Morning-After Pill: Cost, How to Get It, Effectiveness

The morning-after pill refers to several emergency contraceptives sold in stores to anyone of any age. It is a safe and effective way to prevent unintended pregnancy.

Emergency contraception must be used within 72 hours of unprotected sex or a contraceptive failure and is not intended to be used as a routine method for preventing pregnancy.

The morning-after pill is available over the counter (OTC) for around $50 or less (and might be fully or partly covered by your health insurance). While no prescription is needed for some forms, you should be aware of possible side effects and factors that may impact effectiveness.

This article explains options for OTC emergency contraception. Learn how these pills work, how to use them effectively, and where to buy them.

What Is the Morning After Pill?

There are several morning-after pill options available. The U.S. Food and Drug Administration has given most of them its stamp of approval to prevent pregnancy up to 72 hours after unprotected sex (or a failed contraceptive):

• Plan B One-Step is a branded product whose active ingredient is 1.5 milligrams of levonorgestrel. Levonorgestrel works by preventing an egg from fully developing, being fertilized, or attaching inside the uterus, depending on where a woman is in her cycle.

You may prefer any of several generic alternatives, which are usually cheaper than Plan B and include:

• Next Choice One Dose 
• My Way
• Take Action
• AfterPill

The newest option on the block works differently:

• Ella is a form of emergency contraception that depends on the hormone ulipristal acetate to stop ovulation. Unlike Plan B One-Step and its generic counterparts, Ella can be taken up to five days (120 hours) after unprotected sex.

Despite some differences, emergency contraception works best when it's taken as soon as possible after unprotected sex. The ideal time is within 24 hours.

Where to Get the Morning-After Pill

Until 2013, there were point-of-sale and age restrictions on the morning-after pill. Now that all restrictions have been lifted, you should be able to buy them at local drugstores, retail outlets, or online.

Where to Get Plan B One-Step

Store owners have some discretion as to where they can shelve these drugs. Typically, they are found in the family planning aisle, near over-the-counter (OTC) contraceptives (condoms, Today Sponge, VCF, etc.), home pregnancy tests, and personal lubricants, but you may need to ask for them.

To deter theft some stores keep supplies behind the pharmacy or checkout counter. Others may place each box of pills in a large, plastic container that a cashier opens with a key after the product is paid for.

Because people have been known to walk off with the bulky containers, some stores reserve a spot for morning-after pills on their shelves, but instead of displaying the actual box, they place a picture of the product there instead.

The picture includes directions to where to find the product in the store (such as behind the pharmacy counter). Besides picking up emergency contraceptives at many grocery and drug stores, you can also find them online.

Where to Get Ella

Ella is available only by prescription. Depending on the state you live in, your pharmacist may be able to write you a prescription for Ella (without seeing a doctor). Call your pharmacy first, and ask about their procedures and if they have Ella in stock.

You can also get a prescription from your healthcare provider or a family planning clinic.

How Much Does the Morning-After Pill Cost?

The morning-after pill can cost as little as $11 or as much as $50 or more depending on the brand available at your pharmacy. 

Plan B One-Step costs between $40 and $50, while generic morning-after pills (Take Action, My Way, Option 2, Preventeza, My Choice, Aftera, and Contra) can range from $11 to $45. Another generic brand, AfterPill, is sold online for $20 plus $5 shipping. Plan B One-Step is available at discounted rates via GoodRx.

Ella is available online and includes a fast medical consultation and next-day delivery, which costs $90. You can also get Ella at the pharmacy for around $50.

Some insurances cover the morning-after pill without a copay, and you may also be able to use funds from a flexible spending account to cover the cost. Free or low-cost emergency contraception from Planned Parenthood, another family-planning clinic, or your local health department may also be an option.

How Effective Is the Morning-After Pill?

All methods of emergency contraception (prescription and OTC) reduce the risk of pregnancy by 75% to 99% when they are initiated within 72 hours. This means that out of every 100 women using any emergency contraception method, between one and 25 will go on to become pregnant.​ 

When used as directed:

• Ella (ulipristal acetate) is 98% effective.
• Plan B One-Step and generics are 87.5% effective.

Factors that influence the effectiveness of emergency contraception include:

• The amount of time that has gone by since unprotected sex/birth control failure
• The point in your cycle when you had sex. The closer you are to ovulation (after unprotected sex/birth control failure), the less effective emergency contraception will be.

BMI and the Morning-After Pill

It is important to be aware that your weight may affect how well these two morning-after options work to prevent pregnancy.

• Plan B One-Step and generics (levonorgestrel) are most effective for people with a Body Mass Index (BMI) of less than 25. It is not effective for those who have a BMI of 30 or more.
• Ella (ulipristal acetate) is most effective for people with a Body Mass Index of 30 or less. It is not effective for those who have a BMI of 35 or more.

Emergency contraceptive pills can be less effective in obese women. Researchers theorize that morning-after medications may be absorbed more slowly or become stored in body fat instead of circulating in the bloodstream of overweight individuals.

BMI is a simple calculation that helps to establish whether you are underweight, at a healthy weight, overweight, or obese.

Planning Ahead

It's a good idea to buy emergency contraception ahead of time, before you need it—even before you think you may need it. Since it's most effective the sooner you use it, having it readily accessible can save you precious time when it's needed.

Store inventories do ebb and flow. So, just because you've seen an OTC morning-after pill at your local store once does not mean the store will have it when you need it as it could be out of stock.

Plus, if your favorite store keeps its pill inventory in the pharmacy, the pharmacy could be closed if you make a late-night visit (even though the main store could be open).

Since time is of the essence with emergency contraception, try to give yourself every advantage.

Side Effects of the Morning-After Pill

Drinking water can relieve some of the side effects you may experience from the morning-after pill. They include:

• Abdominal pain/cramping
• Breast tenderness
• Dizziness
• Fatigue
• Headache
• Nausea

The side effects of emergency contraception are usually mild and fade quickly. Some women experience no side effects at all. It's more likely that your next period may come sooner or later than usual, and you may have some spotting (or light bleeding) beforehand.

And, rest assured: The pill will not affect your ability to get pregnant in the future. 

Summary

Plan B One-Step, as well as its four generic equivalents, contains levonorgestrel and can be taken up to 72 hours after unprotected sex. The active ingredient in Ella, ulipristal acetate, can be taken up to five days (120 hours) after unprotected sex.

You can buy Plan B and its generics OTC in many drug stores. Ella is sold only by prescription, which a pharmacist may be able to issue. Factors like where you are in your menstrual cycle, how long you wait to start an emergency contraceptive, and your weight can affect how well each method will work. Taking the morning-after pill may trigger some side effects, but they're usually mild and don't last long.