How to Use International Mail-Order Safely and Legally for Medications in 2026

By Joe Barnett On 1 Jan, 2026 Comments (10)

Buying medication from overseas used to be simple. For years, Americans could order pills, supplements, or prescriptions from countries like Canada, India, or the UK, and they’d arrive in the mail with no extra fees - as long as the package was under $800. That changed on August 29, 2025. The U.S. government ended the $800 de minimis threshold for all international mail. Now, even a $15 bottle of blood pressure pills can trigger customs duties, paperwork, and delays. If you still want to use international mail-order for medication, you need to know the new rules - or risk having your package seized, fined, or returned.

What Changed in 2025?

Before August 2025, over 97% of international packages entering the U.S. were cleared without any duty or tax. That included most small medical shipments. The $800 rule made it easy for people to save money on insulin, antidepressants, or generic antibiotics bought from overseas pharmacies. But on August 29, 2025, Executive Order 14324 wiped that rule out. Now, every commercial shipment - even one valued at $5 - must pay customs duty unless it’s a true personal gift under $100.

This isn’t just about revenue. The government says it’s about safety, fairness, and control. But the real impact is on everyday people. A 2025 analysis by the Postal Regulatory Commission found that the new rules could make 65-75% of small international medical shipments economically unviable. That means if you’re buying a $30 monthly supply of metformin from a Canadian pharmacy, you might now pay $40 in duties and fees - wiping out your savings.

Two Ways Duties Are Collected (Until February 2026)

Right now, there’s a temporary system in place that gives you two choices for how duties are calculated. But this won’t last. After February 28, 2026, only one method will remain.

Method 1 (Ad Valorem): You pay a percentage of the item’s declared value. This rate depends on the type of medication and its Harmonized System (HS) code. For most prescription drugs, it’s between 1% and 5%. This method works best if you’re buying low-cost generics.
Method 2 (Flat Rate): You pay a fixed fee based on the country of origin: $80 for countries with low tariffs, $160 for medium, $200 for high. This sounds scary - but it only applies if the carrier chooses it. Most postal services won’t use it because it’s too risky for small shipments.

Here’s the catch: Method 2 is rarely used anymore. Deutsche Post, DHL Parcel Germany, and other major carriers stopped accepting business parcels to the U.S. after August 22, 2025, because they couldn’t figure out how to handle the new rules. So if you’re ordering from a small overseas pharmacy, they may not even ship to you anymore - unless you use a carrier that still works with the U.S., like DHL Express or FedEx.

HS Codes Are Mandatory - And You Need the Right One

Starting September 1, 2025, every commercial shipment must include a six-digit Harmonized System (HS) code. This is a global classification system that tells customs what’s inside the package. For medication, the HS code determines the duty rate. Get it wrong, and you could be charged 300% more than you should.

For example:

Insulin (HS 3001.10) - duty rate: 1.5%
Generic metformin (HS 2932.19) - duty rate: 2.8%
Testosterone gel (HS 3004.90) - duty rate: 5%

Many overseas pharmacies don’t know U.S. HS codes. If your package arrives with a vague label like “vitamins” or “health supplement,” customs will classify it as something else - often at a much higher rate. Always ask your pharmacy to include the correct HS code on the commercial invoice. If they don’t know it, use the USITC’s online tariff database to look it up yourself.

Documents You Must Have - No Exceptions

Forget just sticking a note that says “gift.” Customs now requires full documentation for every commercial shipment. If you’re ordering medication, your package needs:

Commercial invoice: Must list the exact name of the medication, dosage, quantity, manufacturer, and declared value. No vague terms like “medicine” or “pills.”
Packing list: Matches what’s on the invoice.
Proof of prescription (if required): For controlled substances, you may need a copy of your prescription from a U.S.-licensed doctor.
Country of origin: Every item must state where it was made.

Missing any of these? Your package will sit in customs for weeks - or get destroyed. There’s no appeal process for small shipments. If it’s not perfect, it’s gone.

A DHL truck at a home at dusk, customs officer showing a duty invoice as a patient watches nervously from inside.

Who Pays the Duty? And How?

This is the biggest source of confusion. Before 2025, the sender paid nothing. Now, someone has to pay. But who?

There are three options:

The sender pays: The pharmacy includes duties in the price. This is rare. Most overseas pharmacies won’t do it.
The carrier pays and bills you: DHL, FedEx, or UPS will pay customs upfront, then send you a bill. This is the most common route - but it’s expensive. You’ll pay the duty plus a $15-$30 handling fee.
You pay directly to CBP: If your package is flagged, you’ll get a notice from U.S. Customs. You can pay online through Pay.gov using their International Mail Duty worksheet. But you only get 30 days to pay - or the package is returned or seized.

Most people end up paying through the carrier. That’s why using express services like DHL Express is often the only practical way to get medication through now. Standard USPS or Canada Post won’t handle it.

What Medications Are Allowed?

