Have a smart plan for Medicare taxes

Medicare taxes may affect your income and investments—see what you can do.

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Key takeaways

  • Your Medicare tax exposure may include "unearned" income from rental property, the sale of investments, royalties, and other forms of passive income.
  • Consider a Roth IRA conversion, moving taxable investments into tax-advantaged accounts, or other ways to reduce your modified adjusted gross income, or MAGI.
  • The 3 income thresholds to note:
    • $250,000 for married couples filing jointly
    • $125,000 for married spouses filing separately
    • $200,000 for single and head of household (with a qualifying person)

When you hear "Medicare taxes," you probably don't think about your investments. But these taxes affect many upper-income Americans with higher taxes on both wages and investment income. All the more reason to have a tax-smart financial plan in place.

Medicare taxes affect upper-income people in 2 ways. First, a 3.8% Medicare surtax is levied on the lesser of net investment income or the excess of modified adjusted gross income (MAGI) above $200,000 for individuals, $250,000 for couples filing jointly, and $125,000 for spouses filing separately. (To learn how MAGI is calculated, see chart.) Second, wages above $200,000 (individuals), $250,000 (joint filers), and $125,000 (spouses filing separately) will be subject to higher payroll taxes.

Medicare payroll tax on earned income

The Medicare payroll tax is 2.9%. It applies only to earned income, which is wages you are paid by an employer, plus tips. You're responsible for 1.45% of the tax, and it's deducted automatically from your paycheck. Your employer pays the other 1.45%. (If you are self-employed, you pay the full 2.9%.)

High-wage earners will owe an additional 0.9% on earned income above the thresholds mentioned above. So, for example, if you are an individual filer whose income is $225,000, you will pay a 1.45% Medicare tax on the first $200,000, then 2.35% (1.45% plus 0.9%) on the next $25,000. Your employer is required to withhold the extra 0.9% once your wages pass the $200,000 threshold for individuals.

Another example: If you're married, and you and your spouse each earn $150,000, your employers will withhold 1.45% for Medicare tax, because neither of you exceeds the $200,000 individual threshold. But if you file a joint tax return, your combined earned income of $300,000 is $50,000 above the married filing jointly threshold. This means you will have underpaid your Medicare tax by $450 (0.9% of $50,000) and will owe the additional amount when you file your taxes. Speak with your tax advisor about potentially being required to make estimated tax payments.

Tax on net investment income

In the past, taxpayers weren't required to pay Medicare tax on income generated from investments such as capital gains, dividends, and taxable interest. Since 2013, however, you could owe a 3.8% Medicare tax on some or all of your net investment income (as part of the Patient Protection and Affordable Care Act of 2010).

The amount you owe is based on the lesser of your total net investment income or the amount of your MAGI that exceeds $200,000 for individuals, $250,000 for couples filing jointly, or $125,000 for spouses filing separately. 

In other words, you owe the 3.8% tax on the amount by which your investment income exceeds the income thresholds, or, if your wages alone already are higher than the income thresholds, you'll owe tax on the lesser of net investment income or MAGI that exceeds the thresholds.

The chart below summarizes how Medicare taxes work. Picture 3 buckets: one for net investment income, one for compensation (like W-2 wages), and one for additional taxable income. Add the buckets together and they equal adjusted gross income (AGI). Add foreign earned income and it equals MAGI. (Most investors don't have foreign earned income.) There are 2 types of additional Medicare tax: The 3.8% Medicare tax is levied on the lesser of net investment income or MAGI above the thresholds. The 0.9% surcharge is on W-2 income above the thresholds.

3 hypothetical examples

1. Single filer; surtax on investment income
Adam's MAGI is $240,000, of which $180,000 is wages and $60,000 is net investment income. His MAGI is $40,000 over the $200,000 threshold for individuals. He'll owe the 3.8% Medicare tax on his $40,000 over the threshold, because it is less than his $60,000 in net investment income. Remember, the Medicare tax is based on the lesser of MAGI over the threshold or net investment income. Adam's Medicare surtax will be $1,520 (3.8% of $40,000). He won't owe a 0.9% Medicare surtax on wages—his wages are below the $200,000 earned income threshold for individuals.

