You can buy the most common morning-after pill, Plan B One-Step, over the counter at any pharmacy, grocery store, or big-box retailer without a prescription and without an age restriction. Generic versions with the same active ingredient are also available off the shelf. If you need a more effective option or have specific concerns about weight, a prescription alternative called ella is available through a doctor, clinic, or telehealth service. Here’s what to know about each route.
Buying Plan B Over the Counter
Plan B One-Step and its 11 generic equivalents are sold without a prescription to anyone, regardless of age. The FDA removed all age restrictions in 2013. You can find these pills at chain pharmacies like CVS and Walgreens, grocery store pharmacies, and Planned Parenthood health centers. Some stores keep them behind the pharmacy counter or in a locked case, but you do not need to show ID or ask for permission to purchase them.
Brand-name Plan B typically costs around $25. Generic versions can run as low as $13 with a discount coupon. If you have health insurance, the Affordable Care Act requires most plans to cover emergency contraception without a copay, though getting reimbursed for an over-the-counter purchase sometimes requires submitting a receipt or obtaining a prescription from your provider first. It’s worth calling your insurer to ask about their specific process.
Getting a Prescription for Ella
Ella is a different type of morning-after pill that requires a prescription. It works through a different mechanism than Plan B and has two key advantages: it maintains its effectiveness better across the full five-day window after unprotected sex, and it appears to work better for people with a higher BMI.
You can get a prescription for ella from your regular doctor, an urgent care clinic, or a Planned Parenthood health center. Telehealth is another fast option. Planned Parenthood Direct offers ella prescriptions online in 46 states and Washington, D.C., with the medication shipped to your door or sent to a local pharmacy for pickup. Several other telehealth platforms offer similar services. The trade-off is shipping time, so if you’re within the first day or two, picking up Plan B locally may be faster.
In a growing number of states, you can skip the doctor entirely. At least 11 states, including California, Colorado, Oregon, New York, and Virginia, allow pharmacists to prescribe emergency contraception directly. In those states, you can walk into a pharmacy, speak with the pharmacist, and leave with ella the same day.
Timing and How It Affects Effectiveness
Both Plan B and ella can be taken up to five days (120 hours) after unprotected sex, but sooner is always better. Within the first three days, the two pills have similar effectiveness. After that point, ella maintains its effectiveness more reliably, while Plan B’s failure rate starts to climb. A large analysis of Plan B found that pregnancy rates stayed low through four days but increased noticeably at the four-to-five-day mark.
Overall, oral emergency contraception pills have a pregnancy rate of roughly 1.4 to 2.6%, meaning they prevent the large majority of pregnancies but are not a guarantee.
Weight and Effectiveness
Body weight affects how well morning-after pills work, and this is something manufacturers don’t always make obvious. Research has found that emergency contraception becomes less reliable for people with a BMI above 26, which corresponds to roughly 155 pounds for someone 5’5″.
Plan B is the most affected by weight. Ella appears to be impacted too, but to a lesser degree, making it the better pill option for people with a higher BMI. If weight is a concern and you’re within the five-day window, asking for an ella prescription is a reasonable step. The most effective option of all, regardless of weight, is a different approach entirely.
The IUD Option
A copper or hormonal IUD inserted within five days of unprotected sex is the most effective form of emergency contraception available. Studies have found a pregnancy rate of just 0.3% with an IUD, compared to the 1.4 to 2.6% rate seen with pills. That’s roughly five to eight times more effective.
Getting an IUD requires an appointment at a clinic or doctor’s office, so it’s not as quick as picking up a pill. But it has the added benefit of providing ongoing birth control for years afterward. Planned Parenthood health centers and many OB-GYN offices can place an IUD on short notice if you explain it’s for emergency contraception. Under the ACA, IUDs are covered without cost sharing by most insurance plans.
Quick Reference: Your Options
- Plan B or generic (levonorgestrel): No prescription needed, available at pharmacies and grocery stores, around $13 to $25, effective up to 5 days but best within 3.
- Ella (ulipristal acetate): Prescription required, available through doctors, clinics, telehealth, or pharmacists in some states, more effective than Plan B at days 3 to 5 and for higher BMI.
- IUD (copper or hormonal): Requires a clinic visit, most effective option at 0.3% pregnancy rate, doubles as long-term contraception.
If you’re reading this and time is a factor, the fastest path is walking into the nearest pharmacy and buying Plan B or a generic off the shelf right now. You can take it immediately and then follow up with a provider about ella or an IUD if you want a more effective option within the five-day window.