Would you be able to quickly obtain an emergency contraception pill or abortion pill if the need arose? In the wake of the U.S. Supreme Court’s decision striking down Roe v. Wade, millions of health care consumers have pivoted to this question.
Much depends upon your access to reproductive care, from your health to your prospects in life. “People need tools to help them achieve reproductive autonomy,” says Ushma Upadhyay, associate professor in the Department of Obstetrics, Gynecology & Reproductive Science at the University of California San Francisco. “When people have access to abortion, they’re more likely to set and achieve life goals.”
Obtaining and using medication abortion, in particular, can be as complex as the laws of the 50 states. Fortunately for those seeking to avoid or end an unplanned pregnancy, reproductive rights advocates are offering — and frequently updating — valuable services and information sources. Armed with basic knowledge, you’ll feel more confident navigating the process.
Emergency contraception: Avoiding pregnancy after unprotected sex
Emergency contraceptives or morning-after pills work by preventing ovulation. These oral medications prevent pregnancy about 80% to 90% of the time when taken within a few days of unprotected sexual activity.
This oral medication typically costs between $10 and $50, plus the cost of a health care provider visit if you choose a prescription pill. “If you have private insurance or Medicaid, there’s a good chance you can get free or low-cost emergency contraception,” says Megan Freeland, PharmD, director of health communications at Planned Parenthood Federation of America.
“Anyone of any age or gender can buy emergency contraceptives over the counter without a prescription,” Freeland says. Plan B and other over-the-counter emergency contraceptives that have levonorgestrel as the main ingredient are most effective when taken within 72 hours after unprotected sexual activity.
Ella, a prescription morning-after pill, may be a better choice for people who don’t take an emergency contraceptive until four or five days after sex or who weigh between 165 and 195 pounds. Ella may be more effective than levonorgestrel-based pills in these cases, and it reduces the chance of becoming pregnant by 85%, according to Planned Parenthood Direct. It’s best to discuss your choice of any contraceptive with your health care provider.
Ensuring timely and safe access
You may rest easier if you keep a morning-after pill in your medicine cabinet, just in case. When you buy in advance of need, you can also shop for the best deal rather than having to pay whatever it costs at the last minute
“It’s so important to use emergency contraceptives as quickly as possible after unprotected sex,” says Freeland. “So get it before you need it. If you need Ella, keep in mind that getting a prescription can take time.”
Although emergency contraception is available nationwide, a handful of states do allow pharmacies or individual pharmacists to refuse to sell these medications. So check local availability now. If you have trouble obtaining the medication, order it from a reputable online source such as Planned Parenthood.
Medication abortion: Ending a pregnancy without surgery
Abortion pills (actually two pills, taken separately) are not the same as emergency contraceptive pills; they are different pharmaceuticals intended for different situations, and they are affected by the recent Supreme Court ruling.
Whereas emergency contraceptive pills work only within three or five days of sexual activity, abortion pills are effective up to approximately 11 weeks into pregnancy. Like surgical abortion, medication abortion is considered low risk and is preferred by some people for practical or personal reasons. Medication abortion is prescription-only and requires an in-person or virtual visit with a health care provider.
There are many state-by-state differences in abortion access, including medication abortion. Some states have outright bans with few or no exceptions. Some states restrict abortion according to how long you’ve been pregnant; some ban public funding or impose waiting periods, which can be especially expensive if you must travel to obtain medication and care.
What medication abortions cost
Medication abortion is typically nearly as costly as a surgical abortion. In 2021, the median cost for U.S. patients who had to pay entirely out of pocket was $568 for medication abortion, $625 for first-trimester surgical abortion, and $775 for second-trimester surgical abortion, according to a study from Advancing New Standards in Reproductive Health.
Insurance coverage for abortion pills is uneven
Insurance provided by an employer or obtained through a health insurance exchange may or may not cover abortion services, including medication abortion. Ask your insurer what your policy covers; if you can’t obtain or use abortion medication in your home state, also ask about coverage for the state through which you would receive services.
Medicaid covers all or most “medically necessary abortions” in only about 16 states. Ask your state’s Medicaid office if abortion is covered and if so, what restrictions might apply.
Online guides can help you obtain information and medication
Traveling to another state for an abortion is likely to be complicated, time-consuming and expensive. Be aware that getting an interstate abortion — whether via medication or surgery — may be illegal for residents of your home state.
That said, many services are available to help people navigate the medical, financial, logistical and legal challenges of obtaining and safely using abortion pills. Here are some resources:
There’s at least one Planned Parenthood Health Center in every state and the District of Columbia. Many clinics that have been barred by their states from providing medication abortions or surgical abortions are still offering valuable information and advice as well as contraception care.
National Abortion Federation Hotline Fund provides abortion referrals and financial assistance. Some abortion information providers describe strategies that might be illegal in your state. The Repro Legal Helpline offers legal advice on self-managed medication abortions.
The National Network of Abortion Funds provides information on local and national organizations offering financial and logistical assistance for abortion services, travel and associated costs.
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John Rossheim writes for NerdWallet. Email: USexpansion@nerdwallet.com.