Cost of living in the United States

There's no single U.S. cost of living — the biggest variable by far is which state and city you land in — and healthcare stands apart as the one expense category with no real equivalent in most other countries.

Cost of living is a metro-area question, not a national one

More than in almost any other country in this guide series, asking “what does it cost to live in the U.S.?” is close to meaningless without naming a city. Overall cost-of-living indices commonly show more than a 2x gap between the most expensive metros (San Francisco, New York, Honolulu, Boston) and the least expensive (much of the South and Midwest), driven mostly by housing but also touching groceries, transport and services. A grocery basket that costs $120/week in a low-cost metro can run $170–$200/week in a high-cost one; a monthly unlimited transit pass ranges from about $30 in some mid-sized cities to $132 in New York City.

Everyday costs

Outside of rent (covered separately), typical monthly costs for a single adult look like: groceries $300–$500, dining out highly variable but a casual restaurant meal averages $18–$25, a basic phone plan $30–$60, and gym membership $30–$60. Car ownership is close to mandatory outside a handful of dense cities with strong transit (New York, Chicago, Boston, San Francisco, D.C.) — factor in insurance ($100–$250/month depending on state and driving record), gas, and parking, which can itself run $200–$400/month in dense downtowns.

Healthcare: the biggest structural difference

This is the category with no real equivalent in most other developed countries covered in this guide series. There is no universal public health system for the general working-age population; coverage is normally tied to your employer, who typically pays most of the premium and you pay the rest via payroll deduction (commonly $100–$400/month for an individual, more for family coverage). Plans still carry meaningful cost-sharing: average annual deductibles of $1,500–$2,000+ on many employer plans before insurance starts paying its share, plus copays and coinsurance on top.

If you lose your job, COBRA lets you continue your former employer’s exact health plan — but you now pay the full premium yourself (both your former share and the employer’s), often $500–$700+/month for an individual, for up to 18 months. The alternative is buying an individual plan on your state’s ACA marketplace (healthcare.gov or a state exchange), where costs depend heavily on income-based subsidies, and high-deductible health plans paired with a tax-advantaged Health Savings Account (HSA) are a common lower-premium, higher-out-of-pocket option. Whatever plan you choose, verify your specific doctors and hospitals are “in-network” — going out-of-network, even accidentally (a routine risk during ER visits, where you don’t always choose your treating physician), is the root cause of the notorious American surprise medical bill, where a single ER visit or hospital stay can generate bills in the thousands or tens of thousands of dollars even for insured patients, though federal “No Surprises Act” protections since 2022 have closed some of the worst gaps for emergency and certain out-of-network provider bills.

Putting it together

Compared to most other relocation destinations, the U.S. isn’t simply “expensive” or “affordable” — it contains destinations at both extremes, and the two variables that matter most in choosing where to land are which metro area you’ll live in and whether your employer offers strong health coverage. Get both right and daily life can be comparable in cost to Western Europe or Canada; get either wrong and costs — especially an unexpected medical bill or a high-cost-metro lease — can escalate faster than in almost any other country in this guide.