Most expat employees take advantage of group health insurance plans offered by their employer. They can usually be extended to also cover the employee’s spouse or the entire family.
Usually, there is a choice of different packages. Generally, the higher your monthly contributions are, the lower the cost you incur for medical treatment — and vice versa. Virtually no insurance in the US provides 100% coverage. The Agency of Healthcare Research and Quality provides advice and guidance in choosing the right plan for you. In addition, there are two types of healthcare organizations or networks, HMO (Health Maintenance Organization) and PPO (Preferred Provider Organization). They maintain their own network of doctors, and members pay a fixed monthly rate to receive treatment at much lower rates or even free of cost.
Are you still not sure which type of healthcare coverage you need to get and what to look out for? Read our article on US healthcare and health insurance for more information.
At present, no common health risks are known in the United States. General health, safety, and hygiene standards are high, and there are no special immunization requirements for people traveling there. Expats with families whose children are likely to attend school in the USA should, however, make sure that the child’s standard vaccination record is up to date and that no booster injection is outstanding.
There are numerous public and private hospitals across the country. Private hospitals often have more modern facilities and better service, but are considerably more expensive.
The daily cost for hospital treatment can be quite high, and any bills arising from emergency treatment usually need to be settled immediately. If specialist treatment is not required, walk-in clinics in drugstore or supermarket chains offer a cheaper and increasingly popular alternative to doctors. They are staffed by nurses and physician assistants and mostly provide fast and reliable service.
Many North Americans rely on their car(s) for getting around. With the exception of some of the major cities, public transportation is often not adequate. New York City and Washington, D.C. have the most extensive subway and light rail networks, but there are also services operating in Boston, Chicago, Philadelphia, and San Francisco.
Even in these cities, however, remote suburbs are often not connected to the public transportation network. In smaller towns and cities, the only alternative to driving yourself is taking the bus or a taxi. Depending on the city, taxis can be of a standard color or make, such as the famous yellow cabs in New York City, but in other places they may be more difficult to spot. Taxis should always have a valid license, and it is common practice to tip the driver.
Traveling by bus can be a good way to explore the country and its various landscapes. Buses are also used for inter-city travel, e.g. the well-known Greyhound Lines. BoltBus is Greyhound’s cheap city-to-city service where you can find good deals for the major cities on the East Coast. Compared to many other parts of the world, rail services in the USA are underdeveloped. Even though the States has the largest railway network in the world, it is mainly used to transport freight and not passengers. Commuter trains are usually operated by independent companies.
Long-distance and inter-city train services are, however, provided by the National Railroad Passenger Corporation, a government-run company also known as Amtrak. For inter-state travel, most people either make use of the extensive and relatively affordable network of domestic flights or the world’s biggest road network and drive even really long distances to their destination.
Expats thinking about importing their car should contact the American Automobile Association for information on the validity of international driving licenses, insurance, and more. As a general rule, non-residents who bring their own car are exempt from car tax for the first twelve months of their stay. After that first year, the vehicle has to be exported or brought into compliance with federal motor vehicle safety standards.
If you intend to buy a car in the USA, consult the Kelley Blue Book for standard prices of new and used cars before agreeing upon a price with a trader. Driving in the USA is relatively easy. Apart from specific roads and bridges, there is no general road tax, but keep in mind that speed limits are enforced very rigorously.
Although the car is still the favorite mode of transportation for many Americans, many people also find other ways of getting around. You can learn more about public transportation in the USA in our Extended Guide section on Transport and Driving in the United States.
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