You can get the most common form of emergency contraception, Plan B and its generics, without a prescription at any pharmacy, grocery store, or big-box retailer in the United States. There are no age restrictions. Other options, like the prescription pill ella or a copper IUD, require a healthcare provider but may be better choices depending on your timing and body weight. Here’s what you need to know to pick the right option and get it as fast as possible.
Your Three Options
Emergency contraception comes in three forms, and they differ in effectiveness, how long you have to use them, and how you get them.
Levonorgestrel pills (Plan B and generics) are available over the counter. They work best when taken as soon as possible and can be used up to 120 hours (5 days) after unprotected sex. In studies, the pregnancy rate with these pills was 1.2% to 2.1%. Effectiveness drops the longer you wait, so taking one within the first 24 hours gives you the best chance.
Ella (ulipristal acetate) requires a prescription but maintains its effectiveness better over the full 5-day window. It’s specifically more effective than levonorgestrel between 72 and 120 hours after sex. The pregnancy rate in studies was about 1.2%. If it’s been more than three days, ella is the stronger pill option.
A copper IUD is the most effective form of emergency contraception available, preventing pregnancy more than 99% of the time when inserted within 5 days of unprotected sex. It also doubles as long-term birth control for up to 10 years. The tradeoff is that it requires a clinic visit and insertion by a provider.
Where to Get Each Type
For Plan B or its generic versions, walk into any drugstore, grocery store pharmacy, or big-box retailer. You’ll usually find it in the family planning aisle or behind the pharmacy counter (though no prescription is needed). Planned Parenthood health centers also carry it. Prices typically range from $10 to $50 depending on brand and store, with generics on the lower end.
For ella, you need a prescription. You can get one from your regular doctor, a Planned Parenthood clinic, an urgent care center, or through a telehealth service. Because ella stays effective across the full five days, there’s enough time to schedule a telehealth appointment and have it prescribed without losing effectiveness. Several online platforms now offer prescriptions and ship ella directly.
For a copper IUD, you’ll need an appointment at a clinic, OB-GYN office, or Planned Parenthood. Call ahead and explain that you need it for emergency contraception so they can try to fit you in quickly.
Cost and Insurance Coverage
Under the Affordable Care Act, health insurance plans sold through the marketplace must cover all FDA-approved contraceptive methods, including Plan B and ella, at no cost to you when prescribed by a provider. That means no copay, no coinsurance, and no deductible, as long as you use an in-network provider.
The catch: if you buy Plan B over the counter without a prescription, your insurance may not cover it. Getting a prescription first, even a quick one, can save you the full retail price. If you’re paying out of pocket, generic levonorgestrel pills are the most affordable option and are pharmacologically identical to the brand-name version.
Body Weight Affects Pill Effectiveness
This is something many people don’t realize. Research shows that levonorgestrel-based pills (Plan B and generics) become significantly less effective at higher body weights. People with a BMI of 30 or above had roughly four times the risk of pregnancy compared to those with a BMI under 25. For those weighing 80 kg (about 176 pounds) or more, levonorgestrel pills may have essentially no efficacy.
If this applies to you, ella is a better pill option, as it maintains more of its effectiveness at higher weights. A copper IUD is the strongest choice regardless of weight, with that 99% effectiveness holding across all body sizes.
How Emergency Contraception Works
Emergency contraceptive pills work primarily by delaying or preventing ovulation, the release of an egg from the ovary. If there’s no egg available, sperm can’t fertilize anything. This is why timing matters so much: once ovulation has already happened, the pills are far less effective.
Research confirms that levonorgestrel taken after ovulation does not affect implantation of a fertilized egg and results in pregnancy rates similar to placebo. In other words, these pills prevent pregnancy by stopping ovulation, not by disrupting a pregnancy that’s already begun.
The copper IUD works differently. It creates an environment in the uterus that is toxic to sperm, preventing fertilization. This mechanism is why it remains so effective even when placed up to five days after unprotected sex.
What to Do After Taking It
Your period may come a few days early or late after taking emergency contraception. Some people experience nausea, headache, or spotting. These side effects are temporary and typically resolve within a day or two.
If your period is more than a week late, take a pregnancy test. If you’re unsure when your period is due, take a test at least 21 days after the unprotected sex. Testing earlier than this can give a false negative because pregnancy hormones may not yet be detectable.
Emergency contraception does not protect you from pregnancy for the rest of your cycle. If you have unprotected sex again after taking it, you could still get pregnant. If you got a copper IUD, you’re covered going forward, but pill-based options are a one-time fix.