Finasteride is a 5-alpha-reductase inhibitor sold under two Merck brand names for two different FDA-approved uses. Propecia is the 1mg dose approved in 1997 to treat androgenetic alopecia, the medical term for male pattern hair loss. Proscar is the 5mg dose approved earlier to treat benign prostatic hyperplasia (BPH), an enlarged prostate. Generic finasteride, chemically identical to both brands, has been available since 2006 and fully replaced brand-name sales by the mid-2010s.
Generic finasteride 1mg costs $5 to $52 per month in 2026 depending on the pharmacy and whether you use a coupon, a small fraction of the $150 to $300 or more that branded Propecia can run. Costco posts the lowest cash price nationwide, typically $5 to $8 for 30 tablets with no membership discount needed. Most other chains, including CVS and Walgreens, charge $15 to $30 without a coupon and $9 to $15 with a free GoodRx coupon. This guide breaks down the real 2026 price by pharmacy, the Medicare Part D coverage split between hair-loss and BPH use, and what to do if a claim is denied.
Merck's brand-name Propecia (1mg, approved for hair loss in 1997) and Proscar (5mg, approved earlier for benign prostatic hyperplasia) have been fully genericized since 2013, and finasteride was never selected for Medicare price negotiation under the Inflation Reduction Act of 2022 because the generic price is already low. The bigger issue for most patients is not price but coverage: Medicare Part D and most commercial insurance categorically exclude finasteride when used for hair loss, while the same tablet is a covered, low-copay generic when prescribed for BPH. Patients who also qualify for Medicaid based on income should check the Medicaid income limits for their state, since Medicaid's BPH coverage rules mirror Medicare's indication-based split.
What Finasteride Costs by Point of Pay (2026)
The price you pay depends almost entirely on WHERE you pay. The same finasteride can cost many times more at a hospital than at your local pharmacy:
2026 Finasteride Price by Point of Pay| Where you pay | Typical cost | Notes |
|---|
| Retail pharmacy (cash or GoodRx coupon) | $5 - $52/month | Generic finasteride 1mg price range across major chains in 2026. Coupons close most of the gap between chains. |
| Costco cash price (no coupon needed) | $5 - $8/month | Lowest nationwide cash price for 30 tablets of generic finasteride 1mg in 2026. |
| Medicare Part D, finasteride 1mg (Propecia, hair loss) | Not covered; full $5 - $52/month cash price applies | Excluded by statute as a cosmetic/hair-growth agent under Section 1860D-2(e)(2)(A) of the Social Security Act. |
| Medicare Part D, finasteride 5mg (Proscar, BPH) | $0 - $5/month copay | Covered as a Tier 1 generic when prescribed for benign prostatic hyperplasia, not hair loss. |
| Medicaid | $1 - $4/prescription (BPH only in most states) | Coverage for androgenetic alopecia varies by state and is rare; BPH use is covered under the mandatory Medicaid drug benefit. |
Finasteride has no Medicare Part B ASP rate because it is an oral drug billed under Part D, not Part B. Retail prices reflect 2026 GoodRx and chain member-program data. Coverage depends entirely on the prescribed dose and indication, not the plan's formulary design.
Source: GoodRx 2026, CMS Medicare Part D Excluded Drugs List, Walmart/Costco/Kroger pharmacy pricing
Why Hospitals Charge So Much
Finasteride rarely shows up on an inpatient hospital bill because it is a once-daily oral tablet patients take at home for either hair loss or an enlarged prostate condition, neither of which requires hospitalization on its own. When it does appear, usually because a hospitalized patient continued a home BPH prescription during a stay for an unrelated procedure, hospitals bill the tablet at facility rates that bundle acquisition cost with pharmacy dispensing fees, nursing administration charges, and overhead. A tablet that costs pennies to acquire can appear on an itemized 2026 bill at $40 to $150 per dose.
Hospitals have no Medicare Part B benchmark price to reference for finasteride because it is an oral Part D drug, not a Part B injectable or infusion. That leaves inpatient pharmacies free to set facility rates well above the $5 to $52 monthly retail range available at Costco, Walmart, and other chains in 2026. Patients or their families should request an itemized bill, look for the National Drug Code (NDC) of the specific tablet billed, and compare it against the retail cash price before paying. Charges 20 times or more above the outpatient generic price are a standard dispute target with hospital billing departments and can often be resolved with a written appeal or a medical bill analyzer review.
Medicare Part D
Medicare Part D excludes finasteride 1mg (Propecia) when prescribed for androgenetic alopecia (hair loss) under Section 1860D-2(e)(2)(A) of the Social Security Act, the same statutory provision that blocks coverage for weight-loss drugs and fertility treatments. CMS classifies hair-growth agents as a non-Part D drug category regardless of formulary tier, so no Medicare Advantage or stand-alone Part D plan can add hair-loss finasteride to its formulary. Patients taking finasteride strictly for hair loss pay the full 2026 cash price of $5 to $52 per month out of pocket, with no help from the $2,100 annual Part D out-of-pocket cap.
Finasteride 5mg (Proscar) prescribed for benign prostatic hyperplasia is a different story. Every Medicare Part D plan covers generic finasteride for BPH, almost always on the Tier 1 preferred-generic formulary tier with a $0 to $5 monthly copay in 2026, and prior authorization is rarely required for the generic (brand-name Proscar is more likely to trigger a prior authorization request). If your Part D plan denies a finasteride claim, check whether the prescription was submitted with an ICD-10 diagnosis code for hair loss (L64.9) instead of BPH (N40), since that coding mismatch is a common and correctable cause of denial. The Inflation Reduction Act's $2,100 Part D out-of-pocket cap for 2026 applies to BPH-indicated finasteride like any other covered drug, though the low cost makes it unlikely anyone reaches that cap from finasteride alone.
