How to Use International Mail-Order Safely and Legally for Medications in 2025

Buying prescription medications from overseas used to be simple. A quick search, a few clicks, and your pills would arrive in the mail-often cheaper than your local pharmacy. But as of August 29, 2025, that’s no longer true. The U.S. has ended the $800 duty-free threshold for all international packages. If you’re ordering medication from abroad, you’re now dealing with a system that’s stricter, more complex, and far more expensive. And if you don’t follow the rules, your package won’t just be delayed-it could be seized, fined, or even lead to legal trouble.

Why the Rules Changed in 2025

The old system let you import almost anything under $800 without paying taxes or duties. That’s how you could buy insulin from Canada for $30 instead of $300 in the U.S. But the government says that loophole was abused. Millions of packages slipped through without proper inspection. Some contained fake or unapproved drugs. Others were just cheap knockoffs with no quality control. Starting August 29, 2025, every commercial package entering the U.S. must pay duties-no exceptions, unless it’s a personal gift under $100.

This change hit the postal system hard. Deutsche Post, Canada Post, and other major carriers stopped accepting business parcels to the U.S. after August 22, 2025. That means if you’re trying to order from a small foreign pharmacy using regular mail, your package likely won’t even leave the country. The only carriers still handling these shipments are express services like DHL, FedEx, and UPS-and they charge more because they handle customs paperwork for you.

What You Can and Can’t Ship

Not all medications are treated the same. The FDA allows personal imports of prescription drugs under very specific conditions:

• The drug must be for a serious condition with no approved U.S. alternative
• You must have a valid prescription from a licensed U.S. doctor
• Only a 90-day supply can be imported at a time
• The drug must be legally sold in the country of origin
• You cannot be importing in bulk to resell

That means you can’t order ADHD meds, weight-loss drugs, or antibiotics from overseas just because they’re cheaper. Those are tightly controlled in the U.S. and require strict approval. But for chronic conditions like diabetes, hypertension, or arthritis-where generic versions are widely available overseas-you may still qualify.

Also, don’t assume that because a website says it’s “FDA-approved” or “licensed,” it’s legitimate. Many foreign pharmacies are scams. Look for sites with VIPPS certification (Verified Internet Pharmacy Practice Sites) or those listed on the National Association of Boards of Pharmacy’s safe pharmacy directory. If the site doesn’t ask for your prescription, walk away.

The New Duty System: Method 1 vs. Method 2

Now, every package must pay customs duty. But there are two ways it’s calculated-and you need to know which one applies.

Method 1 (Ad Valorem): This is the standard method. Duty is based on the declared value of the item, using the Harmonized System (HS) code. For most medications, the rate is between 0% and 5%. But here’s the catch: you must get the HS code right. If you mislabel your insulin as a “dietary supplement,” the duty could jump to 300% higher than it should be.

Method 2 (Flat Rate): This is a temporary option that ends February 28, 2026. It charges fixed fees based on the country’s tariff rate: $80 for low-tariff countries, $160 for medium, $200 for high. This sounds bad-but if your medication costs $120 and you’re shipping from a country with a 16%+ tariff rate, Method 2 would cost you $160 in duties. That’s more than the item itself. So Method 1 is almost always better if you know the right HS code.

Here’s what you need to know: Method 1 is your best bet. But you can’t just guess the HS code. Use the U.S. International Trade Commission’s online tariff database. For insulin, the correct code is 3001.10.0000. For metformin, it’s 2941.90.5000. Mess this up, and you’re risking a penalty.

Documents You Must Get Right

No more “gift” labels. No more vague descriptions like “health supplement.” CBP now requires full documentation:

• Commercial Invoice: Must list exact drug name, strength, quantity, manufacturer, and value. No abbreviations.
• Prescription Copy: A scanned copy from your U.S. doctor, signed and dated.
• Packing List: Matches the invoice exactly-no missing items.
• HS Code: Six-digit code printed on the invoice. Required since September 1, 2025.

If you’re shipping from a country with a trade agreement (like Canada or Mexico), you may also need a Certificate of Origin. Some countries require this automatically. Others don’t. But if you don’t include it and CBP asks, your package gets held.

For shipments over $2,500 per item, you’ll need to file an AES form with a Letter of Authorization. That’s rare for personal medication orders-but if you’re buying a year’s supply, you might hit that threshold. Don’t ignore it. Penalties start at $10,000 per violation.

Who Pays the Duty? (And How)

This is where most people get confused. Is it the sender? The recipient? The carrier?

Under the new rules, the recipient (you) is legally responsible for paying any duties and taxes. But carriers can collect it upfront. That’s why DHL and FedEx ask for payment before delivery. If you refuse to pay, the package is returned or destroyed.

Some foreign pharmacies now offer DDP (Delivered Duty Paid) shipping. That means they pay the duty for you and include it in the price. It’s more expensive upfront-but you avoid surprises. If you’re ordering from a small pharmacy that doesn’t offer this, assume you’ll pay extra at the door.

And here’s the kicker: if the duty isn’t paid, CBP can hold your package for 30 days. After that, it’s auctioned off or destroyed. No refund. No second chance.

Alternatives to International Mail-Order

If the cost and hassle of international shipping aren’t worth it anymore, here’s what you can do instead:

• Use U.S. mail-order pharmacies: Companies like CVS, Walgreens, and GoodRx offer 90-day supplies of generics for as low as $10-$20 per month.
• Check Canadian pharmacy partnerships: Some U.S. insurers now partner with Canadian pharmacies. You order through your insurer’s portal, and they handle the import legally.
• Apply for patient assistance programs: Drug manufacturers like Pfizer, Novo Nordisk, and Eli Lilly offer free or low-cost meds to qualifying U.S. patients.
• Use international fulfillment hubs: Some companies now warehouse medications in Mexico or Canada and ship them as domestic orders. That avoids U.S. customs entirely.

These options aren’t perfect-but they’re safer, legal, and often cheaper than trying to navigate the new customs system yourself.

Red Flags: When to Walk Away

Here are signs you’re dealing with a risky or illegal operation:

• The site doesn’t ask for a prescription
• They ship from a country known for counterfeit drugs (e.g., India, Pakistan, Bangladesh-without proper certification)
• Prices are too good to be true (e.g., $5 for brand-name insulin)
• The website looks unprofessional, has broken links, or uses free email domains (Gmail, Yahoo)
• They say “no prescription needed” or “FDA approved” without proof

If you’ve been scammed before, you know how hard it is to get your money back. Don’t risk your health-and your wallet-on a website that won’t give you a physical address or customer service phone number.

Final Checklist Before You Click “Buy”

Before you send money overseas:

1. Confirm your medication is allowed for personal import under FDA rules
2. Get a valid U.S. prescription
3. Verify the pharmacy is legitimate (VIPPS or NABP certified)
4. Ask if they offer DDP shipping
5. Confirm they’ll include the correct HS code and commercial invoice
6. Make sure the total value (meds + shipping) doesn’t exceed $2,500 per item
7. Know you’ll pay duties-budget for it

If you skip even one step, you’re gambling with your health and your money. The rules aren’t going back. The system is now built to protect consumers-and punish those who cut corners.

Frequently Asked Questions