Moving to the U.S. as an international nurse comes with many exciting changes! You’ll have a new job, new routines, and new financial responsibilities. One important topic that every international nurse should understand early on is U.S. tax rates and how to file U.S. taxes, since taxes can impact everything from your paycheck to your annual refund. 

In a previous blog post, we shared a helpful checklist for managing money after relocating. Understanding U.S. taxes is mentioned in this post, and we want to expand, as this can be overwhelming if you’re unprepared. 

U.S. taxes can feel confusing at first, particularly if you’re coming from a country with a different system. This guide will break down the basics. Remember, too, that it’s essential that you speak with a qualified tax professional or tax advisor for guidance based on your exact situation. 

How U.S. Tax Rates Compare to Other Countries 

If you’ve never worked in the U.S. before, employment taxes can feel like a big adjustment. In the U.S., you’ll see taxes taken out of every paycheck, which means your take-home pay will be lower than your hourly rate or salary. 

You may also notice that your paycheck includes more than one type of tax, like federal tax, state tax (depending on where you live and work), and Social Security/Medicare. If you’re curious about why this happens or what the deductions mean, the IRS has a simple explanation of paycheck withholding. 

Establishing Tax Residency 

One vital thing for international nurses to know is that tax residency is not the same as immigration status. Your visa or where you are in the immigration process doesn’t always determine how the IRS taxes you. 

Instead, the IRS has its own rules to decide whether you’re considered a U.S. resident for tax purposes. A common one is the Substantial Presence Test, which looks at how long you’ve been in the U.S. 

Because this can affect how you file your taxes, it’s strongly recommended that you get help from a professional tax advisor, especially during your first year in the U.S., to ensure that you file your taxes correctly. 

IRS Rules for Annual Tax Filing 

Once you start working in the U.S., you’ll typically file taxes once a year. Even though taxes are taken from your paycheck, you still need to file a tax return to confirm whether you paid the right amount. 

If too much was taken out, you may be eligible for a refund. If not enough was taken out, you may owe money. “Tax season” is in the spring, and you should receive your W-2 and any other documents needed to file taxes in early February. The IRS shares official deadlines and details in its guide on when to file. 

Staying Organized 

The easiest way to make tax season less stressful is to stay organized. You don’t need anything fancy; just keep your pay stubs, SSN paperwork, and important documents in one folder. When tax time comes, you’ll also need your W-2 (your employer sends it to you). Having everything in one place makes filing faster and easier. 

Seeking Help from a Tax Advisor 

If taxes feel overwhelming, you’re not alone. As we stated earlier, we highly recommend seeking help from a tax expert. You can rest assured knowing you’ve filed correctly, and it can also help you reduce stress and avoid mistakes. 

A tax advisor can help you understand your tax residency, figure out what forms you need, and check if you qualify for credits or tax deductions for nurses. The IRS also offers tips for choosing a tax professional if you’re not sure where to start. 

The Difference between 1040 and W-2 Forms 

You’ll hear these two terms a lot, so here’s the simplest way to understand them: 

A W-2 is what your employer gives you. It shows your total income and the amount of tax withheld. (Here’s the IRS overview of the W-2 form.) 

A 1040 is what you file with the IRS when you do your taxes. (Here’s the IRS overview of Form 1040.) 

In short: W-2 = what you receive. 1040 = what you file. 

The WorldWide HealthStaff Solutions Difference 

WorldWide HealthStaff Solutions (WWHS) does not provide tax advice. However, our team helps ensure you have the information and resources you need to feel prepared as you navigate financial responsibilities such as U.S. taxes. 
 
You’re making a life-changing step by relocating, and WWHS is here to empower you to make confident financial decisions and more, while building your life here and excelling in your nursing career. 



Whether you’re in the process of coming to the U.S. or are considering it for the first time, sign in to your WWHS account or sign up to apply to search for available jobs!