to provide documentation of the event and request that Medicare recalculates your premiums based on your current circumstances.

What are the common life-changing events for IRMAA appeals?

Common life-changing events that may qualify for IRMAA appeals include marriage, divorce, the death of a spouse, full retirement, semi-retirement, loss of income-reducing property, loss of pension income, and employer settlement payments.

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