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Guide to Expat Life for International Employees

Practical advice and guidance for employees moving to new countries

Welcome to Aetna International’s Guide to Expat Life eBook. This valuable resource for employers and employees contains information and advice for those relocating as part of international assignments.

The free, downloadable eBook provides useful information on the logistics of moving abroad, including visa requirements, recommended vaccines, how to access health care, advice to help you stay healthy and quick tips for settling in Hong Kong, South Africa, United, Arab Emirates, United States, Singapore and Canada.

Download the eBook as a print-ready PDF

An employee's guide to relocating overseas

Employers can also read and download our Employer’s Guide to Successful International Assignments to help ensure their teams settle into their new lives — staying healthy, happy and productive.

Hong Kong

Moving to Hong Kong:

  • For expats looking to experience a mixture of ancient Chinese tradition and innovative businesses, housing and transportation, Hong Kong is the perfect destination.
  • Visas:
    • Receiving a work visa in Hong Kong can be difficult.
      • Companies must prove to the Immigration Department that they have advertised in Hong Kong and a lack of suitable local applicants have applied.
      • A few industries recruiting expats are: financial services, architecture and healthcare.
    • Once a visa is confirmed, expats can apply for a dependent visa for family members under 18, parents if they are over 60, and spouses.

Staying Healthy:

  • Hong Kong has an excellent health system, but expats should research health risks before traveling.
    • Health Risks:
      • Air pollution
      • Levels of nitrogen oxides in the air have continued to surpass recommended by the World Heath Authority for the past 5 years.
      • On days when the pollution rating is especially high, avoid being outside for prolonged periods and wear a face mask.
      • Street food
        • Street food may be contaminated. Only buy food from suppliers with a Certificate of Hygiene and ask around to see which stalls and shops are the most popular.
      • Recommended vaccinations:
        • Diphtheria
        • Hepatitis A
        • Typhoid
        • Polio
        • Rubella
        • Tuberculosis

Accessing Care:

  • There are a number of ways to access care in Hong Kong, including through 44 public hospitals and 12 private medical centers.
  • There are three levels of health care providers:  
    • Primary: treatment of basic ailments
    • Secondary: deals with conditions including minor operations, accidents and emergencies, and some specialist services
    • Tertiary: focuses on long-term health problems and more complicated conditions
  • Many private health care centers only offer primary and secondary health care.
  • Expats should invest in international health insurance while in Hong Kong to avoid longer wait times at public hospitals, which require cash payment and a Hong Kong identity card.

Quick Tips to Remember:

  • In the hustle and bustle of Hong Kong, practicing mindfulness strategies can reduce stress. Try:
    • Traditional Chinese therapies, such as Chinese herbal medicines, massages and acupuncture
    • Tai Chi classes
    • Positioning objects through Feng Shui
    • Exploring local temples
    • Meditation

South Africa

Moving to South Africa:

  • 57% of expats find it easy to live in South Africa without speaking the other local languages and 67% have said that settling in has not been a problem.
    • Visas:
      • South Africa has high unemployment, so businesses are incentivized to hire locally. This policy can make the job hunt difficult for expats.
      • A few popular industries for expats are: engineering, education, executive management and information technology.
      • There are several visas for expats who want to work in South Africa, including the general work visa, critical skills visa and the intra-company transfer visa.

Staying Healthy:

  • Although beautiful, diverse, and growing economically, there are health risks to know about in South Africa, and the cost of care is high. HIV and AIDS is the most pressing concern.
    • Health risks:
    • HIV/ AIDS
      • 7.1 million people live with HIV in South Africa, making it the largest HIV epidemic in the world.
      • Prevalence of HIV within the general population is close to 20%.
      • South Africa is making improvements on stemming the epidemic, becoming became the first country in sub-Saharan Africa to fully approve pre-exposure prophylaxis (PrEP), the use of antiretroviral drugs to protect HIV-negative people from infection.
  • Recommended vaccinations:
    • Cholera
    • Hepatitis A
    • Hepatitis B
    • Rabies
    • Typhoid
    • Yellow fever
    • Malaria
    • Tuberculosis

Accessing Care:

  • South Africa has over 200 well-equipped hospitals and clinics, run by trained, professional, English speaking staff.
    • Do your research when choosing a health facility. There is a notable disparity between private and public health centers.
    • The cost of care is high and private health insurance is a must.   
      • Ensure your insurance covers dental and eye health, ambulance provision, emergency and critical care, specialist and routine consultations, elective surgery, and evacuations, if necessary.

