This month I was asked to be on a Three Tomatoes’ panel about living overseas. I lived in the UK for ten years. My children were born in London. My first home was in Notting Hill Gate. My Holland Park playground friends are still there. It was living overseas that propelled me to start a tour company for women: The Women’s Travel Group.

As some of you think about living overseas, there are critical things to consider.

Visas. Glance into your passport visa pages onto which immigration officials stamp approved entry.  Without a visa, you cannot enter another country to work or live. For US citizens going to Europe / Schengen legal duration of your stay is usually 3 months. To stay longer than 3 months, you need a ‘long stay visa’. These differs country to country.    For UK there is now also an online form called ETA-UK. In 2026 for most of Europe, there will be a form called ETIAS.

What does the visa entitle you to?  The most important question on most minds is will I get health care?  The UK has socialized medicine called the NHS. Without legal residency, you cannot access the National Health Service (NHS). Emergency care is offered, sometimes free. Longer stay is not free. Example you are in a car accident on a London street and are taken to an NHS Emergency room by ambulance. Your triage care might be free. If you have to stay overnight, your care is not free.  You should insure healthcare through travelers’ medical insurance. If you’re not a resident in the UK, you pay for NHS hospital treatment, charged 150% of the national NHS rate. SOLUTION; travel insurance for primary payments. For seniors, some Medicare policies cover medical expenses overseas, but only as secondary, which means you pay and submit expenses later. My husband broke his leg and had an operation in Paris: the cost including a single hospital room: $19,000. We paid by American Express then submitted 80 pages (in French) to our insurer. They paid. A big difference is I had to go to a medical supplies store to buy crutches, to a chemist to buy his medicine and find a wheelchair to help him get to the airport.

Medicine overseas? Generally, medicine is cheaper overseas. In my experience, in most countries, you need a local doctor’s prescription to show the pharmacist. The cost of medicine changes country to country with Ireland and Switzerland the highest and Eastern Europe the lowest. Not all US brand medicines are available overseas, and most insurers for medicine only give you 3 months’ supply at one time. Special items like Band-Aids for sensitive skin or your favorite mouthwash or artificial tears might not be available overseas.

Europeans are more comfortable with holistic medicine.  Example: Recently a UK friend fell on a London pavement. Her doctor recommended she use topical Arnica and take Arnica pills to reduce bruising. Wander into a drug store in a major European city and find a herbal and other alternative medicines.  US Brand names might not be available; generics will be. For some traditional travel medicines, like anti malaria pills, buy them overseas if you can. I bought anti malaria pills ‘over the counter’ in London for about $11.

Lodging? Center city rents are high in most European cities. Average 26,000 Pounds in London for small flat or $35000 per year. Rent is quoted by the week or month. Do not expect space, central air or even central heating. Appliances are small. Washers heat their own water; a simple wash takes an hour +. Most heat from radiators is on a clock near the boiler, and goes on and off for peak hours.

Money, bank accounts and checks are different; it night be hard for you to get a European bank account. US banks have European city center offices, but usually for corporate business.  A European credit card is hard to get; fortunately, apple pay and pay pal are more common. (Europe is mainly a cashless society now). American cards will work overseas, Amex less so. If you stay for a long time, move all your billing on line. Printers and office equipment should be bought overseas; your smart phone calls will be expensive but will work. Look into a local sim card; some US smart phones now offer variety of sim cards in phone. Alternatively buy a pay as you go local cell phone and only put in the amount you think you will use.

Entertainment Your favorite streaming movies and TV shows might not be licensed overseas. Generally, theater, opera, and ballet is cheaper in Europe; you might have to join some groups  like The National Theatre, to get the early best seats; again cultural opportunities are reasonable, often subsidized. Senior prices rarely apply to non-legal residents.

Food is expensive. Quality is fabulous, with few additives. Shelf life is as little as 2-3 days. Look into locals’ supermarket carts, you’ll see a difference. They eat more dairy, fresh fruit, bread and less meat. There is less sugar in foods like yogurt. After giving birth to my sons, the hospital social worker suggested a diet of meat or fish 3 times a week and Irish stout to produce milk for them. Products are different, cheddar comes in multiple ages and coffee is marked by country of origin rather than brand. Your own bag is a must. Note: Delivery only is beginning in big cities.

Clothing sizes are smaller. Brands might have the same name but fit differently; colors match local preferences. Shoe lasts are different. Cosmetic colors are in synch with demographics.

Senior discounts like bus, museum tickets etc. usually, but not always, need an official id.

The tough one: making friends overseas. If you want to integrate with locals, you need to do the work.  Join groups like walkers, birders, painters, adult ed courses at community centers, universities or museums. Europeans are slower to become friends; they are not transient like Americans. Avoid political discussions. Copy behaviors you witness. An example is European friends do not talk about business or money. They dress up when going out. They eat later. They have coffee after the meal— with the meal is low class.

This list ends with a Thanksgiving dinner I held for London friends. An American female friend told a hilarious story that included the word f—k. There was a dead silence then uncomfortable shuffling amongst the British guests. You will learn quickly if you move overseas or you’ll return home.