Do You Buy Medicine From Canada? What the January 20 Customs Rule Means for You

A customs rule that worried millions of mail-order drug buyers moved from October 22 to January 20, 2027. Nobody can yet say how it will affect your order. Here is a plan.

The Short Answer

A new mail filing requirement from US Customs and Border Protection (CBP) now becomes mandatory on January 20, 2027. It was due to start October 22, 2026. The change could make it harder or more expensive to receive prescription medicine by mail from Canada and other countries.

Nobody can tell you yet how your order will fare. CBP says that the FDA decides whether a medicine shipment may enter. The US Department of Health and Human Services (HHS) says that the FDA will review personal imports "on a case-by-case basis." We found no detailed FDA guidance as of November 3, 2026. Use the time before January 20 to build a backup plan.

What the Rule Actually Does

For years, packages worth $800 or less entered the country with little paperwork. The government ended that exemption. CBP then wrote a new process for mail, published in the Federal Register on June 24, 2026.

Under the rule, mail that falls under another agency's requirements cannot use the simple process. Medicine falls under the FDA, so from January 20 a mailed medicine package must file through a process called Entry Type 13 or use formal entry. Gabriel Levitt of the nonprofit Prescription Justice told KFF Health News that shippers must post a bond and fill in a detailed data form for each package. KFF Health News also reports that these steps add cost. Levitt says that the data gives the FDA a clearer view of what is inside.

Reuters reports that the rule does not name medicines. It also does not create a new ban in the parts that we read. On October 14, CBP announced the delay and said that there are "no changes to international mail entry procedures before Jan. 20, 2027."

Why So Many People Worry

A 2020 study estimated that 2.3 million Americans regularly import medicine from abroad, and some surveys show higher numbers. The savings can be large. KFF Health News reported these cases.

These are individual reports, not typical prices. The second case is a generic sold abroad, not the US brand product. Ask your prescriber before you accept a foreign generic.

The general manager of the Canadian International Pharmacy Association (CIPA) told KFF Health News that its 51 member pharmacies expected a "complete shutdown." A customs logistics company said that it would keep shipping but could not promise delivery. That uncertainty remains.

What the FDA Says About Personal Imports

The FDA's policy page states: "In most circumstances, it is illegal for individuals to import drugs or devices into the U.S. for personal use." The agency also describes limited cases where it may use discretion. Those conditions include:

• The medicine treats a serious condition, and effective treatment may not be available in the United States.
• The seller does not promote the product to US residents.
• The product does not pose an unreasonable risk.
• You affirm in writing that the product is for personal use.
• The quantity is generally three months or less.
• You provide a US doctor's name, or proof that you began treatment abroad.

Read those conditions closely. Eliquis, Jardiance, and many other imported medicines are sold in the United States, and Canadian pharmacies advertise to US residents. So a typical mail order may not fit the FDA's conditions. That is our reading of the page, not an FDA ruling.

In practice, enforcement has been light. KFF Health News reports that the FDA said in 2022 that it checked about 1 in 2,000 medicine packages. Light enforcement is not legal permission, however, and the new data could change how often the FDA acts. This article is general information and not legal advice. For a question about your own shipment, contact the FDA's Division of Drug Information at 855-543-3784.

Tariffs Add Another Unknown

The federal government set a 100% tariff on many patented drugs in 2026, with lower rates for some trading partners and 0% for generics. CBP's guidance does not mention personal mail. KFF Health News reports that patients paid tariffs on brand-name shipments, but it gives no rate. We could not confirm what a person pays on one package. Ask your pharmacy for the full landed cost before you order.

Build Your Backup Plan Before January 20

1. Count your supply. Find out how many days of medicine you have on hand.
2. Check your timing. If you plan to order again, allow extra time for shipping and stay within your prescription. An order placed early still carries the legal limits above.
3. Keep your US prescription active. Ask your prescriber to confirm that a US pharmacy can fill it if a package stalls.
4. Price the medicine in the United States. Search it on RxGator so that you know your fallback cost.
5. Ask about a cheaper alternative. Your prescriber may know a covered medicine in the same class.
6. Apply for assistance now. Manufacturer programs can take weeks to approve.
7. Tell your prescriber if a package stalls. Do not stop or ration a blood thinner, heart medicine, or diabetes medicine without medical advice.

US Options That May Close the Gap

• Medicare negotiated prices. Negotiated prices for ten drugs began in 2026, including Eliquis at about $231 and Jardiance at about $197 for a 30-day supply. Those prices apply to the plan, so your share depends on your coverage. Fifteen more drugs follow in January 2027.
• The Part D cap. Covered drug costs stop at $2,400 in 2027. Purchases from abroad do not count toward that cap. Run the numbers before you assume that Canada is cheaper for the full year.
• Manufacturer programs. Many brand-name drug makers offer free medicine to people with low incomes. See our patient assistance guide.
• TrumpRx.gov and manufacturer cash offers. Some brand-name drugs now have direct cash prices. Check the list, because it changes.
• Nonprofit and low-cost pharmacies. Rx Outreach and Cost Plus Drugs carry many lower-cost generics.

How to Check a Foreign Pharmacy

The FDA's BeSafeRx program tells consumers to use online pharmacies that require a prescription, have a US address and phone number, offer a licensed pharmacist, and hold a state board license. A pharmacy in another country cannot meet the US license test. Groups such as CIPA and PharmacyChecker set their own standards for foreign pharmacies, but the FDA does not endorse them.

Whichever route you use, avoid any site that sells prescription drugs with no prescription. Avoid sites that offer controlled substances, or that hide their address. Inspect each package when it arrives, and ask a pharmacist if the pills look different.

Frequently Asked Questions

Will my order be stopped after January 20?

We do not know. The FDA has not published parameters for personal imports under the new process.

Could the date change again?

Yes. It moved once already. Check CBP's site and your pharmacy before you rely on any date.

Can I still drive to Canada?

The new rule covers international mail. However, the FDA's general policy on personal imports still applies at the border, and the same legal limits remain.

Should I order a full year of medicine now?

No. The FDA's discretion language generally refers to three months or less, and medicine can expire. A large order also adds cost and risk. Use the extra time to line up a US fallback.

What if my package is held?

Contact the pharmacy first, then your prescriber. If you take a medicine that you cannot safely miss, fill a short US supply while you wait.

What about my state's import program?

Florida and Colorado hold FDA authorization, but KFF Health News reports that neither state has imported any drugs yet. Those programs would not sell directly to you by mail.

The Bottom Line

The January 20 date gives you time, not an answer. Keep your US prescription active and learn your US fallback price now. Search your medicine on RxGator, then talk with your prescriber before your supply runs short.