United States · Insurance
Insurance in United States — health, travel, and digital-nomad cover, what is mandatory, and how to choose a plan.
AI-drafted, editorially reviewed. Confirm specifics with the official authority.
US insurance has two layers that answer to different authorities. Federal social insurance — Social Security and Medicare — is funded by FICA payroll taxes and administered by the Social Security Administration. Almost everything else you buy (auto, home, life) is regulated by your state, not federally. Auto liability insurance is mandatory in almost every state, and to check an insurer is licensed you go to your state insurance department, whose directory is on the NAIC site.
Beyond health cover, US insurance has two layers: federal social insurance — Social Security and Medicare, funded by payroll taxes via the Social Security Administration — and private insurance regulated at the state level (auto, home, life, etc.). Auto liability insurance is mandatory in almost every state. To check an insurer is licensed, use your state insurance department (directory via the NAIC).
- Social Security and Medicare are federal social insurance funded by payroll taxes (FICA), administered by the SSA.
- Most private insurance (auto, home, life, health) is regulated by each state, not federally.
- Auto liability insurance is mandatory in almost every state.
- Verify an insurer is licensed via your state insurance department (find it through the NAIC).
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Separate the federal layer from the state layer
Social Security and Medicare are federal social insurance funded by payroll taxes. Most private insurance is regulated by each state, not federally, so the two layers answer to different bodies.
- 2
Expect FICA on your payslip
Social Security and Medicare are funded by FICA payroll taxes and administered by the SSA. These are deductions rather than policies you choose, so there is nothing to shop for here.
- 3
Get auto liability cover before driving
Auto liability insurance is mandatory in almost every state. Because the requirement and the minimum limits are set at state level, check the rules for the state you actually live in.
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Verify the insurer with your state department
To check an insurer is licensed, use your state insurance department — you can find yours through the NAIC directory. Licensing is a state matter, so there is no single national list to consult.
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Re-check requirements if you move state
Since private insurance is regulated state by state, moving can change your obligations and your insurer's licence position. Treat a state move as a reason to review every policy.
- Federal vs state layers understood
- FICA deductions identified on payslip
- State minimum auto liability limits checked
- Auto policy in place before driving
- State insurance department located via NAIC
- Insurer licence verified before buying
- Policies reviewed after any interstate move
- Social Security Administration (SSA)
Federal social insurance (retirement, disability, survivors).
- NAIC — find your state insurance regulator
Directory of state insurance departments.
Frequently asked questions
Who regulates insurance in the United States?
Mostly your state, not the federal government. Social Security and Medicare are federal social insurance run by the SSA, but auto, home and life insurance are regulated by each state — so the licence check goes to your state insurance department, findable via the NAIC.
Is car insurance required in the US?
Auto liability insurance is mandatory in almost every state. Both the requirement and the minimum limits are set at state level, so check the rules where you live rather than assuming a national standard.
What is FICA on my payslip?
The payroll taxes that fund Social Security and Medicare, which the SSA administers. They are deductions rather than policies you select, so unlike auto or home cover there is nothing to compare or shop for.
How to choose cover
Which cover you need is decided by your residence status and how long you are staying, not by price. Most people end up in one of three situations — and the wrong one is usually chosen by buying travel cover for what is actually a residence, or paying twice for cover the statutory scheme already provides.
Statutory or employer cover — if you live and work here
Once you register as a resident or start a local job, enrolment is usually mandatory and often automatic through payroll. This is the cheapest and broadest cover available to you, so check whether you qualify before buying anything private — see what is mandatory in this country above.
Private or top-up cover — to fill what the statutory scheme leaves out
Dental, vision, prescriptions, private rooms and shorter waiting times commonly sit outside the statutory scheme, and employers often provide a top-up policy. Read what your statutory cover excludes first — buying a full private policy when you only need a top-up is the most expensive mistake here.
International, travel or nomad cover — for short stays and the gap before enrolment
This is the right product in three cases: you are staying too briefly to become a resident, your visa requires proof of cover before arrival, or the statutory scheme has a waiting period after you arrive. It is a bridge, not a substitute — once you are enrolled locally, most people drop it.
Check before you pay
- Does it satisfy the visa or residence requirement? If a permit asks for proof of cover, the policy must meet that authority's stated minimum — not merely exist.
- Where does it cover you? Check whether your home country and any country you transit are included — many international policies exclude your country of citizenship or limit it to a few weeks a year.
- How are pre-existing conditions handled? This is the most common claim refusal — look for the definition, the look-back period and whether a declaration is required.
- Outpatient or hospital-only? Cheap policies often cover hospitalisation but not GP visits, tests or prescriptions — which is most of what you will actually use.
- Direct billing or reimbursement? If the insurer does not pay the hospital directly, you need the cash up front and the paperwork afterwards.
- Is the insurer licensed to operate here? The country's financial regulator — listed in the official authorities below — publishes the register. An unlicensed policy can be unenforceable locally.
- What happens at renewal? Check age limits, whether premiums rise after a claim, and whether cover ends the day your visa status changes.
International providers people commonly use
Richbay is not an insurer or a broker and does not assess your circumstances. These are widely used international providers, listed for the third case above — check eligibility, the terms in the list above, and whether the provider is licensed where you are going.
- SafetyWing
Subscription travel-medical cover aimed at remote workers and long trips; monthly rolling rather than a fixed trip length.
- Genki
Monthly international health cover for nomads and expatriates, with a longer-term plan for people who stay abroad indefinitely.
- Cigna Global
Full international private medical insurance — modular, aimed at people relocating rather than travelling, and generally priced accordingly.
General information, not insurance advice. Cover, eligibility and legal requirements differ by country, visa type and personal circumstances — confirm with the authority and the insurer before relying on any of this.
Government portals
- The White House — Official residence and office of the US President — executive orders, policy briefings, press releases
- U.S. Department of State — US passport and visa services, travel warnings, embassy information worldwide
- Internal Revenue Service (IRS) — Federal tax filing, refund status, ITIN/EIN applications, and Free File program
- USCIS — Green card, H-1B and work visas, naturalization, immigration benefits, and case status