Not all drugs can come in by mail - even if you pay the duty. The FDA bans imports of:

Unapproved new drugs
Controlled substances (like Adderall, Xanax, oxycodone) unless you have a valid U.S. prescription and the medication is FDA-approved
Medications that aren’t labeled in English
Products that look like they’re for resale

For example: You can legally import a 3-month supply of generic lisinopril from Canada if it’s for personal use, properly labeled, and you have a prescription. But you can’t import 12 bottles of the same drug - that looks like you’re reselling it.

The FDA says they mostly ignore small personal shipments - but they’ve increased inspections by 200% since August 2025. If you’re caught importing unapproved drugs, you could face fines, or worse, criminal charges.

What Are Your Alternatives?

If the new rules make international mail-order too risky or expensive, here are three legal alternatives:

Use a U.S. pharmacy that sources globally: Companies like GoodRx or Blink Health partner with international manufacturers to bring down prices - but they handle all the customs paperwork for you.
Order from a Canadian pharmacy with a U.S. warehouse: Some Canadian pharmacies now ship from fulfillment centers in Michigan or New York. No cross-border customs, no duties.
Ask your doctor about patient assistance programs: Many drug makers offer free or low-cost medications to people who qualify based on income. Check websites like NeedyMeds.org.

These options cost more upfront than ordering directly from overseas - but they’re safe, legal, and reliable. And you won’t lose your medication to customs.

Split scene: underground pharmacy in India and U.S. FDA lab examining pills, connected by a broken 'De Minimis' thread.

Final Checklist for Safe, Legal Mail-Order in 2026

If you still want to try international mail-order for medication, use this checklist:

✅ Only buy from pharmacies that are licensed and verified (look for VIPPS or CIPA seals)
✅ Get the exact HS code for your medication - don’t guess
✅ Require a commercial invoice with full product details
✅ Use DHL Express or FedEx - avoid USPS or standard postal services
✅ Never order more than a 3-month supply
✅ Keep a copy of your prescription
✅ Pay duties immediately when billed - don’t wait

If you skip even one step, your package is at risk. The system isn’t designed for small buyers anymore. It’s built for big companies with customs brokers. If you’re not ready for that level of complexity, don’t risk it.

Is It Worth It?

For most people, the answer is no. The savings from buying medication overseas are now often erased by duties, fees, delays, and risk. A $50 bottle of medication might cost you $90 after customs. And if it gets seized, you lose everything - with no refund.

But for some - people on fixed incomes, those without insurance, or those needing medications not available in the U.S. - it’s still a lifeline. Just make sure you’re doing it right. The rules are strict, the penalties are real, and the window for easy cross-border shopping is closed.

Before you click “buy,” ask yourself: Is this worth the stress? Could I get the same drug legally through a U.S. pharmacy for a little more? If the answer is yes - go that route. Your health - and your wallet - will thank you.

Can I still order medication from Canada or India by mail in 2026?

Yes - but only under strict conditions. You must use a carrier like DHL or FedEx, pay all customs duties, provide a commercial invoice with the correct HS code, and ensure the medication is for personal use (no more than a 3-month supply). Standard postal services like USPS or Canada Post no longer accept commercial medical shipments to the U.S.

What happens if I don’t pay the customs duty?

Your package will be held in customs for up to 30 days. If you don’t pay the duty and any handling fees, it will be returned to the sender or destroyed. You won’t get a refund from the pharmacy, and you may be flagged by U.S. Customs for future shipments.

Are generic medications from overseas safe?

Some are - but many aren’t. The FDA doesn’t inspect foreign pharmacies. Only buy from verified sources with VIPPS or CIPA certification. Avoid websites that don’t require a prescription or that sell “miracle cures.” Counterfeit drugs are a real risk, and they can be deadly.

Can I import insulin or other controlled substances?

You can import insulin or similar medications if they’re FDA-approved and you have a valid U.S. prescription. But you cannot import controlled substances like Xanax, Adderall, or opioids unless they’re FDA-approved and you’re the named patient. Even then, customs may still seize them if paperwork is incomplete.

Why did the U.S. eliminate the $800 de minimis threshold?

The government says it’s to protect domestic industries, ensure fair taxation, and improve drug safety. But the main driver was the loss of tax revenue - the $800 threshold allowed $187 billion in annual shipments to enter duty-free. The new rules are expected to generate over $2.8 billion in new customs revenue each year.

What’s the easiest way to buy affordable medication legally?

Use U.S.-based pharmacy comparison tools like GoodRx, Blink Health, or RxSaver. They partner with licensed U.S. and international suppliers and handle all customs, labeling, and delivery. You get lower prices without the risk of customs seizure or legal trouble.

Next Steps

If you’re currently ordering medication by mail:

Check your last shipment’s tracking - did it clear customs? If not, you’re already at risk.
Call your pharmacy and ask if they know the HS code for your medication.
Switch to DHL Express or FedEx if you haven’t already.
Explore U.S. pharmacy discount programs - they’re safer and often cheaper than you think.

The era of easy, no-fee international medication orders is over. But you still have options - if you know where to look and how to play by the new rules.