Common Finasteride Billing Errors
If you received a bill for finasteride that seems too high, or a denied claim that seems wrong, check for these issues in 2026 before paying or appealing:
- Brand-name Propecia or Proscar billed on an itemized statement when the pharmacy actually dispensed generic finasteride, inflating the charge by several times the generic cost.
- Wrong strength billed: a 5mg BPH tablet charged when a 1mg hair-loss tablet was dispensed, or vice versa, which can also trigger an incorrect coverage denial.
- Diagnosis code mismatch: a BPH prescription (ICD-10 N40) submitted with a hair-loss diagnosis code (L64.9), or the reverse, causing an otherwise-covered claim to be denied.
- Telehealth subscription fees bundled with the drug cost on a single non-itemized charge, making it impossible to see how much you paid for the medication versus the consultation.
- Inpatient hospital charge for a continued home BPH prescription marked up to $40 to $150 per tablet when the outpatient generic price is $5 to $52 for a full 30-day supply.
Frequently Asked Questions
Is there a generic for Propecia (finasteride)?
Yes. Generic finasteride has been available since 2006 and was fully genericized by 2013 after Merck's Propecia and Proscar patents expired. As of 2026, more than a dozen FDA-approved manufacturers produce finasteride 1mg (for hair loss) and 5mg (for benign prostatic hyperplasia) tablets. Generic finasteride is bioequivalent to both brand-name products and costs a fraction of the branded price, often $5 to $52 per month depending on pharmacy and coupon versus $150 to $300 or more for the Propecia or Proscar brand.
Does Medicare cover finasteride for hair loss?
No. Medicare Part D excludes finasteride 1mg (Propecia) when prescribed for hair loss because Section 1860D-2(e)(2)(A) of the Social Security Act classifies hair-growth agents as a non-covered drug category, the same rule that blocks coverage for weight-loss drugs. Medicare will not pay any share of the cost regardless of your plan or formulary tier. Medicare Part D does cover finasteride 5mg (Proscar) when prescribed for benign prostatic hyperplasia, usually as a $0 to $5 Tier 1 generic copay in 2026.
Is there a manufacturer patient assistance program for Propecia or Proscar?
No manufacturer coupon or income-based patient assistance program is necessary for finasteride in 2026, because the generic version is inexpensive enough that one is not needed. Generic finasteride costs as little as $5 to $8 per month at Costco and under $52 at any pharmacy without a coupon. If cost is still a barrier, NeedyMeds.org lists free medication assistance resources, and telehealth companies such as Hims, Keeps, and Ro sell generic finasteride subscriptions starting around $15 to $30 per month, including the prescriber consultation.
What if my insurance denies coverage for finasteride?
Check the diagnosis code first. Denials for finasteride are almost always about indication, not price. If your prescriber billed for benign prostatic hyperplasia (ICD-10 code N40) and the claim was still denied, request a written Explanation of Benefits and ask your prescriber's office to resubmit or file a formal appeal; Medicare Part D enrollees can escalate to an Independent Review Entity through CMS. If the prescription is for hair loss (androgenetic alopecia), no appeal will succeed because that use is excluded by federal statute, not by your plan's choice.
Does the Inflation Reduction Act's Maximum Fair Price apply to finasteride?
No. Finasteride was not selected for either round of Medicare drug price negotiation under the Inflation Reduction Act of 2022, and no Maximum Fair Price has been set for it. Because generic finasteride already costs $5 to $52 per month in 2026, it was never a negotiation priority the way high-cost brand drugs like Eliquis or Jardiance were. Finasteride 5mg prescribed for BPH still falls under the general 2026 Medicare Part D annual out-of-pocket cap of $2,100 that applies to all covered Part D drugs combined.
What does finasteride cost without insurance at the pharmacy counter in 2026?
Generic finasteride 1mg costs $5 to $8 for a 30-day supply at Costco with no coupon needed, $9 to $15 at CVS or Kroger with a free GoodRx coupon, and up to $52 on average at other chains without any discount. Brand-name Propecia or Proscar can run $150 to $300 or more per month for the same 30-day supply. Telehealth subscriptions from Hims, Keeps, or Ro that bundle the prescriber visit and generic medication typically run $15 to $30 per month.
What is the difference between Propecia and Proscar?
Propecia and Proscar are both brand names for finasteride made by Merck, but at different doses for different FDA-approved uses. Propecia is the 1mg dose approved in 1997 for androgenetic alopecia (male pattern hair loss) and is excluded from Medicare and most insurance coverage as a cosmetic drug. Proscar is the 5mg dose approved earlier for benign prostatic hyperplasia and is covered by Medicare Part D and most insurance plans as a generic. Generic finasteride is chemically identical in both doses; only the milligram strength and FDA-labeled use differ.
Can I get finasteride through telehealth, and is it cheaper than a pharmacy?
Yes. Telehealth companies including Hims, Keeps, and Ro offer online prescriber visits and generic finasteride 1mg by mail, typically for $15 to $30 per month in 2026, which is competitive with pharmacy cash prices once you count the doctor visit. A local pharmacy visit plus a GoodRx coupon can still be cheaper, at $5 to $15 per month, if you already have a prescription from your own doctor. Neither option is typically covered by Medicare or commercial insurance when the indication is hair loss rather than benign prostatic hyperplasia.
