Free samples and trial offers for health products

A dental office hands each hygiene patient a trial-size tube of the whitening toothpaste it sells at the front desk. A med spa advertises a free full-size serum with any facial booked this month. A chiropractic clinic’s online shop offers a free first month of a supplement subscription, then ships a bottle every 30 days at the regular price. An integrative clinic mails sample packets of its own-label tea to everyone on its newsletter list.

All four are free offers, and the FTC has published a guide on the word free since 1971 (36 FR 21517). This guide reads the three federal texts that decide how these offers work: the FTC’s Guide Concerning Use of the Word “Free” (16 CFR Part 251), the online negative option law in the Restore Online Shoppers’ Confidence Act (15 USC 8403 and 8404), and the unordered merchandise statute (39 USC 3009). It is written for independent practices that sell products, such as dental offices, med spas, chiropractic and integrative clinics. A free consultation or first visit is a service offer with its own guide: free consultation offers. Shipping times and refunds for products you mail are in the Mail Order Rule for health products, and checkout designs that hide a recurring charge in dark patterns on healthcare websites. Free product sent to marketplace reviewers raises the review rules in our guide to selling health products on online marketplaces.

The short version

• “Free with purchase” means the purchase is at the regular price. Under 16 CFR 251.1(b), the buyer pays nothing for the free item and no more than the regular price for the other, and the regular price is the price you openly sold at for a substantial period, such as 30 days.
• Put every condition next to the offer. 16 CFR 251.1(c) says the terms belong in close conjunction with the free offer, and that an asterisk to a footnote is not disclosure at the outset.
• Calling it a gift or bonus does not change anything. 16 CFR 251.1(i) says those words cannot fix an offer that fails the guide.
• A free trial that turns into a charge online has three legal steps. 15 USC 8403 requires clear disclosure of all material terms before taking billing information, express informed consent before charging, and a simple way to stop recurring charges.
• A sample you mail must be clearly marked as a free sample. 39 USC 3009 makes mailing unordered merchandise an unfair trade practice, with an exception for free samples clearly and conspicuously marked as such, and bars billing for it.
• Do not run the same free offer all year. 16 CFR 251.1(h) suggests no more than 6 months in any 12 for one product size or kind of service, and no more than three offers in the same area in 12 months.

Three kinds of free offer, three sets of rules

Free offers in a practice tend to fall into three shapes, and the rules differ for each.

1. A sample with no strings. A trial-size product handed out or mailed, with nothing to buy. The FTC guide on free offers is mostly about offers tied to a purchase, so the main questions are whether the sample is described truthfully and, if it is mailed, whether 39 USC 3009 is met.
2. Free with a purchase. “Free serum with any facial,” “buy two, get one free,” “free travel size with any order over a set amount.” This is the core of 16 CFR Part 251.
3. A free trial that becomes a paid plan. “First month free, then billed monthly until you cancel.” When it is sold online, 15 USC 8403 applies, and the offer is also a free offer under Part 251.

Whatever the shape, the claims on the product and in the ad about what it does are a separate question. See our guides to selling supplements in a medical practice and private-label supplements and skincare.

Free with purchase: what the FTC guide asks

16 CFR Part 251 is a guide, not a rule. It explains how the FTC reads the word free under section 5 of the FTC Act, which declares unfair or deceptive acts or practices in commerce unlawful (15 USC 45(a)). An offer that does not follow the guide is not automatically a violation, but the guide tells you what the agency expects.

The regular price. 16 CFR 251.1(b)(1) says a buyer who is told an item is free if they buy another has a right to believe they pay nothing for the free item and no more than the regular price for the other. The seller may not recover the cost of the free item by marking up the item that must be bought, by substituting a lower quality product or service, or otherwise. 251.1(b)(2) defines the regular price as the price at which the seller openly and actively sold the same product or service, in the same quantity and quality, in that market for a reasonably substantial period, which it gives as a 30-day period. If no substantial sales were made at that price, a free offer is not proper, except for introductory offers.

For a med spa, that means a facial that normally costs a set price cannot go up for the month the free serum is offered, and a smaller or shorter facial cannot be swapped in. If the facial is new and has no regular price yet, see introductory offers below.