2. Single filer; surtax on both earned and investment income
Joan's MAGI is $230,000, of which $220,000 is wages and $10,000 is net investment income. Her MAGI is $30,000 over the $200,000 threshold for individuals. She'll owe the 3.8% Medicare tax on her $10,000 of net investment income, because it is less than the amount she is over the MAGI threshold ($30,000). Joan will also owe 0.9% on the $20,000 she is over the $200,000 earned income threshold for individuals. So Joan's Medicare tax will be $560, which includes $380 (3.8% of $10,000) and $180 (0.9% of $20,000).

3. Married couple filing jointly; surtax on both earned and investment income
Paul and Ann's MAGI is $372,000, of which $330,000 is wages and $42,000 is net investment income. Their MAGI is $122,000 over the $250,000 threshold for married couples filing jointly. They'll owe the 3.8% on their $42,000 of net investment income, because it is less than the amount they are over the MAGI threshold ($122,000). They'll also owe 0.9% on the $80,000 that their wages are over the $250,000 earned income threshold for married couples filing jointly. Their total Medicare tax surcharge will be $2,316, which includes $1,596 (3.8% of $42,000) and $720 (0.9% on $80,000).

What's investment income and what's not

For the purpose of evaluating Medicare tax exposure, it's important to know that "unearned" net investment income includes net rental income, dividends, taxable interest, net capital gains from the sale of investments (including second homes and rental properties), royalties, passive income from investments in which you do not actively participate (such as a partnership), and the taxable portion of nonqualified annuity payments.

Net investment income does not include tax-exempt interest from municipal bonds (or funds); withdrawals from a retirement plan such as a traditional IRA, Roth IRA, or 401(k); and payouts from traditional defined benefit pension plans or annuities that are part of retirement plans. Also exempt are life-insurance proceeds, veterans' benefits, Social Security benefits, and income from businesses in which you actively participate, such as a partnership or a Subchapter S (or "S corporations").

Determining what is or isn't considered net investment income can be challenging, so consult a tax advisor about your situation.

RMDs also count toward your MAGI

If you've reached age 70½ and have begun taking required minimum distributions (RMDs) from a traditional IRA, 401(k) plan, or 403(b) plan, be aware that these withdrawals are included in MAGI and count toward the surtax's income thresholds. When added to net investment income and any wages, they could push you over the thresholds and subject you to the new tax. Qualified withdrawals from a Roth IRA or Roth 401(k), however, are not included in MAGI and net investment income calculations.

6 things to consider

Be prepared. If you're married, filing jointly, and your combined wages will exceed the $250,000 income threshold for couples, you'll want to make sure that your joint Medicare surtax for the year isn't significantly higher than you anticipated.

  1. Contributing to a health savings account (HSA) will reduce your Medicare-eligible wage income, as well as your MAGI. For example, if you’re married, filing jointly, and your combined wages are $280,000, contributing $6,900 to an HSA will reduce your wage income to $273,100 and the Medicare surtax is reduced by $62.10 (or, $6,900 multiplied by .9%, or .009).
  2. Your employer won't take your spouse's income into consideration when figuring your Medicare tax withholding, but you can use IRS Form W-4 to have an additional amount deducted from your pay to cover the extra 0.9% tax on the amount by which you and your spouse exceed the combined income threshold.
  3. Reducing MAGI is difficult for those who are still working. One strategy would be to maximize your contributions to pretax retirement plans like traditional 401(k)s or 403(b)s.
  4. Qualified withdrawals from a Roth IRA or Roth 401(k) plan are not included in your MAGI. If you expect to be close to the MAGI threshold when you begin taking RMDs from a traditional IRA or traditional 401(k), you might consider the effect future taxable distributions will have on your exposure to the tax.*
  5. Another possible strategy would be to shift some of your investments with taxable earnings into municipal bonds and municipal bond funds, whose earnings are excluded from the MAGI and the net investment income calculation. Additionally, investments that produce taxable interest or that pay dividends could be held in a tax-deferred account like an IRA or possibly a tax-deferred annuity.
  6. You may also consider owning a form of permanent life insurance, as the cash value of these policies when withdrawn is not considered net investment income.

All in all, a tax-smart investment plan is more important than ever. With help from a financial advisor and careful execution of a well-designed plan, there may be ways you can potentially reduce net investment income and, thus, the potential impact of this tax. Also talk with your tax advisor to help ensure that your tax planning matches your investment and income needs.

Next steps to consider

Learn more about tax strategies designed to help you keep more of what you've earned.

Get help customizing your portfolio while seeking to manage tax liability.

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