What people wish they’d known

Many British people who move to the USA love the opportunities and the energy. But the same few surprises come up again and again. Knowing them early makes the first year easier.

1. Healthcare costs money even with insurance

Most people get health insurance through their employer. You pay part of the premium (the monthly cost of the plan) from your salary, and then you pay a share of each bill. According to KFF’s 2025 survey of employers:

• The average premium was $9,325 a year for single cover and $26,993 for family cover. Workers paid on average $1,440 and $6,850 of that
• The average deductible (what you pay yourself before the insurance pays) was $1,886 for single cover
• After the deductible, you usually pay a copay (a fixed fee, on average $27 to see a family doctor and $45 for a specialist) or coinsurance (a percentage of the bill, on average 19%)
• Small employers often pass on more of the cost: workers at firms with 10 to 199 staff paid $8,889 on average for family cover

Compare the health plan as carefully as the salary. See Healthcare and insurance and Understanding a US job offer.

2. Holidays are short

No federal law requires paid holiday, paid sick days or paid public holidays. They are a matter of agreement between you and your employer, and some states add rules of their own. In March 2025, private-sector workers got on average 11 days of paid vacation after 1 year, rising to 16 after 5 years. The UK minimum is 5.6 weeks. Negotiate holiday before you sign, and see Working in the USA.

3. Your visa depends on your job

• Most work visas (H-1B, L-1, E-2, O-1) tie you to one employer or business. If the job ends, there is currently a grace period of up to 60 days to find a new sponsor, change status or leave
• On 11 September 2026, the Department of Homeland Security published a proposal to remove that 60-day grace period. It still applies for now, so check USCIS for the latest position
• The H-1B is a lottery, and since September 2025 a $100,000 fee on some new H-1B petitions has been fought in the courts: two federal courts have blocked it and the government is appealing, so check USCIS. See How do I get a job in the USA?
• Visa appointments at the US Embassy in London are limited, so apply as early as you can. Applicants for some visas, including H-1B and J, are told to set their social media accounts to public

Don’t resign, sell your home or book flights until your visa is approved. Rules can change quickly, so check the official pages and get advice from an immigration attorney. See Visa routes to the USA.

4. You start with no credit score

Your UK credit history doesn’t move with you. The same big credit agencies operate in both countries, but they keep separate records, and US lenders identify you by your Social Security number. Without a US score, renting a flat, getting a phone contract or a credit card can be harder or need a bigger deposit. Some lenders use Nova Credit to read your UK credit file. Otherwise, a secured credit card (where you put down a cash deposit that becomes your limit) is a common way to start. See Building a credit score.

5. The price on the label isn’t the price you pay

Sales tax is added at the till, not shown on the shelf, and it varies by state and city. On 1 January 2026, the average combined state and local rate was 8.99% in California, 8.54% in New York and 6.25% in Massachusetts. In a sit-down restaurant, a tip of 15% to 20% or more of the bill is expected. Budget for both. See Food, shopping and tipping.

6. Rents vary hugely by city

Nationally, rents are flat: the median was $1,388 a month in September 2026, 0.4% lower than a year before. But San Francisco is very different: rents in the city were up 26% in a year, driven by technology jobs. Austin rents were down 2.1%. Rents are quoted by the month, and landlords often ask for proof of income and a credit check. See Renting a home.

7. Making friends takes effort

Many people find Americans easy to talk to and quick to invite you to things. Turning that into close friendship takes longer, especially in car-based suburbs. Most people say the first year is the loneliest. Joining something regular, such as a school group, a sports league, a running club, a faith group or volunteering, helps most. See Making friends.

8. Your money gets more complicated

Once you are a US tax resident, you are generally taxed like a US citizen: on your worldwide income, including interest and gains on savings you leave in the UK. Get cross-border tax advice before you move or invest money. See Your money in the UK and UK tax when you leave.