Disclose conditions at the outset. 16 CFR 251.1(c) says all terms, conditions and obligations on which receiving and keeping the free item depend should be set out clearly and conspicuously at the outset, in close conjunction with the offer. A footnote reached by an asterisk next to the offer is not disclosure at the outset. In an ad, a social post or a booking page, the conditions belong in the same line or block as the word free: which service must be booked, by when, while supplies last if that is true, one per patient if that is true.

Introductory offers. Under 16 CFR 251.1(f), a free offer tied to a new product or service sold at a stated price is only proper if the seller expects, in good faith, to end the offer after a limited time and then sell the product or service on its own at the same price it carried during the offer.

Negotiated prices. 16 CFR 251.1(g) says that if a product or service is usually sold at a price reached by bargaining, rather than at a regular price, it is improper to call another item free with the sale. A practice that quotes treatment packages case by case should not advertise a free add-on to those packages.

Frequency. So that a free offer stays special, 16 CFR 251.1(h) says a single size of a product or a single kind of service should not be advertised with a free offer in a trade area for more than 6 months in any 12-month period, at least 30 days should pass before another such offer in the same area, no more than three such offers should be made in the same area in 12 months, and sales of the product in the promoted size during the offers should not exceed 50 percent of total sales of that size in the area. A standing “free sample with every cleaning” sign that never comes down is the kind of offer this paragraph is about.

Other words. 16 CFR 251.1(i) says an offer that fails the guide is not corrected by calling the item a gift, given without charge, a bonus, or any other term that gives the impression it is free. The same applies to promotions sold as gift cards; see med spa gift card promotion rules.

When you get the product from a supplier. 16 CFR 251.1(d) says a supplier that knows, or should know, a reseller is not passing a free offer on, or is using it to deceive, should stop offering the product as promoted to that reseller. If a manufacturer’s promotion arrives with “free” stickers or displays, the practice running it in its own office is the reseller, so the offer should reach patients as the supplier described it.

Free trials that turn into a charge

The free first month that rolls into a paid subscription is a negative option. The Telemarketing Sales Rule defines a negative option feature as a provision in an offer under which the customer’s silence or failure to take an affirmative action to reject goods or services or to cancel the agreement is interpreted by the seller as acceptance (16 CFR 310.2). 15 USC 8403 uses that definition for transactions effected on the Internet.

Under 15 USC 8403, it is unlawful to charge or attempt to charge a consumer for goods or services sold online through a negative option feature unless the seller:

1. Disclose first: provides text that clearly and conspicuously discloses all material terms of the transaction before obtaining the consumer’s billing information;
2. Get consent: obtains the consumer’s express informed consent before charging the consumer’s card, bank account or other financial account; and
3. Allow cancelling: provides simple mechanisms for the consumer to stop recurring charges.

For a free trial, the material terms a patient would care about include that the trial ends and billing starts, the date or event that starts it, the amount and how often it is charged, how to cancel and by when to avoid the first charge. Those terms belong above the field where the card number is entered, not behind a terms link. Consent should be an action the patient takes for the recurring charge itself, such as a checkbox that is not pre-ticked next to the terms. Cancelling should be as easy as signing up was; our guide to membership auto-renewal rules covers the cancel path in more detail.

The statute reaches transactions on the Internet. A free trial signed up for at the front desk or on the phone is outside the text of 8403, but it is still subject to the FTC Act’s ban on deception in 15 USC 45(a), and the Part 251 points above still apply to the word free. We did not read the Telemarketing Sales Rule’s own negative option provisions for this guide.

What a violation can cost. 15 USC 8404(a) treats a violation of the ROSCA chapter as a violation of an FTC rule on unfair or deceptive acts or practices. Under 15 USC 45(m)(1)(A), the FTC can seek a civil penalty for a rule violation committed with actual knowledge, or knowledge fairly implied from objective circumstances, that the act is unfair or deceptive and prohibited. The statute sets the cap at $10,000 per violation; that amount is adjusted for inflation each year, and 16 CFR 1.98(d) lists $53,088 per violation for penalties assessed after January 17, 2025.

Mailing samples: the unordered merchandise statute

39 USC 3009(a) makes mailing unordered merchandise an unfair method of competition and an unfair trade practice under 15 USC 45(a)(1). Unordered merchandise is merchandise mailed without the prior expressed request or consent of the recipient (39 USC 3009(d)). There are two exceptions: free samples clearly and conspicuously marked as such, and merchandise mailed by a charitable organization soliciting contributions.