Quick Tips to Remember:

  • South Africa has high levels of violent crime and two-thirds (64%) of expats rate their personal safety negatively. Expats should take the necessary precautions to secure their homes and possessions, including living in a gated community and employing private security.

United Arab Emirates

Moving to the UAE:

  • The UAE’s beauty, safety, tax-free salaries and excellent health care make it a top destination for expats. However, the UAE’s legal and constitutional system is complicated and may seem unfamiliar to expats who have never lived in the Middle East. 
    • The UAE was recently ranked as a top 10 destination for expats.
    • The most popular emirates for expat workers in the UAE are Dubai and Abu Dhabi.
    • Expats make up 80% of the UAE’s population.
  • Visas:
    • In Dubai and Abu Dhabi, work visas, called Labour Cards, are handled by employers prior to arrival. Expats will also need to procure a residence visa.
    • Many expats work for large international companies while in the UAE, including those in petroleum and financial services.

Staying Healthy:

  • Health risks are relatively low, but care can be expensive and not all treatments may be available.
  • Health Risks:
    • Depression is one of the most common health complaints in Dubai.
      • Nearly 18% of the population suffers from depression.
      • Unless explicitly stated in your UAE health insurance policy, psychiatric treatments are often excluded from health coverage.
      • Some prescriptions, including Diazepam (Valium), antidepressants (SSRIs, Prozac, etc.), and anything containing codeine are illegal, unless explicit permission is granted by the Ministry of Health.
    • Heat
      • Temperatures can reach 122 °F in the summer, so expats must take care to avoid conditions like dehydration and heat stroke.
  • Recommended vaccinations:
    • Hepatitis A
    • Hepatitis B
    • Tetanus
    • Typhoid
    • Rabies

Accessing Care:

  • Healthcare in the UAE ranks 27th in the world.
  • The UAE has many public and private hospitals available to expats. Expats can even find “healthcare cities,” which include one or more hospitals, several outpatient medical centers, labs, educational, research and specialist institutes, and employ thousands of healthcare professionals.
  • Health insurance is required for expats in both Abu Dhabi and Dubai.

Quick Tips to Remember:

  • The UAE is 95% Muslim, so expats would do well to respect customs and traditions, which greatly influence the law.
    • Some local laws and customs:
      • A permit is necessary for the purchase of alcohol from registered vendors.
      • Electronic cigarettes are illegal.
      • Public displays of affection are not accepted and may even lead to arrest.
      • Homosexuality is illegal.

United States

Moving to the U.S.:

  • The U.S. offers a strong economy and diversity in backgrounds, climate and landscape. However, immigration laws are in flux.
  • Visas:
    • In 2016, 1,183,505 people were granted lawful permanent resident status in the U.S.
    • Expats are required to obtain a Green Card to live and work permanently in the U.S., or they can also apply for employment-based non-immigrant visas, which are often quicker to obtain, but temporary.
    • Popular industries include: technology, engineering, professional services, and financial services.

Staying Healthy:

  • Although serious health risks in the U.S. are rare, expats should research risks in their intended destination.
  • Health Risks:
    • Opioid addiction
      • From 1999-2016, more than 350,000 people died from an overdose involving any opioid, including prescription and illicit opioids.
      • More than 191 million opioid prescriptions were written to American patients in 2017.
  • Climate
    • Weather varies significantly around the U.S., ranging from the sweltering summers in the south to mild year-round weather in the west.
    • Expats with health conditions such as asthma, atopic dermatitis, or arthritis should think carefully before relocating to a new climate.

