You can buy the morning after pill over the counter at virtually any pharmacy in the United States, no prescription and no ID required. The most common type, sold under the brand name Plan B and several generic versions, is available to anyone of any age. A second, more effective option called ella does require a prescription, but you can get one quickly through telehealth. Time matters: both types work best when taken as soon as possible, and the window closes at five days (120 hours) after unprotected sex.
Where to Buy It Without a Prescription
Plan B One-Step and its generics sit on pharmacy shelves or behind the counter at most major drugstores, grocery store pharmacies, and retail chains. You do not need to ask a pharmacist for permission, show ID, or prove your age. The FDA removed all age restrictions for these products in 2013. If you don’t see it on the shelf, ask the pharmacist, as some stores keep it in a locked case to prevent theft rather than for any legal reason.
Without insurance, Plan B generics typically cost between $10 and $50, depending on the store. Name-brand Plan B tends to run closer to $40 to $50. Prices vary, so calling ahead or checking online can save time and money when you’re in a rush.
How to Get Ella (the Prescription Option)
Ella uses a different active ingredient and stays effective longer than Plan B, particularly during days three through five after unprotected sex. It requires a prescription, but getting one is fast. Planned Parenthood offers telehealth visits with no appointment needed, and a provider can send your prescription to a local pharmacy or have the medication mailed to you. Other telehealth platforms offer similar services. Your provider will help determine which pill is right for you based on when you had sex, your weight, and your location.
You can also get a prescription for ella from your regular doctor, an urgent care clinic, or a sexual health clinic. If you’re within the first three days, Plan B and ella work about equally well. But if it’s been more than 72 hours, ella is the better choice.
Insurance Coverage and Cost
Under the Affordable Care Act, most health insurance plans must cover emergency contraception without a copay. This applies to both Plan B and ella. The catch: for over-the-counter Plan B, many insurance plans require you to get a prescription first before they’ll reimburse you. That feels redundant since you don’t need a prescription to buy it, but it’s how the billing works. If cost is a concern and you have insurance, getting a prescription from your doctor or a telehealth visit can make it free.
Without insurance, ella typically costs $40 to $60 at the pharmacy. Sexual health clinics and some Planned Parenthood locations offer emergency contraception for free or on a sliding scale based on income.
The Time Window for Each Type
Both Plan B and ella can be taken up to five days after unprotected sex, but their effectiveness drops differently over that window. Plan B works best within the first 72 hours. After that, pregnancy rates climb noticeably. A large analysis found that pregnancy risk stays low when Plan B is taken within four days but increases meaningfully at four to five days. Ella maintains its effectiveness more consistently across the full five-day window, which is why providers recommend it when more time has passed.
Neither pill works as well as taking it right away. If you have Plan B available now, take it now rather than waiting to get ella, unless you’re already past the 72-hour mark.
Weight Can Affect How Well It Works
This is something many people don’t realize. Plan B becomes significantly less effective in women weighing over about 155 pounds (70 kg) or with a BMI above 26. One study found that the estimated pregnancy rate jumped from 1.4% in women weighing 143 to 165 pounds to over 6% in women weighing 165 to 187 pounds. That’s a meaningful difference.
Ella is less affected by weight, making it a better option for people in higher weight ranges. The most effective emergency contraception regardless of weight is the copper IUD, which prevents pregnancy more than 99% of the time when placed within five days. Getting one requires a clinic visit, but if you’re concerned about weight-related effectiveness, it’s worth asking about.
How the Morning After Pill Works
Emergency contraceptive pills work primarily by delaying or preventing ovulation. If your body hasn’t released an egg yet, the pill keeps that from happening so sperm have nothing to fertilize. This is why timing matters so much: once ovulation has already occurred, the pills become much less effective. They do not end an existing pregnancy. If a fertilized egg has already implanted, the morning after pill will not affect it.
Side Effects to Expect
Most side effects are mild and short-lived. Nausea is the most common, and some people experience vomiting, fatigue, headaches, dizziness, breast tenderness, or cramping. These typically resolve within a day or two.
The bigger disruption is to your menstrual cycle. Your next period may come earlier or later than expected, and you might notice spotting in the days after taking the pill. This is normal. However, if your period is more than seven days late, take a pregnancy test. A missed period is the main sign that emergency contraception didn’t work.
The Copper IUD as an Alternative
If you can get to a clinic quickly, a copper IUD is the most effective form of emergency contraception available. It prevents pregnancy more than 99% of the time when placed within five days of unprotected sex, and it works equally well regardless of body weight. It also doubles as ongoing birth control for up to 10 years. The tradeoff is that it requires an in-person appointment for insertion, which may not be realistic in every situation. Sexual health clinics and Planned Parenthood locations can often accommodate same-day or next-day visits for this purpose.