Two more parts of the statute matter for a practice that mails products. Under 3009(b), merchandise mailed in violation of the statute, or under its exceptions, may be treated as a gift by the recipient, who may keep, use or dispose of it with no obligation to the sender. Under 3009(c), the sender may not mail that recipient a bill or a dunning letter for it.

In practice: mark every mailed sample as a free sample on the package, do not follow it with an invoice, and do not treat a mailed sample as the start of an order or a subscription unless the patient asked for that. A clinic that mails a sample and then ships and bills full bottles because the patient did not call to refuse has turned a sample into exactly what the statute forbids.

Using a patient list to decide who gets a product sample is a separate HIPAA question. Our HIPAA marketing rules guide covers when a communication about a product is marketing that needs authorization, and our direct mail for medical practices guide covers the mailing itself.

Patients with Medicare or Medicaid

Anything of value given to Medicare or Medicaid patients can raise the federal beneficiary inducement question when it is tied to choosing a provider or a service. Our guide to free consultation offers reads that law and the OIG’s nominal value guidance; apply it before you advertise free products alongside covered services.

Use and avoid

• Use: “Free travel-size serum with any facial booked by November 30, one per client, while supplies last,” in the same line as the offer. Avoid: “Free serum!*” with the terms in small print at the bottom of the page.
• Use: the facial at the same price it carried for the prior 30 days. Avoid: raising the facial price, or shortening the facial, during the free serum month.
• Use: “Your first month is free. On December 1 we charge $X every 30 days until you cancel online or by phone,” above the card field, with an unticked consent box. Avoid: “Free trial” on the button and the recurring charge only in the terms link.
• Use: a sample packet printed “Free sample.” Avoid: an unmarked packet followed by an invoice or an automatic shipment.
• Use: a free offer that runs for a set period and then stops. Avoid: the same free offer on the same product all year.

An illustration

This is a made-up example, not a client. An integrative clinic adds an online shop for its own-label magnesium powder. The product page has a large “Try it free” button. After the patient enters a card number, a line in grey under the order button says the patient will be enrolled in monthly delivery at the regular price after 14 days. Cancelling requires a phone call during office hours. The same week, the clinic mails unmarked sample sachets to its newsletter list, with a note saying a full tub will follow unless the reader opts out.

The fix: the button changes to “Start a 14-day free trial,” and the trial length, the monthly price, the first charge date and how to cancel move above the card field. A separate, unticked box asks the patient to agree to the recurring charge. Cancelling is added to the patient’s online account in the same number of steps it took to sign up. The mailed sachets are marked “Free sample,” the “full tub will follow” note is dropped, and full tubs ship only to readers who order one. The clinic also checks the newsletter list against our HIPAA marketing guide before the next mailing.

Checklist

• Regular price for the purchased item shown and unchanged for the prior 30 days (16 CFR 251.1(b)).
• Every condition in the same block as the word free, no asterisk footnote (251.1(c)).
• Introductory offer: a good faith plan to end it and keep the same price (251.1(f)).
• No free add-ons to case-by-case priced packages (251.1(g)).
• Offer calendar kept, within 6 months in 12 and three offers per area (251.1(h)).
• Online trials: material terms before billing information, express consent, simple cancel (15 USC 8403).
• Mailed samples marked “free sample,” never billed, never turned into an order by silence (39 USC 3009).
• Medicare and Medicaid patients checked against the beneficiary inducement law.
• Product claims on the sample checked separately.

How we help

We build product pages, checkout steps and promotions for independent practices as part of lead generation, search and Google Ads work, with offer wording written against the rules as read on the day. An AI front desk can answer “how do I cancel my trial” the same way every time. We are not a law firm. Related guides: money-back guarantees in healthcare ads and our guide to healthcare marketing rules.

Sources

• 16 CFR Part 251: Guide Concerning Use of the Word “Free” and Similar Representations
• 15 USC 8403: Negative option marketing on the Internet
• 15 USC 8404: Enforcement by Federal Trade Commission
• 16 CFR 310.2: Telemarketing Sales Rule definitions
• 15 USC 45: Unfair methods of competition unlawful; prevention by Commission
• 16 CFR 1.98: Adjustment of civil monetary penalty amounts
• 39 USC 3009: Mailing of unordered merchandise

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