Chelsey Tucker graduated with a Bachelor of History degree from Metropolitan State University in 2019. She now writes about insurance with her specialty being life insurance and has been quoted on Help Smart Phone and MEL Magazine.

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Dan Walker graduated with a BS in Administrative Management in 2005 and has been working in his family’s insurance agency, FCI Agency, for 15 years. He is licensed as an agent to write property and casualty insurance, including home, auto, umbrella, and dwelling fire insurance. He’s also been featured on sites like

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Reviewed by Daniel Walker
Licensed Auto Insurance Agent

UPDATED: Mar 19, 2020

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The lowdown...

    • The Affordable Care Act requires insurance plans to cover emergency contraceptives, including Plan B
    • Additionally, at least one type of birth control from each of the 18 contraceptive categories must be covered
    • These birth control methods must be covered without any additional co-payment or co-insurance
    • If you work for a religious employer, there may be some exemptions to this coverage mandate
    • The Plan B pill is also available over the counter with no prescription necessary to purchase it; however, you will have to pay the full price

Plan B One-Step is one type of emergency contraception. However, the terms Plan B pill and morning after pill are often used to describe all kinds of emergency contraception, whether it is Plan B One-Step or a generic form of the pill, such as Take Action or My Way.

Emergency contraceptives are meant to protect pregnancy after engaging in unprotected sex. The sooner you take it after unprotected sex, the more likely it is to be effective.

Plan B One-Step is just one pill with 1.5 milligrams of levonorgestrel, a type of progestin, in it. Keep in mind that the Plan B pill will not work if you are already pregnant. It works either by preventing your body from ovulating or directly interfering with fertilization. It does not induce a miscarriage.

It should be taken no more than 72 hours after sexual intercourse but is most effective within 24 hours. It should not be taken as your regular form of birth control but can be helpful if something went wrong with your typical birth control plan or if you forgot.

Those who weigh more than 165 pounds, have a known allergy to the ingredients, or are having irregular vaginal bleeding should not take the Plan B pill.

There are some side effects of the pill, but not all women experience them. Some of these side effects include:

  • Nausea
  • Fatigue
  • Headaches
  • Dizziness

Vomiting is another side effect, and if you believe you have regurgitated the pill, you should speak to your medical provider about your next steps and find out whether they recommend taking a second dose to prevent pregnancy. Abnormal bleeding or changes in your menstrual cycle may also occur.

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Is Plan B covered by my health insurance?


The Affordable Care Act mandates that all health insurance plans, unless they are exempt under grandfathered status or for religious reasons, cover birth control, including the Plan B pill.

Birth control and the Plan B pill should be included at no additional cost to you, as long as it is prescribed by a doctor.

Some plans will only cover the generic version of the morning after pill or other birth control methods. Check with your insurance provider for the specific benefits provided by your plan.

In this case, your health insurance plan may only cover the generic versions of the Plan B pill, such as Take Action, Next Choice One Dose, or My Way, as opposed to Plan B One-Step. However, premium plans may cover name-brand birth control medications.

It is important to note that the Affordable Care Act does not require health insurance plans to cover abortions or drugs that may induce abortions. Additionally, services or procedures that limit a man’s reproductive ability, such as vasectomies, are also not required coverage.

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What are the 18 contraceptive categories?


The Affordable Care Act regulations state that one type of birth control option from each of the 18 contraceptive categories must be covered.

Sterilization surgery and a sterilization implant are covered, as well as an implantable rod for birth control purposes. Intrauterine devices, whether they are copper or hormonal made with progestin, are included.

A birth control injection and the patch are both covered, in addition to:

  • Diaphragms
  • Vaginal contraceptive rings
  • Cervical caps
  • Sponges
  • Spermicide
  • Female condoms

Different types of oral contraceptives are also included like estrogen and progestin, as well as pills that only contain progestin and continuous use pills that affect your menstruation cycles.

Two out of these 18 contraceptive categories are allocated to emergency contraceptives. The first category refers to the morning after pill, while the second category is specifically for a different type of emergency contraceptive, known as Ella.

What is Ella?

Ella, also known as ulipristal, is another type of emergency contraceptive that is similar to the Plan B pill.

Ella works by preventing ovulation, which occurs when an egg is released during your menstrual cycle. Additionally, it can thicken your vaginal fluid which makes it harder for sperm to reach the egg and has an effect on your uterine lining in another effort to prevent pregnancy.

Just like Plan B, Ella should not be used as your usual form of birth control, and if you already know that you are pregnant, you should not be taking it, as it can cause harm to the unborn fetus.

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If you regularly use a hormonal birth control, you should wait five days after taking Ella before starting to take your birth control again because the hormones can interact. All possible effects are:

  • Headache
  • Nausea
  • Dizziness
  • Stomach pain
  • Irregular bleeding
  • Changes in your menstrual cycle

There are some differences between Plan B One-Step and Ella.

Many forms of the Plan B pill are available over the counter, while you can only get Ella with a prescription from your medical provider.

Ella may be more effective than other Plan B pills, that only contain progestin, particularly five days after having unprotected sex. Remember that Plan B is most effective within 72 hours, while Ella has shown to be effective up 120 hours after sex.

Ella may also be better for women who are overweight, as Plan B is not recommended for women who weigh more than 165 pounds. Ella may also be more successful when you are closer to ovulation.

Are there exemptions to this mandate?


If your health insurance plan has grandfathered status, it may not be subject to the requirements under the Affordable Care Act. For a group health insurance plan to qualify for grandfathered status, it must have been created before March 23, 2010.

If you work for a religious employer, your birth control coverage may be affected.

If you specifically work for a church or another type of house of worship, they do not have to provide you with any birth control coverage. You will have to pay for it entirely on your own.

However, if you work for an organization that has religious affiliations, such as a hospital, institute of higher learning, religious non-profit, or some other type of organization that objects to contraceptives on religious grounds, they are not required to offer you contraceptive coverage directly. You will instead be covered through a separate administrator.

Your employer will not be required to arrange or pay for your contraceptive coverage, but it will be offered to you without additional payment through a third party. If any of these circumstances apply to you, you should contact your employer or insurance company to get more information on exactly what is and is not covered under your health plan.

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How can I get the Plan B pill without health insurance?

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If you do not have health insurance or if your health plan is exempt from the contraceptive coverage mandate, you still have options. Many public health clinics, such as Planned Parenthood, offer free women’s health services, including birth control options, for low-income women.

Your pharmacy may be able to help, as well. Plan B One-Step is available over the counter, as are the generic versions of this progestin-only pill.

You can purchase them in cash, and you do not need a prescription, insurance, or even identification to prove your age. It is available to everyone without restriction.

Plan B One Steps costs on average $50, while the generic versions may be available at a slightly lower price.

If you do have insurance, you can still purchase Plan B over the counter, without a prescription. However, your insurance does not necessarily have to cover it without the prescription, so you should discuss this with the pharmacist or your medical provider.

Additionally, some websites allow you to purchase the Plan B pill online, so you can have it on hand in advance, in case something goes wrong with your typical birth control method. Ella, however, is only available for purchase with a prescription.

The Affordable Care Act requires that all new health insurance plans cover both types of emergency contraceptive pills, in addition to 16 other types of birth control. Plan B and Ella are only for emergency use and should not take the place of your typical birth control method.

If you work for a religious employer or have a health plan with grandfathered status, they may be exempt from this mandate. However, you still have options, especially since Plan B is available for purchase at pharmacies over the counter.

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