Emergency contraception ranges from about $8 to $50 for over-the-counter pills, around $50 or more for the prescription option, and up to $1,800 for an IUD, though insurance and discount programs can bring all of these close to zero. The exact price depends on which type you choose, where you buy it, and whether you have insurance.
Over-the-Counter Pills: $8 to $50
Levonorgestrel pills (sold as Plan B One-Step, Take Action, and other generics) are the most common and accessible form of emergency contraception. You can buy them without a prescription at pharmacies, drugstores, and online. Brand-name Plan B typically sits at the higher end of the range, while generics can cost significantly less.
The average retail price for generic levonorgestrel is about $24, but pharmacy discount tools like GoodRx bring that down to roughly $12. Some stores price it even lower. Hy-Vee, for example, has listed generic levonorgestrel for as little as $8.31 with a discount coupon. If cost is a concern, asking for the generic version and checking discount programs before you pay can cut the price in half.
These pills work best when taken as soon as possible after unprotected sex. Within 72 hours, effectiveness runs between 87% and 90%. Between 72 and 120 hours (three to five days), it drops to roughly 72% to 87%. Every hour matters, so speed is more important than finding the cheapest option.
Ella (Prescription Pill): About $50 or More
Ella uses a different active ingredient than Plan B and requires a prescription. It generally costs about $50 or more at a pharmacy without insurance. The advantage of ella is that it stays effective for up to five days (120 hours) without the same steep drop-off in effectiveness that levonorgestrel pills experience over that window.
Getting the prescription adds a step, but it doesn’t have to add cost. Most insurance plans are required to cover prescription birth control and related doctor visits. Telehealth services can also issue a prescription quickly, sometimes the same day. Planned Parenthood health centers, local health departments, and family planning clinics may provide ella for free or at a reduced price based on your income.
The Copper IUD: $0 to $1,800
A copper IUD is the most effective form of emergency contraception, preventing more than 99% of pregnancies when inserted within five days of unprotected sex. It also doubles as long-term birth control for up to 10 to 12 years. The total cost, including the device, medical exams, insertion, and follow-up visits, ranges from $0 to $1,800.
That wide range reflects whether you have insurance. Many health insurance plans cover the full cost, making it free. Without insurance, it’s a significant upfront expense, though the per-year cost becomes very low if you keep it as ongoing contraception. The practical barrier is timing: you need a provider who can fit you in quickly, since it must be placed within that five-day window.
What Insurance Covers
Under the Affordable Care Act, most private insurance plans must cover FDA-approved contraceptive methods without charging you a copay or deductible. This includes prescription emergency contraception like ella and IUDs. For over-the-counter levonorgestrel pills, coverage has been less consistent. A 2024 federal rule proposes requiring insurers to cover recommended OTC contraceptives without requiring a prescription and without cost-sharing, with the provision set to take effect for plan years beginning on or after January 1, 2026.
In the meantime, some insurers already cover OTC emergency contraception if you get a prescription for it, even though you don’t technically need one. It’s worth calling your insurance company or checking your plan’s formulary before paying out of pocket. If your plan covers it, you could pay nothing.
Lower-Cost Options Without Insurance
If you’re uninsured or underinsured, several paths bring the price down. Planned Parenthood health centers use sliding-scale fees based on your income, the services you need, and available state or local funding programs. Staff work within your budget to make care affordable. Local health departments and Title X family planning clinics offer similar income-based pricing.
For the OTC pill specifically, buying a generic version online or at a discount pharmacy is the simplest route. Store-brand levonorgestrel contains the same active ingredient at the same dose as Plan B. The difference is packaging and price, not effectiveness.
Why Body Weight Affects Your Choice
One factor that can change which option is worth the cost: your weight. Research shows levonorgestrel-based pills (Plan B and generics) become significantly less effective as body weight increases. At a BMI of 30 or above, the risk of pregnancy is roughly four times higher compared to someone with a BMI under 25. At around 70 kg (about 154 pounds), effectiveness starts to decline, and at 80 kg (about 176 pounds), levonorgestrel may provide essentially no benefit. The reason is pharmacological: people at higher weights absorb roughly 50% lower peak concentrations of the drug.
Ella performs somewhat better at higher weights, though its effectiveness also decreases. The copper IUD is the most reliable option regardless of weight. If you weigh over 155 pounds, spending more on ella or an IUD is likely a better investment than buying an over-the-counter pill that may not work as well for you.
Quick Cost Comparison
- Generic levonorgestrel (OTC): $8 to $25, no prescription needed, effective up to 72 hours (some benefit up to 120 hours)
- Plan B One-Step (OTC): $40 to $50, no prescription needed, same effectiveness window as generics
- Ella (prescription): $50 or more without insurance, effective up to 120 hours with less drop-off than levonorgestrel
- Copper IUD: $0 to $1,800, requires a provider visit, over 99% effective, doubles as long-term birth control
With insurance, all of these can potentially cost nothing. Without insurance, generic levonorgestrel pills with a discount coupon are the cheapest option at under $15, as long as you’re within the effective time and weight range.