Fine Print Guide

Guide

New to the US

US insurance may work very differently from what you're used to. Health coverage is mostly tied to jobs, car insurance is priced on your history in the US, and every state sets its own rules. Here is the order most newcomers sort things out in.

At a glance

  1. Get health coverage from day one Depends on state or visa
  2. Get renters insurance before you move in Often required by someone else
  3. Get car insurance before you drive Required by law
  4. Understand why liability limits are high here Optional
  5. Check what your job gives you: life and disability Optional
  6. If you buy a home: home insurance, and check flood risk Often required by someone else

  1. 1 Get health coverage from day one

    Depends on state or visa

    Medical care in the US is expensive: an emergency room visit can cost thousands of dollars. There's no national health service, so you need a plan.

    • If you have a US job: ask HR when the employer plan starts. Some plans have a waiting period of up to 90 days. Some people cover the gap with a short-term travel medical plan.
    • If you don't: moving to the US opens a special enrollment period, usually 60 days from your arrival, to buy a plan on the marketplace.
    • Help with Marketplace premiums depends on your income and immigration status, and a 2025 federal law narrowed it. From 2027, many lawfully present immigrants who don't have a green card can still buy a Marketplace plan but won't get help with premiums. Check HealthCare.gov for the current rules.
    • Some visas, like J-1, set their own minimum coverage. Some states, including California and Massachusetts, require residents to have coverage.
    The four numbers that decide what a health plan costs you

    The premium is what you pay monthly. The deductible is what you pay before the plan starts sharing costs. After that you pay a copay or coinsurance. The out-of-pocket maximum caps your yearly total. See the worked example on the health insurance page.

    Read more: Health insurance · Travel insurance

  2. 2 Get renters insurance before you move in

    Often required by someone else

    Many leases require it. It covers your belongings against fire, theft and water damage, and protects you if you accidentally damage someone else's property or a guest is hurt. The landlord's insurance covers none of that.

    Read more: Renters insurance

  3. 3 Get car insurance before you drive

    Required by law

    Almost every state requires liability insurance, and you need it the moment you drive a car you own off the lot.

    • License: most insurers want a US driver's license. Many states only let you use a foreign license for a limited time, so start early.
    • No US driving record: your record abroad usually doesn't count, so you may be priced like a new driver for a year or two. Ask insurers whether they accept driving records from your home country; a few do.
    • No US credit history: in most states, insurers use credit history in pricing. Building credit will lower your price over time.
    • Limits: state minimums are low. Higher liability limits cost more but protect more of your savings.

    Read more: Car insurance

  4. 4 Understand why liability limits are high here

    Optional

    Lawsuits over injuries can lead to large awards in the US, and the person who wins can pursue your savings and future wages. That's why Americans often carry higher liability limits on car and home policies and add an umbrella policy for $1 million or more.

    Read more: Umbrella insurance

  5. 5 Check what your job gives you: life and disability

    Optional

    Employers often offer group life and disability insurance when you start, sometimes free. It's easy to overlook in the first weeks, and it usually ends when the job ends. If your family depends on your income, see whether it's enough.

    Read more: Life insurance · Disability insurance

  6. 6 If you buy a home: home insurance, and check flood risk

    Often required by someone else

    Your lender will require home insurance. Federally regulated or backed lenders also require flood insurance if the house is in a high-risk zone. Standard home insurance doesn't cover flood, even outside those zones.

    Read more: Homeowners insurance · Flood insurance

Things that often surprise people

  • Health insurance usually comes through your job, and changing jobs can mean changing plans and doctors.
  • Doctors and hospitals outside your plan's network can cost far more, or not be covered.
  • An explanation of benefits from your health plan is not a bill.
  • Car insurance prices depend on your ZIP code and, in most states, your credit history.
  • Parents visiting you need visitor medical insurance. Green-card holders can usually buy into Medicare only after 5 years of residence, and it's premium-free only with enough US work history.
  • Insurance is regulated by each state, so the rules and required coverages change when you move between states.
  • Standard home and renters policies don't cover flood.
  • Using some public benefits can matter for certain immigration applications. Check the USCIS public charge guidance before applying for programs like Medicaid.

Official sources