Accessing Care:

  • The United States has an excellent, world-renowned health care system, although it can be expensive.
    • The median charge for outpatient conditions in the emergency department is $1,233.
    • Many hospitals in the U.S. are privately owned, which facilitate shorter wait times for medical services.
    • Most expats do not immediately qualify for any financial assistance with medical costs through government-sponsored programs such as Medicare or Medicaid, so comprehensive health insurance is necessary to cover treatment.
  • Recommended vaccinations: 
    • Tetanus and diphtheria
    • Haemophilus influenzae type B (Hib)
    • Hepatitis A
    • Hepatitis B
    • Rotavirus

Quick Tips to Remember:

  • There are 10 federal holidays in the U.S., ranging from traditional holidays like New Year’s Day and Christmas to memorial holidays for Martin Luther King Jr. and George Washington’s birthday. However, not all businesses observe each holiday, so it is important expats check with individual employers


Moving to Singapore:

  • Tiny, safe, and rich in culture and diversity, Singapore is a welcoming destination for expats who want to experience the beauty of Asia in a bustling city.
    • Its population is about 5.6 million, with noncitizens accounting for 39% of this total.
    • 99% of expats living in Singapore feel safe.
  • Visas:
    • Foreigners are actively recruited to work in Singapore in a wide range of industries, including IT, funds management, venture capital, insurance media, advertising and aerospace.
    • Different roles require different work visas and visas are classified by employment level, ranging from professionals, skilled and semi-skilled workers, and trainees and students.

Staying Healthy:

  • Health risks in Singapore are relatively low compared to some other Asian countries, but there are still steps that expats should take.
    • Health Risks:
      • Zika Virus
        • In 2016, Singapore had an outbreak of the Zika virus.
        • Practicing mosquito bite-protection, especially for pregnant individuals, is a critical deterrence step.
      • Smog
        • Singapore currently has “moderate” air quality, but pollution rates have hit hazardous levels as recently as 2015.
    • Recommended vaccinations:
      • Hepatitis A & B
      • Typhoid Fever
      • Japanese Encephalitis
      • Rabies
      • Yellow Fever
      • Tuberculosis

Accessing Care:

  • Singapore has one of the best health systems in the world.
    • Singapore has 18 public and not-for-profit hospitals and 10 private hospitals and specialist clinics.
    • Singapore was ranked first in progress made in meeting the health-related United Nations Sustainable Development Goals.
      • Singapore has a universal healthcare system for permanent residents and citizens, who pay into the mandatory Medisave program, which provides basic coverage.
      • Expats may be offered health insurance through their employer, but plans may not provide full coverage or be suitable for those with existing medical conditions.

Quick Tips to Remember:

  • Singapore was ranked as the world's most expensive city in 2016, so managing your finances is critical.


Moving to Canada:

  • Canada offers a financially stable, diverse, and welcoming environment for expats who seek a high standard of living.
    • 45% of expats in Canada are considering staying in the country permanently.
    • 81% of expats regard the attitude towards foreign residents as friendly.
  • Visas:
    • Canada has a more complex visa application process than some other industrialized nations.
      • Expats can apply for one of three visas, including The Federal Skilled Worker Program, the Federal Skills Trade Program and the Canadian Experience Class Immigration Program.
      • Each region has its own application program for expats.
    • A few popular industries for expats include: energy and natural resources, construction and manufacturing.

Staying Healthy:

  • Health risks for expats to Canada are relatively low, yet risk remains.
    • Health Risks:
      • Altitude:
        • Certain regions have a very high altitude. Gradually acclimate to changes in altitude to avoid potentially dangerous side effects, such as Acute Mountain Sickness.
      • Mental Health:
        • 1 in 5 Canadians experience a mental health problem each year.
        • Expats can identify mental health resources in Canada through a number of associations and government initiatives, including the Mental Health Commission of Canada.
    • Recommended vaccinations:
      • Hepatitis A
      • Hepatitis B
      • Rabies

Accessing Care:

  • Canada has an excellent, publicly funded healthcare system, informally known as “Medicare.”
    • The Canada Health Act establishes criteria and conditions for all health insurance plans in Canada.
    • Most healthcare services are free at point of access and are distributed regionally.
    • Most health services, including specialists, are accessed by a government issued Health Card. All permanent residents, even children, must register for a Health Card with their territory or province, which can take three months to obtain.

Quick Tips to Remember:

  • Climate and culture vary dramatically in Canada. Expats should pay particular attention to the local language spoken in their region, with Ontario using English and Quebec using French.