(NerdWallet) – Would you be able to quickly get an emergency contraceptive pill or an abortion pill if the need arose? Following the United States Supreme Court’s decision to overturn Roe v. Wade, millions of health care consumers have pondered this question.
Much depends on your access to reproductive care, from your health to your outlook in life. “People need tools to help them achieve reproductive independence,” says Ushma Upadhyay, associate professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of California, San Francisco. “When people have access to abortion, they are more likely to set and achieve life goals.”
Obtaining and using medical abortion, in particular, can be as complex as the laws of all 50 states. Fortunately for those seeking to avoid or end an unplanned pregnancy, reproductive rights advocates offer — and frequently update — valuable services and sources of information. 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 80-90% of the time when taken a few days after unprotected sexual activity.
This oral medication usually costs between $10 and $50, plus the cost of a visit to a health care provider if you choose a prescription pill. “If you have private insurance or Medicaid, chances are you can get free or low-cost emergency contraception,” says Megan Freeland, PharmD, director of health communications at the Planned Parenthood Federation of America.
Medicine available without a prescription
“Anyone, regardless of age or gender, can buy over-the-counter emergency contraceptives without a prescription,” Freeland says. Plan B and other over-the-counter emergency contraceptives that contain levonorgestrel as the main ingredient are most effective when taken within 72 hours of unprotected sexual activity.
Ella, a prescription morning-after pill, may be a better choice for people who don’t take emergency contraception until four or five days after sex or who weigh between 165 and 195 pounds. Ella may be more effective than levonorgestrel pills in these cases, and it reduces the risk of getting pregnant by 85%, according to Planned Parenthood Direct. It is best to discuss your contraceptive choice with your health care provider.
Guarantee fast and safe access
You can rest easier if you keep a morning after pill in your medicine cabinet, just in case. When you buy in advance, you can also look for the best deal rather than having to pay what it costs at the last minute.
“It’s so important to use emergency contraceptives as soon as possible after unprotected sex,” Freeland says. “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 few states allow pharmacies or individual pharmacists to refuse to sell these drugs. So check local availability now. If you have difficulty obtaining the drug, order it from a reputable online source such as Planned Parenthood.
Medical abortion: ending a pregnancy without surgery
Abortion pills (actually two pills, taken separately) are not the same as emergency contraceptive pills; they’re different pharmaceuticals for different situations, and they’re affected by the recent Supreme Court decision.
While emergency contraceptive pills only work within three or five days of sexual activity, abortion pills are effective until around 11 weeks of pregnancy. Like surgical abortion, medical abortion is considered low risk and is preferred by some people for practical or personal reasons. Medical abortion is prescription only and requires an in-person or virtual visit with a healthcare provider.
There are many state-to-state differences in access to abortion, including medical abortion. Some states have outright bans with few or no exceptions. Some states restrict abortion based on the length of your pregnancy; some prohibit public funding or impose waiting times, which can be particularly costly if you have to travel for medication and care.
How much do medical abortions cost
Medical abortion is usually almost as expensive as a surgical abortion. In 2021, the median cost for U.S. patients who had to pay entirely out of pocket was $568 for medical 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 patchy
Insurance provided by an employer or obtained through a health insurance exchange may or may not cover abortion services, including medical abortion. Ask your insurer what your policy covers; If you cannot obtain or use abortion drugs in your home state, also inquire about coverage in 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 get 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 medical or surgical — may be illegal for residents of your home state.
That said, many services are available to help people overcome the medical, financial, logistical, and legal challenges of obtaining and safely using abortion pills. Here are some resources:
- There is at least one family planning health center in every state and in the District of Columbia. Many clinics that have been blocked by their states from providing medical or surgical abortions still offer valuable information and counseling as well as contraceptive care.
- Abortion Finder and Ineedana can help you find an abortion provider closest to you, although some people may have to travel hundreds of miles.
- The National Abortion Federation Hotline Fund provides abortion referrals and financial assistance.
- Some abortion information providers describe strategies that may be illegal in your state. The Repro Legal Helpline offers legal advice on self-managed medical 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.